Blue Cross & Blue Shield of Rhode Island v. Najarian

865 A.2d 1074, 2005 R.I. LEXIS 22, 2005 WL 240935
CourtSupreme Court of Rhode Island
DecidedFebruary 3, 2005
Docket2004-361-Appeal
StatusPublished
Cited by10 cases

This text of 865 A.2d 1074 (Blue Cross & Blue Shield of Rhode Island v. Najarian) is published on Counsel Stack Legal Research, covering Supreme Court of Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blue Cross & Blue Shield of Rhode Island v. Najarian, 865 A.2d 1074, 2005 R.I. LEXIS 22, 2005 WL 240935 (R.I. 2005).

Opinion

*1077 OPINION

WILLIAMS, Chief Justice.

The controversy before us involves two well-known insurance companies vying to provide the health care plan offered by the State of Rhode Island (State) to about 52,000 state employees, retirees and eligible dependants. Both the plaintiff, Blue Cross and Blue Shield of Rhode Island (Blue Cross), and the defendant-interve-nor, UnitedHealtheare (United), submitted bids for the three-year contract expected to commence on January 1, 2005. Shortly after the State tentatively awarded the contract to United, Blue Cross protested the award pursuant to the State Purchases Act, G.L.1956 chapter 2 of title 37. After the State rejected its bid protest, Blue Cross filed a complaint in the Superior Court seeking injunctive relief. Initially, Blue Cross’s request for a temporary restraining order was denied but, after a hearing on preliminary injunction, the lower court granted Blue Cross’s prayed for relief and the State was enjoined from implementing the contract with United and was ordered to re-solicit bids for the health care contract.

The State and United filed timely appeals to this Court. Upon careful review of the record and after giving the requisite deference to both the awarding authority’s decision and the Superior Court justice’s findings, we reverse the judgment of the Superior Court and reinstate the contract as awarded to United.

I

Facts and Travel

With the state’s then-current health care insurance contract with Blue Cross set to expire on December 31, 2004, Beverly Na-jarían (Najarían), the director of the Department of Administration (department), organized a task force to solicit and analyze bids before recommending an insurance company to her in her capacity as the State’s chief purchasing officer. Stephen Johnston (Johnston), the department’s deputy director, was named project manager. His first order of business was to hire Hewitt Associates (Hewitt), a consulting firm well-versed in health care policy, to assist in the overall bidding process. A consulting team from Hewitt, led by Robert Kennedy (Kennedy), drafted a proposed Request for Proposals (RFP) that the State accepted after some revision.

The RFP was issued on July 9, 2004, and covered three classes of subscribers: the State’s active employees (population I), early retirees (under the age of sixty-five) (population II), and retirees sixty-five years and older (population III). The RFP was almost ninety pages long and required all interested health care vendors to submit detailed proposals. The specific RFP requirements relevant to this lawsuit will be addressed below as needed.

Blue Cross and United were the only companies that submitted proposals by the August 12, 2004 deadline. William Anderson (Anderson), the department’s purchasing administrator, opened the sealed bids before the public, as required by § 37-2-18(d) of the State Purchases Act (act). Anderson became involved in the bid process shortly before the bids were submitted, after the purchasing administrator who had issued the RFP went on administrative leave. According to the deposition testimony submitted to the trial justice, Anderson was the only person directly involved in the bid selection process up to that point who had read the state procurement regulations detailing the act. 1

*1078 After the bids were opened, they were sent to Johnston, who was heading the Technical Review Subcommittee (subcommittee). The bids then were sent to Hewitt, which analyzed and scored the various components of the proposals. Hewitt had several questions while reviewing the bids, and, on August 20, 2004, follow-up questions were issued to both bidders. After Blue Cross and United submitted their responses, the State conducted recorded telephone conversations with each bidder to further clarify their proposals and answer any of the insurance providers’ questions. On September 20, 2004, Najarían determined that the competitive sealed bids were in excess of the funds available for the contract, and that there were “no additional funds available from any source so as to permit an award to the lowest responsive bidder * * Accordingly, the State e-mailed both bidders, asking that they each submit a “best and final” offer. Blue Cross and United both complied.

Shortly thereafter, Hewitt submitted to the subcommittee its analysis, in which United received 81.1 points and Blue Cross received 74.9 points overall. The subcommittee studied Hewitt’s report and determined that, of the two, United’s proposal was in the best interest of the State. That recommendation was then put before the Architectural, Engineering and Consultant Services Committee (A & E Committee), whose three members were vested with the responsibility of overseeing the bid process of all professional service contracts exceeding $20,000, § 37-2-59, to ensure that it is conducted efficiently and fairly. Two members, Anderson and Johnston, both voted to accept the recommendation of the subcommittee that the contract be awarded to United. The third member, Dr. George de Tarnowsky, a member of the general public appointed to serve on the A & E Committee, voted against the decision. 2 Najarían then reviewed the A & E Committee’s recommendation and, to the dismay of Blue Cross, tentatively awarded the contract to United.

At that point, James Purcell (Purcell), the acting president and CEO of Blue Cross, wrote a letter of complaint to Governor Donald Carcieri. The letter was forwarded to Najarían, who forwarded it on to her legal counsel. The letter engendered some discussion between the State and United. 3 After these discussions, United changed its bid (1) to exclude a fee of $0.99 per employee per month (PEPM) for a twenty-four-hour nurse line, and (2) to provide crossover services for population Ill’s Medigap indemnity program free *1079 of charge. 4 Blue Cross filed a formal bid protest with Najarían, who rejected the protest upon the advice of legal counsel.

Blue Cross also filed a complaint in the Superior Court seeking equitable relief enjoining the State from executing the contract to United and forcing the State to resolicit bids. The trial justice allowed the parties to conduct limited discovery in which the parties deposed seven witnesses. The trial justice then considered the deposed testimony in lieu of live testimony, heard oral arguments and considered numerous exhibits presented by the parties. After her deliberations, the trial justice granted the relief Blue Cross had requested.

In explaining her decision, the trial justice found that the State had committed six “wrongful acts”:

“1. In violation of the applicable statutory scheme and departmental regulations, the [State] modified the [RFP] after bids were submitted, without notice to [Blue Cross] with respect to of-ferors’ fees for the first year of the contract. [The State] then wrongfully modified [Blue , Cross’s] bid and evaluated its proposal based upon a higher fee than the one it submitted as its offer.

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Bluebook (online)
865 A.2d 1074, 2005 R.I. LEXIS 22, 2005 WL 240935, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blue-cross-blue-shield-of-rhode-island-v-najarian-ri-2005.