A rebellious lawsuit over the business practices of one of the companies running KanCare, the Brownback administration’s privatization of the $3 billion Kansas Medicaid program, just got more explosive.
The lawsuit was filed against the health insurance company Sunflower State Health Plan Inc, for accusing it of unethical behavior, saying the plaintiff-an executive who was fired trying to extort it.
In a federal court in Kansas City, Kan., Sunflower and its parent company, Centene Corp., declared the former executive charged a $3 million payment from the business in return for not reporting it to the Kansas attorney general’s Medicaid fraud unit.
Sunflower refused to be extorted by calling them “spurious,” and rather shoeing documents copies of her allegations and demand to the director of Kansas Medicaid Services, the director of the Kansas Division of Health Care Finance, the Kansas Attorney General’s Office, the U.S. Attorney’s Office, and the FBI.
The counterclaim asks for unspecified injuries from the former employee, Jacqueline Leary, for damage of method and vilification.
Reacting to Sunflower’s allegations, Leary’s attorney, Lewis Galloway, declared the company’s counterclaim “paper thin” and its corruption charge “the most ludicrous thing ever.”
In the phone, interview galloway said to Sunflower’s Attorney “I have a very serious and specific concern about lawyers behaving this way,” and “If they truly believe that I am, in my practice, engaging in some type of extortion, they have a professional and ethical responsibility to make that known to the bar. Now they didn’t do that.” Sunflowers did not respond to Galloway.
Sunflower’s counterclaim developed in answer to Leary’s accusation that Sunflower and its subsidiaries, Centene, classified workers to move KanCare members continuously from high-cost providers as a cost-saving measure. Centene arranged a similar counterclaim against Leary.
A former Vice President of Network Development and contracting at Sunflower, Leary. Battles she was dismissed after she complained to the directive, stating that continued unfair and probably unconstitutional.
KanCare, which established separate organizations in the price of managing the state’s Medicaid Program was originated in January 2013. The business transferred approximately all of the states In October, Leary filed a Lawsuit, in fact, Medicaid enrollees into health plans run by Sunflower and two other managed care organizations, Amerigroup and UnitedHealthcare. Shortly after it was reported that the three companies running KanCare collectively cost $76.2 million in 2014 after acquiring losses of $110 million in the year 2013.
Attorney appealed that Sunflower leaders required her to steer Sunflower members endlessly from providers that had agreed to be repaid at rates larger than 100 percent of standard Kansas Medicaid rates. The company was declaring they have fired Leary because of her poor job performance. In its counterclaim, Sunflower says Leary failed to settle undefined medical provider problems, chose to go shopping rather than serving in providing for a mid-year review, and consistently showed a lack of professionalism, organization and responsiveness in her job position.
Centene did their own investigations of Sunflower, which ended in a judgment that there was no wrongdoing on the part of Sunflower,” according to the counterclaim.
Also writes in the Occupational Safety and Health Administration ruled against Leary in September, getting there was convincing proof she was dismissed for poor performance and not in retaliation for asserting her concerns about Sunflower’s business practices.
Galloway, Leary’s attorney, said he planned to seek removal of the counterclaim and take the case to trial.
The lawsuit, which names Centene, Sunflower, and two top Centene executives as respondents, claims that Sunflower administrators required her to drive Sunflower features continuously of providers that should get to be paid at rates higher than 100 percent of standard Kansas Medicaid rates.
Leary claims that defendant Rob Hitchcock, Centene’s executive vice president of health plans, voiced concern at a February 2013 conference regarding the company’s poor financial achievement and told Leary not to allow new KanCare features to primary care physicians affiliated with the University of Kansas Medical Center. KU Med Center was one of the providers that should negotiate more special reimbursement rates.
Hitchcock emphasized that these steps were important in order to dramatically increase (Sunflower’s) economic production in both the short term and long term and to avoid a negative impression to the financial performance of Centene,” Leary’s lawsuit states. Hitchcock also explained that men did not like academic centers because the medical students plan too many ideas and tests.
