Business Context and Reporting Period
This Form 8-K was filed by Molina Healthcare, Inc. on October 30, 2019, reporting an event that occurred on October 29, 2019. The filing concerns a notification from the Texas Health and Human Services Commission (HHSC) regarding the STAR+PLUS Medicaid Managed Care program in Texas.
Key Financial Metrics
The filing does not provide comprehensive financial statements, revenue, profit, cash flow, or debt metrics for the company as a whole. Specific data points related to the Texas STAR+PLUS program include:
- Current Membership: Approximately 86,000 enrollees across six service areas (Bexar, Dallas, El Paso, Harris, Hidalgo, and Jefferson).
- Historical Revenue: Premium revenue for the STAR+PLUS program was approximately $1.2 billion for the nine months ended September 30, 2019.
Material Changes and Contract Awards
HHSC notified Molina Healthcare of Texas, Inc. of its intent to award contracts for the STAR+PLUS program in the Hidalgo and North East service areas. Key details include:
- Contract Term: Initial term of 3 years.
- Effective Date: Anticipated operational start date of September 1, 2020.
- Program Scope: Integration of Acute Care services and Long-Term Services and Supports (LTSS) for individuals aged 65 or older, blind, or disabled.
Outlook, Risks, and Management Commentary
Management stated that the company does not expect this matter to affect its earnings during fiscal year 2019. However, the company is seeking to understand the basis for HHSC's selection of intended contract awards. The filing includes a Safe Harbor statement highlighting significant risks, including:
- Uncertainties regarding the STAR+PLUS Procurement process.
- The basis for the intended awards.
- Potential protest filings by other health plans.
Investor Verification Checklist
- Verify the final status of the HHSC contract awards for the Hidalgo and North East service areas, as the filing only reports an "intent" to award.
- Monitor for any protest filings by competing health plans that could delay or alter the contract terms.
- Confirm the operational readiness and transition plans for the September 1, 2020 effective date.
- Review subsequent filings for updates on the company's understanding of the selection basis.