The man, or the face, that Health Net had pushed to the forefront to make life difficult for Sovereign Health and thousands of behavioral care patients is an unusual choice. Matthew Ciganek is an auditor by discipline and is expected to know his way around the intricacies of finances. But there is no record to show that Ciganek’s competence includes anything about insurance.
He is the head of Health Net SIU but court records indicated Ciganek was without a firm grasp of matters about insurance. For instance, a deposition revealed that the SIU chief could not differentiate between co-pay and co-insurance. This could mean that Ciganek would be easily overwhelmed by the task and its further concern that SIU point man has zero training and experience on the job he is performing.
Ciganek Clueless On Basic Functions Of SIU
True to form, the SIU chief proved he is not up to the task. Backed by the lawyers it hired, Health Net put 121 treatments center into the SIU by default. The process went on and without objection from Ciganek despite the absence of investigation and evidence to support the decision. It was quite clear that Health Net had intended to proceed with its plan, unmindful that the maneuver was devoid of justifiable rationale.
The Health Net SIU has yet to establish a robust case of fraud. Yet, it pushed through with the underserved punishment of treatment centers, foremost of which were Sovereign-operated facilities. It became apparent that the SIU acted on a questionable agenda, and thanks to the clueless Ciganek, the plan was rolling ahead as intended.
The plot thickened when the SIU sent out letters, and yes, they bear the Ciganek signature, that accused treatment providers of submitting fraudulent payment claims. The letters contained further demands that, according to the providers, were designed for difficult compliance. In other words, the targeted treatment centers saw the worsening of their predicament and pushed them to near hopelessness. The whole thing played using Ciganek’s name, but it was a common understanding that the SIU head was left out of the loop by Health Net’s lawyers.
Why Health Net SIU Exists
The rationale for SIU is to identify anomalies but for Health Net, it was clear from the beginning that the operation will bear down on care providers who do not toe the line. The reason for its existence was clear – intimidate and frighten treatment centers that are bold enough to blow the whistle on the insurer’s illegal activities. And as things started to unfold, it was no longer a surprise that Health Net batted for a non-insurance to be the SIU chief.
In hindsight, Ciganek was a disastrous choice to lead the Health Net SIU as he grapples in the dark in carrying out the true mission as provided by the law. But as far as Health Net is concerned, Ciganek is the perfect SIU man as he acts and behaves to the insurer’s biddings.
