Medicaid clients have reason for concern

Besides the uncertainty that comes with the change, it appears there are some disturbing issues involved as the $1.5 billion contract is transferred from a local nonprofit health plan.

Though the state Department of Human Services insists the switch in services for the 37,000 low-income elderly, disabled and blind residents will be seamless, a coalition of doctors and patients are worried because the companies do not have significant operations in Hawaii.

In fact, the state has had to seek federal government approval to delay the start of the new contract for three months so that the companies have time to set up a network of doctors and health care providers.

Both companies -- WellCare Health Plans Inc., based in Florida, and UnitedHealth Group Inc., based in Minnesota -- have had trouble recently. WellCare is being investigated by federal and Florida authorities about possible government overpayments. In April, UnitedHealth was among a group of insurers being scrutinized by the New York attorney general in another fraud investigation.

While these problems might not have any direct effect on the companies' abilities to fulfill the contract, the state should be concerned about them if for nothing other than assuring recipients and health care providers.

The coalition has filed a lawsuit to invalidate the contract that will change from a fee-for-service program to a managed care system.