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Archive for Thursday, March 15, 2012

Former health insurance executive questions Brownback’s Medicaid plan

March 15, 2012

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— A man who once worked for two major health insurance companies is cautioning Kansas lawmakers and residents to question Gov. Sam Brownback’s proposal to move the state’s Medicaid program to a managed-care system.

Wendell Potter, a former public relations spokesman for Cigna Corp. and Humana Inc., spoke Tuesday to advocates for the developmentally disabled and testified before a Kansas Senate committee about his concerns with Brownback’s plan, called KanCare.

Potter told the advocates that he doesn’t question Brownback’s or Lt. Gov. Jeff Colyer’s motives. But, he added, “I will say that I’m certain there are ways to improve care and services and save money other than just handing you all over to for-profit insurance companies.”

Five companies are bidding for three state Medicaid contracts for KanCare, which is scheduled to take effect Jan. 1. Those companies are Coventry, WellCare, United Health Care, Amerigroup and Sunflower State Health Plan, which is a subsidiary of Centene.

Potter said he decided to get out of the health care industry after such experiences as visiting a clinic in Tennessee where thousands of uninsured people waited for hours in the rain to receive care. The final straw was when a California girl, 17-year-old Nataline Sarkisyan, died after Cigna declined to pay for a liver transplant, The Topeka Capital-Journal reported (http://bit.ly/yvVQye).

“When Nataline died, so did any desire I had to continue to work for an industry that I came to realize was getting between people and their doctors to that extent,” Potter said.

Potter has testified before Congress about his concerns with a health insurance industry that makes increasing shareholder profits its top priority.

Critics contend that the KanCare process is moving too fast and say including long-term care of developmentally disabled people in managed care contracts has not been successful elsewhere. The House and Senate are considering resolutions asking that the contracts be delayed six months.

A House committee also is hearing a bill by Rep. Jim Ward, D-Wichita, that would exclude long-term care of the developmentally disabled from the plan. And the governor’s office announced Monday that Brownback had written an amendment to increase his proposed budget by $1 million to educate patients and providers on the KanCare transition.

“I think what you’re seeing is a reflection that the concerns of thousands of people still mean something,” said Tom Laing, executive director of Interhab in Topeka, which hosted Potter’s address. “Both to the administration and the Legislature.”

Before Potter spoke Tuesday, Laing read a statement signed by Colyer and Department on Aging Secretary Shawn Sullivan that thanked the advocates for their work and the “meaningful dialogue” with the administration.

“We remain committed to providing integrated care and better outcomes to the Kansans who will be served,” the statement read. “We believe that with state oversight, contractual protection and private-sector resources, we can better coordinate and manage all services.”

In testimony before the Senate Public Health and Welfare Committee, Potter told legislators that several of the companies bidding on the KanCare contracts have raised concern from state and federal regulators and the American Medical Association.

He encouraged lawmakers to ask whether the companies bidding on KanCare have the staff and resources to implement it, along with asking about their patients’ satisfaction in other states, what percentage of their revenue is used to pay medical claims, and why Blue Cross and Blue Shield — the state’s largest insurer — declined to bid on the plan.

Comments

viva_la_revolucion 2 years, 1 month ago

Ha!, Wellcare is getting ready to settle on a fraud case with the DOJ and the state of Florida for double billing. They are also in trouble with the SEC. http://www.theledger.com/article/20120226/NEWS/120229430/1374?p=2&tc=pg

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bobberboy 2 years, 1 month ago

this is the kind of person we need to have looking after our interests ! RECALL BROWNCRACKED !!

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Paul R Getto 2 years, 1 month ago

+1. The answer is the second one. In this faith-based administration evidence of past failures is not necessary to consider. The only objectives are to cut taxes, shrink government and sell what is left to the highest bidder, often one of your friends or friends of friends. The Bush family perfected this art, but it is not all that new and both the major political parties are practicing this dark art.

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just_another_bozo_on_this_bus 2 years, 1 month ago

It all comes down to philosophy-- does Medicaid exist to provide medical care to those in need, or to funnel profits to well-connected insurance companies?

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Michael LoBurgio 2 years, 1 month ago

Privatized Health Insurance Killing Small Pharmacies

Privatizing public services always - ALWAYS - costs more for worse service. And in Kentucky it's destroying jobs by killing small businesses.

Kentucky legislators are threatening to subpoena three managed care companies after the state's 550 small pharmacies complained that they're being pushed out of business by the companies' low Medicaid reimbursements.

The situation is bad enough that the Kentucky Medical Association says some doctors have discussed taking out short-term loans to offset delays in claims reimbursement from the companies.

http://www.theygaveusarepublic.com/diary/10077/privatized-health-insurance-killing-kentuckys-small-pharmacies

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Paul R Getto 2 years, 1 month ago

"“I think what you’re seeing is a reflection that the concerns of thousands of people still mean something,” said Tom Laing, executive director of Interhab in Topeka, which hosted Potter’s address. “Both to the administration and the Legislature.” === You are right, Mr. Laing, but until these concerns mean something to the administration and many in the legislature, the weak and disabled who cannot fight for themselves are at risk. Thank you for being their advocate in a dark time. The truth behind the Blue's refusal to bid on this project should come out.

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