jonetta rose barras: Plus ça change, plus c’est la même chose
That French phrase came to mind in recent weeks as I discovered that DC Deputy Mayor for Health and Human Services Wayne Turnage and other officials in Mayor Muriel Bowser’s administration seemed to be up to their old shenanigans around a new Medicaid managed care procurement. The initial request for proposals (RFP) released in November required that each bidder submit a signed agreement with every hospital in the city, knowing that MedStar Health — which operates three hospitals in the District — previously refused to make such arrangements with at least one company.
Then, the DC Office of Contracting and Procurement (OCP) refused to accept new certification dates for local and minority companies that had been provided by the DC Department of Small and Local Business Development; that decision resulted in three of the four initial bidders being “disqualified,” according to government sources.
Trying to recover from that self-generated problem, the OCP announced a “supplemental solicitation” on Feb. 1. It also added language indicating that bidder scores would not ultimately determine the winner. “Rather, the total scores will guide the District in making an intelligent award decision based upon the evaluation criteria.”
Am I the only person smelling a foul odor?
The more things change, the more they stay the same, indeed.
Before all of that, the DC Board of Ethics and Government Accountability opened an investigation in response to a complaint that accused Turnage and DC Council staffer Eric Goulet of violating the DC government employee Code of Conduct.
Further, the Contract Appeals Board issued an opinion in response to Amerigroup DC’s formal complaints about the bungled 2020 managed care procurement that resulted in AmeriHealth Caritas DC Inc., CareFirst BlueCross BlueShield Community Health Plan and MedStar Family Choice being declared the winning bidders. In essence, the CAB asserted that the DC Council had stripped it of its jurisdiction and authority in this case.
“On November 16, 2021, the Board denied and dismissed the September 10, 2021, protest in CAB No. P-1128, holding that: the Council of the District of Columbia, via the Contracts with Managed Care Organizations for the Provision of Health Care Services to District Residents Approval and Authorization Emergency Act of 2021 (‘MCO Contracts Emergency Act’), specifically removed the Board’s jurisdiction to hear protests regarding the exercise of AmeriHealth’s and CareFirst’s option periods and Contract No. CW94721 with MedStar,” wrote Administrative Law Judge Nicholas Majett, with Chief Administrative Law Judge Marc Loud Sr. concurring.
Interestingly, Majett made a point of asserting that the mayor did not circumvent the CAB’s initial ruling that required the reevaluation. He made no mention, however, of the executive’s subsequent manipulation of that reassessment.
In an email dated Dec. 31 to the mayor’s communications director, LaToya Foster (a copy of which was sent to me and others), Turnage called the CAB’s opinion a “significant win for the Mayor in that the CAB specifically noted that the Mayor (and by extension OCP and the Department of Health Care Finance) did not violate the CAB’s December 1, 2020, ruling.”
Turnage is an expert propagandist.
Don’t let your eyes glaze over. The managed care contract is $1.5 billion of public money annually. It affects the health care of more than 250,000 adults and children. It is not some minor government procurement.
Let’s go to the clips: Readers may recall that in 2020 — during the opening chapter of the pandemic — Bowser and Turnage decided to shift the health care of tens of thousands of Medicaid recipients and members of the DC Health Care Alliance. That procurement became a messy affair, with Amerigroup DC filing multiple protests over the next year.
The CAB ruled the administration violated local “procurement laws and regulations as well as the terms of the solicitation.” It also determined that the evaluation of the offerors’ proposals was “unreasonable” and that the contracting officer “failed to independently evaluate the proposals.” The mayor and her minions were ordered to reevaluate the bids; the company with the lowest score would be excluded. A CAB ruling on another Medicaid contracting matter made it clear that MedStar would likely be the loser.
Throughout most of 2021, Turnage went all-in to prevent MedStar Family Choice Inc. from being kicked out. Among other things, he sought the council’s help, including via legislation to provide a waiver to the city’s procurement law. The deputy mayor seemed engaged in deliberate contract steering in plain public view.
The council became a conspirator when, following Chairman Phil Mendelson’s lead, it disregarded its own previous pledge not to neuter the CAB and approved the MCO emergency legislation in early October.
That bill ignored the fact that the reevaluation — which occurred on Sept. 28, prior to the end of the fiscal year, as per the CAB’s initial ruling — shifted the winning bidders. AmeriHealth Caritas of DC Inc. came in first. CareFirst BlueCross BlueShield Community Health Plan of DC was second. Amerigroup DC, which had been denied a contract, came in third. MedStar Family Choice Inc. was fourth; it was the loser, according to facts presented in Majett’s written opinion.
The information about the evaluation was never made public — although Bowser administration officials and lawyers at the DC Office of the Attorney General knew the results before the council took its vote. The OAG was the legal representative of the Department of Health Care Finance before the CAB; Turnage is simultaneously DHCF executive director and the deputy mayor.
Upon going through the motions of a fair review, the Bowser administration found a way to block Amerigroup’s ascent to contractor. “After performing a re-evaluation as ordered by the Board, the District removed MedStar’s proposal from further consideration, ranked Amerigroup third among the three remaining offerors, and determined that a contract award could not be made to Amerigroup because it did not have a hospital agreement with MedStar Health hospitals,” Majett wrote in his opinion.
That, dear readers, is an example of the fine art of contract steering.
Giving the mayor an assist, the council, through its emergency legislation, awarded MedStar Family Choice a new sole-source agreement.
The machinations and maneuvers around the 2020 procurement make clear, in my view, why the OCP has decided to include language in its latest offering that could moot evaluation scores. Government sources told me the OAG continues to advise both the OCP and the deputy mayor during the process of this new 2022 procurement.
“Any legal advice OAG provides to District agencies is protected by attorney-client privilege, and only the client can waive privilege. We don’t have [a] comment here, and I’d suggest reaching out to the mayor’s office or OCP with additional questions about managed care contracting,” the OAG spokesperson told me.
Cody A. Leihgeber-Carpenter, the OCP communications director, told me via email that language in the request for proposals issued by “OCP on behalf of our client agencies” is intended “to ensure the District obtains goods and services at the best value for District residents.”
Further, he said, “Amendments issued during the solicitation phase allow the District to clarify or elaborate on its requirements. Amendments are posted publicly on OCP’s website.”
Leihgeber-Carpenter didn’t explain why a second solicitation was released or why the traditional use of scores as the key evaluation tool to determine a procurement winner is being deemphasized for what appears a more “subjective” selection model.
Adding more subjectivity to the DC government’s procurement process seems like a dangerous precedent.
As for the BEGA investigation into allegations that Turnage and Goulet violated the employee Code of Conduct, the agency’s director, Ashley Cooks, did not reply to my request for comment.
“I will not legitimize this egregious breach of government protocol by opining on a BEGA investigation before they render a decision in response” to the complaint, Turnage told me via email. “You should inform your source that her breach of the [confidentiality] of this process cannot easily be reconciled with her position in District government.”
I’m confused as to whom Turnage is referring.
Goulet was equally disturbed by the investigation when we spoke by telephone last week. He was accused of having a conflict of interest because his wife works for Georgetown University; MedStar owns and manages Georgetown University Hospital. He refused to comment on the record that day.
Two days later, on Friday evening, he sent an email, indicating that he had “received confirmation today from BEGA that the investigation into the complaint filed against me is considered closed and that BEGA has dismissed the complaint. I am grateful to BEGA for their thoroughness, fairness, and professionalism in promptly investigating and dismissing this frivolous and vindictive personal attack against me and my family.”
I asked him to share his correspondence with BEGA. Goulet didn’t respond to that email request.
At-large DC Council member Robert White, chair of the Committee on Government Operations and Facilities, has oversight of OCP. Through a spokesperson he promised to “continue to monitor this procurement given its importance to the city and the incredible challenges the District has seen with the MCO procurement process over the last few months and years.”
“We expect to get more information at our upcoming oversight hearing of OCP on February 17th,” he added.
Stay tuned.
jonetta rose barras is an author and freelance journalist, covering national and local issues including politics, childhood trauma, public education, economic development and urban public policies. She can be reached at thebarrasreport@gmail.com.
I am tired of this administration. Bowser, Bonds, Mendelson all need to not be re elected.
Turnage needs to be fired.
All at DCHA need to be fired. I hope teh audit that HUD is finally doing will get more federal government oversight. DCHA is a mess. Mismanagement and fund embezzlement.
Why is the city Council working hand in glove with the mayor? I’m very disappointed in Phil Mendelssohn. I used to think he was a pretty honest person
Because the Medicaid program that impacts the lives of over 100k DC residents was in the process of melting down? Should they have sat by and watched all the poor residents in the city lose their health insurance? You all should get educated before being led astray by this biased drivel.
I am completely lost in all of this. Sorry.