Local health insurer protests requirement to deal with Guam Regional Medical City
TakeCare Insurance Company, Inc. has filed a protest at the Guam Department of Administration against the FY19 Request for Proposal for the Government of Guam Group Health Insurance Program, which is used to select health insurance for Government of Guam employees, retirees and foster children.
According to TakeCare, the protest became necessary because DOA and its team included a requirement in the RFP that in order to be a qualified participant in the procurement, the interested health insurance companies have to include Guam Regional Medical City in their provider networks.
Guam law only requires that prospective offerors include all government health care services, such as GMH. Requiring all Offerors' proposals to include GRMC in their networks violates several Guam laws, including the recently passed Public Law 34-83, according to the news release, which maintains this is not in the public interest.
There is plenty of bad blood between TakeCare and GRMC. The hospital last year started billing TakeCare clients directly for unpaid emergency services, contending the company has declined a reasonable settlement of the claims. A GRMC spokesman said,
"We have offered discounted rate packages similar to those accepted by Guam’s three other principal health insurance providers. However, TakeCare has walked away from the negotiating table regarding historical claims settlement, and has not responded to GRMC’s latest network agreement proposal.”
According to the TakeCare release, "To give a private entity like GRMC so much power effectively removes the government's control over the RFP, and puts GRMC in control of which insurers could and could not offer health care services to government employees."
TakeCare's protest requests that the RFP be cancelled or revised to remove the requirement that GRMC be included in the offerors' provider networks.