Sunday, January 23, 2011

UnitedHealth testifies under oath losing money in Hawaii

David Heywood, Executive Director of UnitedHealth's Medicaid and Medicare operations in Hawaii, testified recently in federal court that the company "has been losing money."


This is the same company whose Medicaid revenues exploded by 93% between June 2008 and September 2010, at the same time Medicaid membership only increased by 45%.

This is the same company that just reported fourth quarter 2010 profit up ten percent, and their annual profit for 2010 up 21%.

This is the same company that presumably received the state increase in capitation payments as Wellcare on July 1, 2010.

Perhaps UnitedHealth defines "losing money" differently than the rest of the world.

The federal court case in question had been narrowed down over time to the issue of whether or not UnitedHealth and Wellcare provided the elderly and people with disabilities with the same access to medical care as enjoyed by the rest of Hawaii's Medicaid program.  The two companies exclusively operate Hawaii's Medicaid program for the elderly and people with disabilities, called QExA.

The judge concluded his ruling with the comment that "plaintiffs have not established that the QExA program is in violation of any federal law."  Narrowing the focus of the case obviously had an impact on that issue, since it is well-known that UnitedHealth and Evercare, along with Hawaii's Medicaid office, have been under federal investigation for criminal fraud and violation of numerous federal laws since the fall of 2009.

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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.