UNITEDHEALTHCARE OF PENNSYLVANIA, INC., Petitioner v. DEPARTMENT OF HUMAN SERVICES, Respondent
No. 1978 C.D. 2016
Commonwealth Court of Pennsylvania.
Argued September 11, 2017 Decided October 4, 2017
172 A.3d 98
On March 1, 2016, the Department issued Request for Proposals No. 12-15 (the RFP) to obtain competitive sealed proposals from managed care organizations (MCOs) to implement CHC, a managed care program to provide integrated physical health and long-term services and supports for older Pennsylvanians and adults with physical disabilities. (Record Item (R. Item) 13, Final Determination ¶¶ 6-8; R. Item 9 Ex. 1, RFP at 1, 42, Reproduced Record (R.R.) at 157a, 198a.) The RFP divided the Commonwealth into five geographic zones--the Southwest, Southeast, Lehigh/Capital, Northwest and Northeast zones--and invited MCOs to submit proposals for one or more of those five zones. (R. Item 13, Final Determination ¶ 7; R. Item 9 Ex. 1, RFP at 2-5, 7, 14, R.R. at 158a-161a, 163a, 170a.) The RFP stated that the Department anticipated awarding CHC agreements to no fewer than two and no more than five offerors for each zone. (R. Item 9 Ex. 1, RFP at 5, R.R. at 161a.)
The RFP required that the proposals contain a Technical Submittal, which was weighted as 80% of the total points in scoring the proposals, and a Small Diverse Business (SDB) Submittal, weighted at 20%, and offerors could receive up to 3% in bonus points for committing to Domestic Workforce Utilization. (R. Item 9 Ex. 1, RFP at 14, 38-40, R.R. at 170a, 194a-196a.) To be considered a responsible offeror eligible for selection, an offeror was required to earn at least 70% of the available Technical Submittal points. (Id. at 40, R.R. at 196a.)
The RFP provided that the evaluation of the Technical Submittal would be based on four criteria: soundness of approach, fi-
Jeffrey A. Belkin, Atlanta, GA, for petitioner.
Sallie A. Rodgers, Deputy Chief Counsel, Harrisburg, for respondent.
Dorothy A. Hickok, Philadelphia, for intervenor UPMC For You, Inc.
Amy S. Kline, Philadelphia, for intervenor Vista Health Plan, Inc.
Joshua D. Wolson, Philadelphia, for intervenor Pennsylvania Health & Wellness, Inc.
BEFORE: HONORABLE RENÉE COHN JUBELIRER, Judge, HONORABLE JOSEPH M. COSGROVE, Judge, HONORABLE JAMES GARDNER COLINS, Senior Judge
OPINION BY SENIOR JUDGE COLINS
UnitedHealthcare of Pennsylvania, Inc. (UnitedHealthcare), in this petition for review, appeals a final determination of the Department of Human Services (Department) under Section 1711.1 of the
The deadline for submission of proposals was May 2, 2016. (R. Item 9 Ex. 5, Selection Memorandum, R.R. at 230a.) The Department received proposals for one or more zones from a total of fourteen MCOs, consisting of eight proposals for the Southwest zone, fourteen proposals for the Southeast zone, twelve proposals for the Lehigh/Capital zone, nine proposals for the Northwest zone, and nine proposals for the Northeast zone. (R. Item 13, Final Determination ¶ 18; R. Item 9 Ex. 5, Selection Memorandum, R.R. at 230a-231a.) UnitedHealthcare did not file any protest with respect to the terms of the RFP and timely submitted proposals for all five zones. (R. Item 13, Final Determination ¶ 19; R. Item 9 Ex. 5, Selection Memorandum, R.R. at 232a-235a.) Following evaluation and scoring of the proposals, the Department selected Pennsylvania Health & Wellness, Inc. (PHW), Vista Health Plan, Inc. (Vista),1 and UPMC For You, Inc. (UPMC) for contract negotiations for all five zones because their proposals achieved the three highest overall scores for each zone. (R. Item 13, Final Determination ¶ 20; R. Item 9 Ex. 5, Selection Memorandum, R.R. at 232a-237a.)
PHW, Vista, UPMC, and UnitedHealthcare all satisfied the 70% threshold on their Technical Submittals in all zones. (R. Item 9 Ex. 5, Selection Memorandum, R.R. at 232a-235a.)2 UnitedHealthcare‘s proposal was ranked fourth overall in all five zones. (Id.) UnitedHealthcare‘s technical score was fourth highest in all five zones, below the technical scores of the three selected offerors. (Id.) UnitedHealthcare‘s SDB score was fourth highest in three zones and sixth highest in two zones, below the SDB scores of selected offerors PHW and Vista in all zones and the SDB scores of nonselected offerors with lower overall scores. (Id.) PHW, Vista, UPMC, and Uni-
tedHealthcare all received the Domestic Workforce Utilization 3% bonus points in all zones. (Id.)
On August 30, 2016, the Department notified UnitedHealthcare that PHW, Vista, and UPMC had been selected for all five zones and that UnitedHealthcare was not selected for any zone. (R. Item 13, Final Determination ¶ 21; R. Item 1, Protest Ex. B, R.R. at 32a.) On September 15, 2016, the Department conducted a debriefing meeting with UnitedHealthcare at which it provided information to UnitedHealthcare concerning the strengths and weaknesses of its proposal and advised UnitedHealthcare that its proposal was ranked fourth in all zones. (R. Item 13, Final Determination ¶¶ 22, 24-26; R. Item 1, Protest at 3 & Ex. I, R.R. at 7a, 47a-52a.)
On September 22, 2016, more than seven days after it was notified that it was not selected, but within seven days of the debriefing, UnitedHealthcare filed a bid protest seeking an order selecting UnitedHealthcare for all five zones or, in the alternative, the setting aside of the selection of PHW, Vista, and UPMC and issuance of a new solicitation of proposals. (R. Item 1, Protest at 17, R.R. at 21a.) UnitedHealthcare asserted five substantive grounds for this protest: a claim that the Department‘s weighting of HEDIS rates in its evaluation of the proposals was unfair because UnitedHealthcare was required to submit its Pennsylvania HEDIS rates while PHW, which had no existing Pennsylvania HMO, was permitted to choose which state HEDIS rates to submit; a claim that delegation of the SDB scoring of the proposals to DGS and BDISBO was improper; and three claims concerning the qualifications of the three selected offerors. (Id. at 4-12, R.R. at 8a-
On September 30, 2016, UnitedHealthcare filed a Supplemental Protest. In this filing, UnitedHealthcare did not raise any new claims of error in the Department‘s evaluation of the proposals, but asserted that the Department had treated UnitedHealthcare unequally in the documents and information provided in the debriefing and response to protests and reiterated its request for an evidentiary hearing. (R. Item 3, Supplemental Protest, R.R. at 57a-60a.)
On November 28, 2016, the Director of the Department‘s Bureau of Administrative Services (Director) issued a final determination denying UnitedHealthcare‘s protest. The Director ruled that UnitedHealthcare did not have a right to the documents it requested under the Procurement Code and rejected its request for a hearing. (R. Item 13, Final Determination at 22-24.) The Director held that the standard applicable to his review of the protest was whether the Department‘s selection of offerors was “clearly erroneous, arbitrary, capricious or contrary to law.” (Id. at 7.) The Director ruled that the specific protest grounds asserted by UnitedHealthcare, including its HEDIS and SDB claims, were barred as untimely, and further concluded that even if timely, they were without merit. (Id. at 9-19.) UnitedHealthcare timely appealed this final determination to this
Court.4
Contrary to UnitedHealthcare‘s contentions, the denial of the documents that it requested and the failure to hold an evidentiary hearing on the protest did not violate its constitutional rights to procedural due process. A disappointed bidder or offeror seeking a government contract has no right to have a contract awarded to it and therefore has no legal interest protected by the due process clause of the Fourteenth Amendment to the United States Constitution or the Pennsylvania Constitution that confers any rights to an adequate protest process. Premier Comp Solutions, LLC v. Department of General Services, 949 A.2d 381, 384-85 (Pa. Cmwlth. 2008); Stanton-Negley Drug Co. v. Department of Public Welfare, 943 A.2d 377, 384-85 (Pa. Cmwlth. 2008); Durkee Lumber Co. v. Department of Conservation and Natural Resources, 903 A.2d 593, 598-99 (Pa. Cmwlth. 2006); Corizon Health, Inc. v. Department of General Services, (Pa. Cmwlth. No. 1740 C.D. 2012, filed Jan. 4, 2013), slip op. at 10-11, 2013 WL 3960974 at, *5-*6.6 A protestant‘s rights are limited to the procedures provided in the Procurement Code. Premier Comp Solutions, LLC, 949 A.2d at 384-85; Corizon Health, Inc., slip op. at 10-11, 2013 WL 3960974 at *5-*6.7
Nor was there any violation of UnitedHealthcare‘s rights under the Procurement Code. The Procurement Code does not provide protestants a right to production of documents or other discovery.
UnitedHealthcare argues that underlying documents concerning the procurement are necessarily part of the record under Sections 1711.1(e), (h), (i) of the Procurement Code and therefore must be provided to the protestant. This argument is directly contrary to the language of these statutory provisions.
The Procurement Code also does not give protestants a right to a hearing and grants the agency head or designee reviewing the protest discretion to decide whether a hearing should be held.
UnitedHealthcare‘s assertion that the Director applied an incorrect standard of review likewise fails. UnitedHealthcare argues that an agency head is required in ruling on a bid protest to determine whether the challenged procurement decision is the most advantageous to the agen-
UnitedHealthcare‘s HEDIS and SDB protests were challenges to the evaluation and selection of offerors for negotiation. The Procurement Code provides that the standard of review applicable to such protests is whether the determination was “clearly erroneous, arbitrary, capricious or contrary to law.”
In Gateway Health Plan, Inc., this Court analyzed and rejected the same argument asserted by UnitedHealthcare that the Director was required to exercise a broad standard of review. The Court held, based on
Finally, the Director correctly held that UnitedHealthcare‘s HEDIS and SDB protests were time-barred. The Procurement Code sets strict and mandatory time limits for the filing of protests.
If a bidder or offeror, a prospective bidder or offeror or a prospective contractor fails to file a protest or files an untimely protest, the bidder or offeror, the prospective bidder or offeror or the
prospective contractor shall be deemed to have waived its right to protest the solicitation or award of the contract in any forum. Untimely filed protests shall be disregarded by the purchasing agency.
A protest filed more than seven days after the disappointed offeror or bidder had notice of the grounds for the protest is thus barred as untimely, even if no contract has yet been awarded, even if the protest was filed within seven days of the agency‘s selection of bidders or offerors, and even if the protestant did not subjectively understand or appreciate the ground for protest. Bureau Veritas North America, Inc., 127 A.3d at 876-78; JPay, Inc., 89 A.3d at 764-65; Collinson, Inc. v. Department of Transportation, 959 A.2d 480, 482-84 (Pa. Cmwlth. 2008); Cummins v. Department of Transportation, 877 A.2d 550, 553-55 (Pa. Cmwlth. 2005); Common Sense Adoption Services v. Department of Public Welfare, 799 A.2d 225, 231 (Pa. Cmwlth. 2002). The fact that a debriefing later occurs does not delay the seven-day period for filing a protest, if the offeror or bidder had notice of the ground for protest before the debriefing or the debriefing provided no additional information on which the protest is based. Bureau Veritas North America, Inc., 127 A.3d at 877-78.
Where the protest challenges a term or provision of the invitation for bids or request for proposals or the issue that it raises was apparent from the invitation for bids or request for proposals, the offeror or bidder must file that protest no later than seven days after it has notice of that term or provision, despite the fact that no selection or rejection of any bids or proposals has occurred. CenturyLink Public Communications, Inc., 109 A.3d at 829; JPay, Inc., 89 A.3d at 764-65; Collinson, Inc., 959 A.2d at 482-84; Cummins, 877 A.2d at 553-55; Common Sense Adoption Services, 799 A.2d at 231. If an offeror first raises such a challenge in a protest filed more than seven days after it submits its proposal, that ground of protest is barred as untimely. CenturyLink Public Communications, Inc., 109 A.3d at 827-30; JPay, Inc., 89 A.3d at 764-67; Common Sense Adoption Services, 799 A.2d at 231-34. Where the protest is based on additional facts learned less than seven days before the protest is filed and not apparent from the procurement documents, however, it is timely even if filed more than seven days after the agency‘s selection decision, provided that it is filed before the contract award or within seven days of the contract award. Grant Street Group, Inc. v. Department of Community and Economic Development, 106 A.3d 810, 813-14 (Pa. Cmwlth. 2014); Omnicare, Inc. v. Department of Public Welfare, 68 A.3d 20, 25-26 (Pa. Cmwlth. 2013).
Here, UnitedHealthcare did not file a protest within seven days of the date that it knew or should have known of the facts giving rise to its HEDIS and SDB challenges. The HEDIS protest asserted that allowing non-Pennsylvania offerors to submit HEDIS rates from a state of their choosing gave PHW an unfair advantage over UnitedHealthcare because it was “free to submit HEDIS rates for the state
in which [its] performance rates were best” and that allowing out-of-state HEDIS rates prevented a valid comparison between offerors. (R. Item 1, Protest at 8-9, R.R. at 12a-13a.) UnitedHealthcare knew in March and April 2016 from the RFP and the addenda that Pennsylvania offerors were required to submit Pennsylvania rates and that non-Pennsylvania offerors could choose which state‘s HEDIS rates to submit. (R. Item 9 Ex. 1, RFP at 25-26, R.R. at 181a-182a; R. Item 9 Ex. 4, Addendum No. 3, R.R. at 224a, 226a; R. Item 9 Ex. 6, Addendum No. 5, R.R. at 239a, 241a-244a.) UnitedHealthcare also knew that a non-Pennsylvania offeror, PHW, had been selected over it on August 30, 2016, more than seven days before it filed any protest.
The SDB protest asserted that delegation of scoring the SDB component to BDISBO was improper because BDISBO lacks the expertise to evaluate whether a subcontractor is competent to perform work under the CHC agreement and that awarding a high SDB score for a greater than 20% SDB commitment was improper because SDBs are “prone to financial and other transition issues which could impact the level of service to ... recipients.” (R. Item 1, Protest at 11-12, R.R. at 15a-16a.) UnitedHealthcare knew from the RFP that the scoring of the SDB component was delegated to BDISBO and offerors with higher SDB commitments would receive higher scores on the SDB component. (R. Item 9 Ex. 1, RFP at 38-40, R.R. at 194a-196a.) UnitedHealthcare, however, did not file any protest until September 22, 2016.
With respect to the HEDIS protest, UnitedHealthcare argues that its claim is that the Department improperly weighted the HEDIS rates and that it first learned at the September 15, 2016 debriefing that the Department may not have adequately evaluated the state for which PHW submitted HEDIS rates. UnitedHealthcare did not, however, show that it learned any additional information at the debriefing that gave it a basis to assert such a protest ground. The only information provided in the debriefing concerning HEDIS was that UnitedHealthcare‘s HEDIS rates “showed limited improvement even with the implementation of key initiatives to improve them” and that this was listed as one of 15 weaknesses in UnitedHealthcare‘s proposal. (R. Item 1 Ex. I, Debriefing Script at 3-6, R.R. at 49a-52a.) UnitedHealthcare did not base its protest on any inaccuracy in the Department‘s characterization of its HEDIS rates and it knew its own HEDIS rates when it submitted them in its proposal.
With respect to the SDB protest, UnitedHealthcare argues that it learned in the debriefing that only the certification of the SDB subcontractors was evaluated by BDISBO and not their capability of performing the CHC agreement obligations. UnitedHealthcare, however, admitted in its Protest that it obtained no additional information concerning the SDB scoring at the debriefing. (R. Item 1, Protest at 3, R.R. at 7a (“Despite a prior request from UnitedHealthcare that personnel from DGS familiar with the SDB scoring be present at the debriefing to explain the scoring and respond to UnitedHealthcare‘s questions, no such personnel were present and the representatives of DHS present at the debriefing were unable to answer any specific questions regarding SDB scoring“).)
Because UnitedHealthcare had notice of the grounds for its HEDIS and SDB protests more than seven days before it filed its protest and learned no additional information supporting these claims at the debriefing, the Director correctly held that these grounds for protest were untimely.
For the foregoing reasons, we conclude that UnitedHealthcare has not shown any error in the Director‘s determination. Accordingly, we affirm the denial of UnitedHealthcare‘s bid protest.
ORDER
AND NOW, this 4th day of October, 2017, the final determination of the Director of the Bureau of Administrative Services of the Department of Human Services is AFFIRMED.
