TakeCare is reviewing its options after the Office of Public Accountability issued a decision Tuesday denying the health insurance company's protest over a government of Guam requirement that essentially requires coverage at Guam Regional Medical City.
The decision to dismiss TakeCare's protest, signed by hearing officer Anthony Camacho, states TakeCare missed the filing deadline to file a protest. The OPA decision also mentions GovGuam's stance that the matter should be dismissed because TakeCare is not an actual or prospective bidder. Without GRMC in its network, TakeCare would not qualify as a bidder for GovGuam's 2020 health insurance contract, GovGuam contends.
TakeCare has not been able to secure an agreement with GRMC. Guam law requires GovGuam's health insurance provider to cover care at a private hospital in addition to Guam Memorial Hospital. The law gave GRMC a business boost because it is the only private hospital on Guam.
TakeCare's appeal asserts that requiring health insurers to cover care at GRMC would "eliminate competition and deny equal protection."
After the dismissal of its administrative protest, TakeCare still has the option of challenging GovGuam by filing a lawsuit in the Superior Court of Guam. As of Tuesday afternoon, TakeCare was not certain if it would.
"We are reviewing the Office of the Public Auditor's decision with legal counsel and will consider other options available to us, including possibly judicial review," the company stated.
TakeCare asked for the request for proposal at issue to be canceled or amended to remove the minimum requirement for bidders to include GRMC in their provider networks.