Monday, July 5, 2010

Wellcare says "We prefer them to die because it's cheaper": Federal complaint includes Hawaii

According to a recently unsealed federal whistleblower complaint, those were the words of Dr. Vince Kunz, Medical Director for Wellcare's Heath Services Area.  They're quoted on page 35.

The case was filed in Florida on June 21 under seal.  When Wellcare announced on June 25 they were settling a potential federal suit with Florida for perhaps less than a quarter of the amount due, the complaint was unsealed  the following Monday, June 28.  It was followed shortly by two more whistleblower suits on June 29.

The June 21 False Claims Complaint included not just Wellcare, but also UnitedHealth (along with other for profit health insurance companies like Humana and Amerigroup).  It accuses these companies of violating the Hawaii False Claims Act, 36 Hawaii Revised Statutes 661-21(f), which essentially makes it illegal to steal money from the State (page 8).

Hawaii Attorney General Mark Bennett has been served with this complaint, but there has been no word of any local investigation. 

The June 21 complaint is a sixty page document packed with details of the many different accounting schemes used to steal federal and state Medicaid funds.  (The Tampa Tribune did a great summary article).  It is the result of an eighteen-month FBI investigation where a high-placed Wellcare executive wore hidden cameras to meetings and found documents sitting in the printer.  It also accuses other companies such as UnitedHealth with knowing collusion in some of these schemes.

Estimates are that the actual theft could be as high as $600 million. With damages, the total amount Wellcare could be in the hole for could be as much as a billtion dollars.

Hawaii is apparently due a share of that.  Are we going after it, or is this another source of federal funding our state leaders are apparently willing to forego in deference to Wellcare and Unitedhealth?

No comments:

Post a Comment

About Me

My photo
I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.