103 So. 3d 1095
La. Ct. App.2012Background
- Blue Cross challenged a district-court reversal of a DOA/OGB decision awarding the HMO contract to Blue Cross after withdrawing the EPO contract.
- OGB issued NICs for two administrative-services-only health plan contracts (HMO and EPO) effective July 1, 2010.
- Proposals were Humana, UHC, and Blue Cross for HMO; Blue Cross, UHC, and FARA for EPO.
- Blue Cross received the highest scores in both NIC evaluations; OGB merged the EPO into the HMO plan to reduce costs.
- Humana and UHC protested the award, asserting Blue Cross’s HMO proposal included a nationwide network violating HMO NIC specifications.
- DOA affirmed OGB’s decisions denying protests; district court reversed, finding unlawful or improper procedure; this court reversed that judgment.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the district court used proper review standard | Humana/UHC say 49:964(G) applies to adjudications | Blue Cross/DOA argue analogical use of standards; no substantial difference | No abuse; analogy to 49:964(G) applied; standard satisfied |
| Whether OGB had discretion to withdraw the EPO NIC and award one contract | Protesters argued withdrawal violated process | OGB acted in best interests and avoided duplicative costs | OGB had discretion to withdraw EPO NIC and award only one contract |
| Whether HMO NIC required a statewide network and prohibited nationwide reprice | HMO NIC required statewide network; nationwide reprice violates NIC | NIC not prohibiting nationwide use for repricing; broad network allowed | HMO NIC did not expressly prohibit nationwide reprice; allowed |
| Whether procurement was competitive bidding or competitive negotiation | Severely limits OGB’s discretion; argues bidding standards apply | Process was competitive negotiation; appropriate under statute | Process was competitive negotiation; OGB discretion insulated from arbitrariness |
| Whether district court erred in overturning DOA/OGB findings based on evidence | Procedural issues; potential misapplication of standards | Record supports agency findings and scores; no arbitrary action | District court erred; findings upheld |
Key Cases Cited
- Save Ourselves, Inc. v. Louisiana Environmental Control Comm’n, 452 So.2d 1152 (La. 1984) (APA review analogy; deferential standard applied)
- Metro Riverboat Associates, Inc. v. Louisiana Gaming Control Bd., 797 So.2d 656 (La. 2001) (APA adjudication definitions; not always required hearing)
- Summers v. Sutton, 428 So.2d 1121 (La.App. 1st Cir.1983) (great weight to agency findings; deference in review)
- Calcasieu League for Environmental Action Now v. Thompson, 661 So.2d 143 (La.App. 1st Cir.7/14/1995) (arbitrary or capricious standard; fairness of agency action)
- Fleetcor Technologies Operating Co., LLC v. State ex rel. Div. of Admin., Office of State Purchasing, 30 So.3d 102 (La.App. 1st Cir.2009) (discretion to select most advantageous offer; statutory framework)