DOA reviewing TakeCare’s protest

TakeCare health insurance (PNC file photo)

Guam – The Department of Administration is currently reviewing the protest filed by TakeCare Insurance Company regarding the Request for Proposal (RFP) for the Government of Guam Group Health Insurance Program.

TakeCare filed a formal protest to DOA onn Friday, May 3.

TakeCare, in a release, said it intended to submit a response to the RFP and to comply with Public Law 35-2 via a previously contracted lease arrangement of NetCare’s network, which includes Guam Regional Medical City.

The protest  was filed after TakeCare learned that GRMC took the position on May 1, 2019 in correspondence with NetCare,
that it would “not allow any other local health plan to access NetCare’s in-network rates with GRMC” and that all
“Guam-based health plans need to directly contract with GRMC for in-network rates.”

DOA director Edward Birn shared his thoughts about the protest Tuesday during an interview with NewsTalk K57’s Morning’s with Patti.

“TakeCare has shown themselves to be – shall we say feisty in the past couple of years, so yes something like this could be anticipated,” he said.

“I can’t say too much about the details because it’s not public until we we agree or disagree with the protest…We have an attorney from the Office of the Attorney General assigned to us for this particular task and they’re looking at it now,” he added.

TakeCare said they have attempted many times to negotiate in good faith with GRMC for a direct provider services agreement.
Instead, according to the insurance company, GRMC provided TakeCare rates that are exorbitantly higher – nearly 70 percent – in comparison to that of other local health insurers.

According to TakeCare, it has repeatedly requested that GRMC and TakeCare move forward with an agreement at this time solely for GovGuam members, as required by PL 35-2. GRMC has repeatedly denied these requests, according to TakeCare.

TakeCare is requesting DOA to cancel the RFP and revise it to comply with the law and to enforce a stay in the procurement process until the resolution of the protest.

So while DOA’s legal team sifts through the long list of accusations made by TakeCare against GRMC, the RFP and Public Law 35-2, Birn reminds the community of the underlying purpose of the administration’s efforts.

“My concern is always for the GovGuam employees. This whole effort is to produce the best healthcare coverage that we can for them and certainly, they need that the re-enrollment doesn’t take place till the beginning of the finance year, till the beginning of October. We want as much time as possible for people to understand the policies that are being offered because healthcare is inherently complex,” Birn said.