Illinois has awarded a more than $4 billion prison medical care contract to the same company it’s used for three decades, despite multimillion-dollar lawsuits against the firm and statewide complaints alleging substandard care.

Pittsburgh-based Wexford Health Sources was one of two companies responding to a request for proposals from the Illinois Department of Corrections, but it was not the low bidder. Wexford’s offer came in $673 million higher than one from VitalCore Health Strategies of Topeka, Kansas, according to a procurement announcement reviewed Friday by The Associated Press.

The initial term of Wexford’s contract is five years for $1.956 billion, with a five-year renewal worth $2.201 billion.

State officials’ decisions on contract awards are not based on cost alone. But Wexford has also been roundly criticized for its performance, facing numerous multimillion-dollar lawsuits that accuse the company of delayed or shoddy health care and backlash for relying on off-site doctors to determine whether and what treatment is necessary. Positions for medical professionals continue to suffer high vacancy rates.