Friday, April 29, 2011

How much of a raise did Hawaii give Evercare and Ohana?

Wellcare reported in their 2010 year-end SEC filing that the "Hawaii program rate increases, which we believe have improved the stability of the program, also were effective July 1, 2010."

The "also" referred to "net increases of approximately 2.5% to 3.0% in Florida effective September 1, 2010 and 1.5% to 2.0% in Georgia effective July 1, 2010."

The company directly blames its $254.3 million in litigation-related costs for 2010's net annual loss.

For the year ended December 31, 2010, the net loss was $53.4 million compared to $39.9 million of net income for the same period in 2009. Excluding investigation-related and litigation-resolution costs of $167.6 million and $86.7 million, net of tax, net income would have been $114.2 million and $126.6 million for the years ended December 31, 2010 and 2009, respectively.

Hawaii Senate Bill 1274, which is openly back by health insurance companies like Wellcare, UnitedHealthcare, HMSA and others, will help get Wellcare out from under some of those exhorbitant legal expenses.

My question is why are we allowing a state/federal contractor to divert $254,300,000 in taxpayer funds away from medical care to fighting federal allegations that the company is stealing from those same taxpayer funds?

It's taken since October 2007, but in March Florida finally issued federal indictments for Medicaid fraud against five former Wellcare employees. The investigation and indictments cover criminal fraudulent scheming and theft between 2003 and 2007.

According to the March 3, 2011 story from Associated Press in Florida, Wellcare, "which is one of the state's largest Medicaid providers, spent $2.4 million on political contributions in the 2004 and 2006 elections."

More than 95 percent of it went to Republicans, who pushed forward a nationally watched plan that funnels more state and federal Medicaid spending than ever through private companies, which profit most by providing the least care.

The fact the company still has legal expenses in the $254 million range would seem to imply other investigations are ongoing. Somewhere.

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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.