Before WellCare became part of Centene Corp.’s business portfolio in January 2020, the former had struggled with a series of lawsuits that raised questions on the insurance provider’s business practice. The legal troubles had exposed WellCare’s contentious relation with employees and its tendency to violate the law to increase profits. Amazingly, the same can be attributed to Centene, WellCare’s parent company.
Centene started the year 2020 with the great news that it has become one with WellCare. The move further solidified Centene’s position as the largest Medicaid-managed organization in the United States. Michael Neidorff’s dream of making his company among the biggest in the country is coming into form. The development is undoubtedly good news for Centene and WellCare, but not necessarily welcome by insurance policyholders. And this is especially true for Americans who depend on Medicaid for their health coverage.
Centene and WellCare operating as one could mean the perpetuation of the two companies’ misdeeds. Should that be the case, Medicaid members are in for a rough ride – as they experienced with the insurers in the years past – moving forward.
WellCare’s Fraud-Plagued Record
WellCare’s business dealings in Georgia should interest people who have been keeping tabs on how the easily committed fraud, duped insurance customers, and eventually got away with its wrongdoings. In 2009, the company faced a bevy of cases that alleged criminal and civil offenses. The wheels of justice turned as WellCare low-level officials were imprisoned, and the company paid out hundreds of millions in settlement.
It might be that as a result of the legal troubles, WellCare’s business took a hit but apparently not hard enough. The company stayed in the industry and went on to profit more and, along the way, commit more mistakes. Again in Georgia, former employees brought WellCare to the court in 2014 and accused the company of fraud.
The court filing about the case indicated that WellCare cheated Medicare, the healthcare program funded by federal and state governments. The plaintiffs said WellCare senior executives pressured them to deny payments for medically necessary hospital stays. The employees were fired for not following the order handed from the top. And they blew the whistle on WellCare’s profit-driven business decisions.
The lawsuit said WellCare refused Medicaid coverage to patients and kept the money. It appeared that WellCare officials did not care that the claims made were from low-income policyholders. Medicaid was designed to provide quality medical care to poor Americans, but insurers like WellCare are robbing these people of the chance to get proper treatment for their conditions.
WellCare’s former employees claimed their former bosses disregarded the sufferings of Medicaid patients to increase profits. It’s unclear if the insensitive executives were made to face the law, but it’s undeniable that WellCare had escaped punishment. The company still exists and is now part of Centene’s burgeoning empire.
The Truth: WellCare Is Just Being Centene
The WellCare situation is not news, really. Centene has set a precedent, so WellCare is just following its parent’s lead. An example of Centene’s blundering behavior is how it handled its subsidiaries’ controversial prison health deals. Deaths and sufferings marred how Centene ran the prison system’s healthcare, but the company got to renew existing deals and won fresh contracts in most cases.
Such victories made Centene CEO Michael Neidorff bolder and even unapologetic. When queried about the issues hounding his group of companies, his immediate reply was the problems will not bog down Centene. Profit will continue to shoot up despite the complications, according to him. Then Neidorff uttered not a word of apology for the people who suffered directly because of Centene’s actions.
Neidorff also dealt with lawsuits by paying off or making life hard for those who did accuse Centene of wrongdoings. An example is behavioral care provider Sovereign Health, whose treatment centers were shuttered because the insurer refused to pay for the services already rendered. Sovereign sought the assistance of the court. In turn, Neidorff hired legal experts to hurt its foe. That is why it should be clear now why Centene picked up WellCare despite its legal problems. Neidorff has grown accustomed to such situations, and he knows how to make the problems go away.
