In a quick turnaround, the Kentucky Supreme Court has upheld a lower court ruling that five insurance companies will retain the right to oversee most of the state’s $15 billion annual Medicaid business, appearing to end a long-running court fight.

Anthem Kentucky, which had challenged the contract award, will be excluded, according to a Supreme Court order issued Thursday.

The decision comes just one week after the Supreme Court heard arguments on the complex contract dispute and is the result of a tie vote among the six justices who heard the case.

Kentucky Supreme Court hears from insurers fighting over share of state’s Medicaid business

Because the justices were divided 3-3, no opinion was issued on the merits of the case. Instead a single page order stated that court rules dictate that in the event of a tie vote, the 2022 Kentucky Court of Appeals decision will stand.

The order stated that justices Angela McCormick Bisig, Robert B. Conley and Michelle Keller voted to affirm the appeals court ruling, while Debra Hembree Lambert, Christopher Shea Nickell and Chief Justice Laurance B. VanMeter voted to overturn the lower court. The seventh member, Justice Kelly Thompson, did not hear the case and did not vote.

Anthem, which had remained as a sixth provider known as a managed care organization, or MCO, while the case was pending, had argued bidding irregularities and other flaws meant the contracts should be rebid.

But the successful bidders argued at the March 7 hearing? that the contracts dating back to 2019 are valid with no significant flaws in the bidding process.

“The problem is that Anthem lost,” said lawyer Michael Abate, who represents Humana Health Plan, one of the five successful bidders. “It’s time for this case to end.”

Lawyers for the state Cabinet for Health and Family Services, which oversees Medicaid, and the Finance and Administration Cabinet, which handles contract awards, also argued the appeals court decision should be affirmed.

Wesley Duke, general counsel for the cabinet, said the state had decided on a maximum of five MCOs.

“The 1.5 million members of Medicaid are best served by five MCOs,” he said. “The Court of Appeals decision should be affirmed.”

The ruling means five companies originally awarded the business in 2019 will remain in change of care for most of the 1.5 million people enrolled in Medicaid, a federal-state health plan.?