Professional Documents
Culture Documents
STATE OF MINNESOTA
COUNTY OF RAMSEY
Case No.
Plaintiff,
SUMMONS
v.
Minnesota Department of Human Services; and
Lucinda E. Jesson, in her capacity as
Commissioner of the Minnesota Department of
Human Services,
Defendants.
ACKNOWLEDGMENT
The undersigned hereby acknowledges that costs, disbursements and reasonable attorney
and witness fees may be awarded pursuant to Minn. Stat. 549.211, subdivision 2, to the party
against whom the allegations in this pleading are asserted.
DISTRICT COURT
STATE OF MINNESOTA
COUNTY OF RAMSEY
UCare Minnesota, a Minnesota Non-Profit
Corporation,
Case No.
Plaintiff,
v.
COMPLAINT
Minnesota Department of Human Services; and
Lucinda E. Jesson, in her capacity as
Commissioner of the Minnesota Department of
Human Services,
Defendants.
Plaintiff UCare Minnesota ("UCare" or "Plaintiff'), for its Complaint against Minnesota
Department of Human Services; and Lucinda E. Jesson, in her capacity as Commissioner of the
Minnesota Department of Human Service ("DHS" or "Defendants"), states and alleges as
follows:
NATURE OF THE ACTION
1.
As a result of UCare's proven track record, UCare currently serves more Prepaid
Medical Assistance Program ("PMAP") and MinnesotaCare members in Minnesota than any
other health plan.
3.
DHS announced on July 28, 2015, that UCare would no longer serve Minnesota's
4.
DHS's decision will result in the largest disruption in public health insurance
DHS's decision arose from a procurement process that violated statutes and
services to more than 510,000 members in Minnesota and western Wisconsin. UCare is
headquartered in Minneapolis, Minnesota.
8.
DHS is a department of the State of Minnesota formed and existing under the
10.
11.
Venue is proper in Ramsey County for this action under Minn. Stat 542.01,
PMAP in 62 counties.
13.
At just over 370,000 members, UCare has the largest PMAP and MinnesotaCare
enrollment in Minnesota.
14.
UCare currently serves more people from diverse cultures and more people with
disabilities enrolled in Medical Assistance than any other health plan in Minnesota.
15.
promote health equity for all of its members, but especially members who are persons of color,
new immigrant populations and those with Limited English Proficiency.
16.
populations and has been recognized nationally and locally as a model for effective delivery of
care to state public program populations.
17.
UCare has been the innovative health plan in developing and providing creative
initiatives to meet the needs of unique communities across Minnesota. UCare was the first plan
to offer free transportation to medical and dental appointments. UCare was the first plan to offer
a mobile dental clinic, which UCare provides in partnership with the University of Minnesota
Dental School.
18.
longer serve Minnesota's PMAP and MinnesotaCare enrollees was the result of a competitive
procurement process that started with a Request for Proposal (RFP) dated January 26, 2015.
19.
The RFP explained that DHS was undertaking a statewide procurement in the 87
The RFP stated that, if a county is in a Metropolitan Statistical Area, for PMAP it
will require "at least two managed care organizations (MCOs) be selected to provide health care
services in that county," and the remaining rural counties "are not required to have more than a
single MCO."
21.
The RFP stated that for MinnesotaCare "a minimum of two MCOs will be
After reviewing the various proposals, at least 47, and reportedly as many as 55,
county boards passed resolutions recommending that DHS contract with UCare to provide
services in their respective counties.
24.
On July 28, 2015, DHS announced the winners of the competitive procurement
process, and that UCare would no longer serve PMAP and MinnesotaCare enrollees, effective
January 1, 2016.
25.
PrimeWest, Itasca Medical Care, South Country Health Alliance, and Hennepin Health.
26.
DHS sent a letter to UCare stating that it "selected another Responder(s) to enter
into contract negotiations to meet the State's needs for this statewide procurement."
27.
DHS did not act in a manner consistent with the recommendations of counties
31.
UCare's elimination from the marketplace undercuts the free choice encouraged
by the legislature and removes a demonstrated plan with a history of success serving diverse,
immigrant, and non-English language speaking populations.
CLAIMS
COUNT I: VIOLATION OF STATE PROCUREMENT LAW
32.
Plaintiff realleges paragraphs one (1) through thirty-one (31) as though fully set
forth herein.
33.
34.
35.
36.
DHS lacked proper standards to follow when deciding to draw the line that
39.
DHS failed to follow the statutory directive to allow county boards to "mutually
DHS's design of the RFP process effectively caused the county boards to
42.
UCare is entitled to recover its costs, expenses, and reasonable attorney fees
Plaintiff realleges paragraphs one (1) through forty-two (42) as though fully set
forth herein.
44.
45.
Before DHS released the cost data book, UCare objected to the potential adverse
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competitive impact on UCare resulting from how DHS intends to present cost data in the data
book for the RFP price bidding.
46.
Over UCare's objections, DHS released its cost data book with UCare cost
DHS not only revealed UCare's confidential information, but also potentially
negatively impacted UCare in a number of counties where UCare is the only health plan, or
where UCare has the majority of members, because UCare's actual county-specific health care
costs were provided to competitors.
49.
section 256B.69, subdivision 9c, which prohibits the release of nonpublic plan data.
COUNT III: UNLAWFUL DESTRUCTION OF DOCUMENTS
50.
Plaintiff realleges paragraphs one (1) through forty-nine (49) as though fully set
forth herein.
51.
process.
52.
Plaintiff realleges paragraphs one (1) through fifty-three (53) as though fully set
forth herein.
55.
An actual controversy exists between UCare and DHS concerning the competitive
procurement process and DHS's decision to exclude UCare from the marketplace.
56.
57.
Plaintiff realleges paragraphs one (1) through fifty-six (56) as though fully set
forth herein.
58.
UCare will suffer irreparable harm if DHS excludes UCare from the opportunity
DHS's unlawful conduct has and will continue to irreparably harm UCare.
60.
The public interest favors allowing UCare the opportunity to provide health care
services to eligible recipients of PMAP and MinnesotaCare in the counties that recommended
UCare.
61.
WHEREFORE, the Plaintiff prays for judgment in favor of the Plaintiff and against
Defendants, and temporary and permanent injunctive relief:
1.
Ordering DHS not to destroy any documents related to the competitive procurement
process;
2.
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Ordering DHS to address questions regarding the extent to which other applicants
have been allowed to modify bids or submissions with additional offers, negotiations, or otherwise;
5.
Ordering DHS to suspend all managed care enrollment activities for PMAP and
MinnesotaCare for 2016, including the distribution of any materials to beneficiaries identifying
health plan choices for open enrollment, until UCare is allowed to be offered as a choice for PMAP
and MinnesotaCare in counties that recommend UCare in 2016;
6.
Ordering DHS to provide UCare the opportunity to negotiate with and enter into a
contract with DHS, which will allow UCare to be offered as a choice for PMAP and MinnesotaCare
in 2016 in the counties that recommended UCare;
7.
Ordering that UCare is entitled to an award of its attorney fees, costs, and
For such other and further relief as the Court deems just and equitable.
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