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Iowa DHS: Medicaid director's private email 'improper'

cigaretteman

HB King
May 29, 2001
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Iowa’s Medicaid director had improper communications with an insurance company worker and former lawmaker during a critical review period that ended with the for-profit company being selected to help privatize the state’s $4.2 billion annual Medicaid program, the state acknowledged in court Monday.

Iowa Department of Human Services Director Chuck Palmer insisted in court that those communications with former Rep. Renee Schulte — some via private, non-state emails with Medicaid Director Mikki Stier — had no bearing on Iowa’s selection of four companies that are in line to manage the state’s Medicaid program.

And state attorney Diane Stahle described the issue as “a rabbit hole.”

RELATED: Iowa can't show the math of Medicaid savings estimate | Questions persist in child Medicaid program

But the three companies challenging the state’s selection — Aetna, Meridian and Iowa Total Care — say it’s just one of many examples of nepotism, improper review and even illegal actions taken by the state in a flawed and “haphazard” process. They are asking Administrative Law Judge Christine Scase to rule against the state’s process, which could force Iowa to start the privatization process over.

“If this is a rabbit hole, it’s the size of the Grand Canyon,” Mark Weinhardt, an attorney for Aetna, said about Schulte’s involvement.

Schulte, a Cedar Rapids Republican, worked as a paid consultant for Iowa’s Department of Human Services starting in January of 2013, soon after she lost re-election. She terminated her nearly $100,000-a-year contract with the state on Feb. 20, four days after Gov. Terry Branstad announced Iowa was seeking competitive bids to contract with private companies to manage its Medicaid program. Days later, she began working for WellCare.

Schulte posted a response to social media shortly after the state selected the winning companies stating that she helped WellCare with its bid, which raised questions about whether she provided the company unfair or insider information.

Schulte and Stier communicated via Stier’s private email account during a so-called blackout period where people involved with the bid process were to communicate only through a designated contact officer, evidence submitted as part of the case shows.

Schulte referred comment Monday to WellCare spokeswoman Crystal Warwell Walker, who said the company is re-emphasizing training to ensure such communications do not happen again.

"These limited communications did not include any state employees involved in the scoring process," Warwell Walker added.


Emails presented Monday in court say that Stier told Schulte that WellCare had been one of the companies selected roughly five days before the decision was publicly announced. Palmer said that, if that email is accurate, he would consider that communication to have been inappropriate.

Palmer additionally testified that it was entirely his decision to hire Schulte in 2013, which was done without a competitive selection process or job posting.

"It was no one else's idea. It was no one else's decision," Palmer said when questioned in court about whether Gov. Terry Branstad had suggested or directed that Schulte be hired by the state.

The hearing, which is scheduled to last all week, involves the single-largest set of publicly bid government contracts in the state’s history. If the contracts are approved by the federal government, for-profit companies will manage Iowa’s Medicaid program, which serves roughly 560,000 poor or elderly Iowans, starting as early as Jan. 1.

The four companies selected by the state — Amerigroup, WellCare, UnitedHealthCare and AmeriHealth — have faced accusations of fraud or mismanagement and some have resulted in hundreds of millions of dollars in fines. The companies have also collectively been cited with more than 1,500 founded services errors, investigations published by The Des Moines Register show.

RELATED: Serious service errors plague Medicaid companies | Medicaid bidders tried to keep proposals secret

Thirty-three attorneys introduced themselves at the start of Monday’s hearing, which Stahle described as an “unprecedented” number.

Some of the attorneys for the four companies selected to take over Iowa’s Medicaid generally described Iowa’s process as fair and concise. The three companies challenging the state’s process outlined Monday some of the flaws they will explore later this week. Among them:

  • PENALTIES OVERLOOKED: Why some companies with no record of fraud or mismanagement scored lower than winning bidders who have paid hundreds of millions of dollars in fines or penalties.
  • CRIMINAL DISCLOSURE: Whether WellCare’s initial failure to disclose its past fraudulent behavior in Florida that resulted in CEO prison sentences broke bidding rules.
  • FLAWED REVIEW: That a committee of four reviewed the bids in such a way that widespread inaccuracies and summaries skewed the results with little or no consideration for what’s best for the state beyond a numeric review that critics say is flawed.
Scase said she plans to draft a proposed decision within two or three weeks following this week’s hearings. Any party, including the state, can appeal, which means the issue could go to District and the Iowa Supreme Courts.

The hearing will resume at 9 a.m. Tuesday. It is open to the public at the Iowa State Bar Association building, 625 E. Court Ave., in Des Moines.

http://www.press-citizen.com/story/...id-directors-private-email-improper/74640246/
 
I thought it was a bad idea when Branstad dusted Palmer off and put him back in government. Just too cozy of a relationship.
I'm sure the usual suspects will be around to vociferously defend this use of a private server as an efficient move to save the taxpayers some money. Nothing to see here. Move along.
 
Medicaid shouldn't even exist. It costs too much money. The many people on Medicaid don't amount to anything in life.
 
Medicaid shouldn't even exist. It costs too much money. The many people on Medicaid don't amount to anything in life.

Yes, we should all just pay for their expensive emergency room visits and hospitalizations through higher hospital fees instead.
 
I'm sure the usual suspects will be around to vociferously defend this use of a private server as an efficient move to save the taxpayers some money. Nothing to see here. Move along.

This is an acceptable way of conducting government business apparently.
 
This is an acceptable way of conducting government business apparently.

Wing is gonna need more brooms with all the things they are sweeping under the rug these days, voting fraud by top conservatives, etc.
 
Yeah, maybe we should come up with a law that actually addresses that because Obamacare sure doesn't.

http://www.modernhealthcare.com/article/20150117/NEWS/301169969
Yes, it's called "single payer". No question that it would reduce medical care costs. We could also allow the federal government to negotiate costs of pharmaceuticals. For the life of me, I can't remember which party is standing in the way of either of these cost saving methods.

I know your pea picking Republican heart will immediately say that single payer won't reduce costs, but the evidence is overwhelming against you. Every country that has a single payer system pays lower costs than the United States.
 
We could also allow the federal government to negotiate costs of pharmaceuticals. For the life of me, I can't remember which party is standing in the way of either of these cost saving methods.

My private carrier does this for me already.

Making Hospitals and pharmacies compete is not some magic that only the federal government can conjure.
 
So you support the FBI's investigation of Hillary?

You didn't ask me, but that hasn't stopped me from voicing my opinion. The answer is sure. If she broke the law, the FBI and the United States Attorney's office should prepare charges. Are they also going to investigate Colin Powell?
 
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My private carrier does this for me already.

Making Hospitals and pharmacies compete is not some magic that only the federal government can conjure.

However, the purchasing power of a single, united payer system is much more powerful. I would wager a fair amount that your private carrier pays more for procedures than Medicare pays.
 
You didn't ask me, but that hasn't stopped me from voicing my opinion. The answer is sure. If she broke the law, the FBI and the United States Attorney's office should prepare charges. Are they also going to investigate Colin Powell?

Did Colin Powell destroy 30K emails that were under subpoena?
 
Yes. Monopolies can be very powerful.

If you have the opinion that healthcare is a free market system you need to get that out of your head. Until we make the decision that the poor, the elderly, and uninsured, are ineligible for care, the government will continue to be involved. Since the government is involved, they should push for lower prices. Are you saying there is not enough profit in medicine? Have you seen the new Children's Hospital at UIHC?
 
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Yes, it's called "single payer". No question that it would reduce medical care costs. We could also allow the federal government to negotiate costs of pharmaceuticals. For the life of me, I can't remember which party is standing in the way of either of these cost saving methods.

I know your pea picking Republican heart will immediately say that single payer won't reduce costs, but the evidence is overwhelming against you. Every country that has a single payer system pays lower costs than the United States.


Yeah, and all those countries must pay their doctors a lot less than we do as well, otherwise, how do you explain the disproportionate number of foreign-born doctors in this country?
 
Did Colin Powell destroy 30K emails that were under subpoena?

No, but George Bush and Karl Rove did...

Not long after George W. Bush assumed the presidency in 2001, Rove, his top political aide, set up a private email server for use in the White House. The stated purpose of the system — the primary domain name on which was gwb43.com — was that it would be used exclusively for the sort of political correspondence that Bush and Rove were not permitted to do on the taxpayer’s dime.

Seven years later, Bush and Rove were embroiled in two competing scandals — the Valerie Plame scandal, in which operatives for Vice Pres. Dick Cheney, including Rove and Scooter Libby, were accused of unmasking Valerie Plame, a CIA specialist in the black market for weapons of mass destruction, for purely partisan reasons, and the U.S. Attorney purge, in which Rove’s political operation in the White House was accused of ordering Attorney General Alberto Gonzales to purge eight U.S. attorneys who were qualified prosecutors and replace them with political hacks with little or no prosecutorial experience.

Rove escaped prosecution in the Libby case, but Libby was convicted (Bush quickly commuted the sentence) on March 6, 2007, at the same time Bush and Rove were under fire for purging the U.S. attorneys. During the investigation, it came to light that Rove’s server had been used to send official, non-political emails — correspondence that was required by law to be preserved under the Presidential Records Act.

On April 12, 2007, Rove’s operation admitted that it had deleted at least 5 million emails from the server. In December 2009, technicians who had examined the server reported that the number of emails that had been deleted was far greater — 22 million.

What was in the emails? No one will ever know.

http://www.pensitoreview.com/2015/0...t-height-of-u-s-attorney-scandal-media-yawns/
 
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How is it that this can be a f****** party issue? The allegation is that members of government (including the governor) had private/backroom dealings to hand off a huge government pot of cash in exchange for, potentially, very little.

And that is a r/l issue simply because of the party who did it?
 
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No, but George Bush and Karl Rove did...

Not long after George W. Bush assumed the presidency in 2001, Rove, his top political aide, set up a private email server for use in the White House. The stated purpose of the system — the primary domain name on which was gwb43.com — was that it would be used exclusively for the sort of political correspondence that Bush and Rove were not permitted to do on the taxpayer’s dime.

Seven years later, Bush and Rove were embroiled in two competing scandals — the Valerie Plame scandal, in which operatives for Vice Pres. Dick Cheney, including Rove and Scooter Libby, were accused of unmasking Valerie Plame, a CIA specialist in the black market for weapons of mass destruction, for purely partisan reasons, and the U.S. Attorney purge, in which Rove’s political operation in the White House was accused of ordering Attorney General Alberto Gonzales to purge eight U.S. attorneys who were qualified prosecutors and replace them with political hacks with little or no prosecutorial experience.

Rove escaped prosecution in the Libby case, but Libby was convicted (Bush quickly commuted the sentence) on March 6, 2007, at the same time Bush and Rove were under fire for purging the U.S. attorneys. During the investigation, it came to light that Rove’s server had been used to send official, non-political emails — correspondence that was required by law to be preserved under the Presidential Records Act.

On April 12, 2007, Rove’s operation admitted that it had deleted at least 5 million emails from the server. In December 2009, technicians who had examined the server reported that the number of emails that had been deleted was far greater — 22 million.

What was in the emails? No one will ever know.

http://www.pensitoreview.com/2015/0...t-height-of-u-s-attorney-scandal-media-yawns/

You mistake me for someone who ever voted for a Bush.

Let's throw all of those criminals in jail.(Hillary included)

Agree?
 
Agree, if it's determined that something was done improperly. But, when a similar situation gets defended and largely ignored by one party..only to turn around have have a big problem with it when it's the other party. Well, then it's hard to have a unified opinion on holding people accountable.
 
Yeah, and all those countries must pay their doctors a lot less than we do as well, otherwise, how do you explain the disproportionate number of foreign-born doctors in this country?

How many of those doctors come from developed countries with an active single payer system? Put another way, how many of those doctors come from Great Britain, Canada, France, or Germany? How many come from Sweden? The answer is very few. Those doctors come from countries in which there is little formed medical system, therefore not much of a chance of making a decent living.
 
Are you advocating the dilution of science and service?

If so then yes, the government is your champion.
You are completely clueless. Who pays for the continuing development of science in medicine? As far as service goes, the patient would still be able to have a choice in seeking care. No one is talking about universal providers, just universal payers.
 
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How is it that this can be a f****** party issue? The allegation is that members of government (including the governor) had private/backroom dealings to hand off a huge government pot of cash in exchange for, potentially, very little.

And that is a r/l issue simply because of the party who did it?
IowaHawk.....It is just Terry being Terry. It was his decision solely. No legislation required. At risk is a $4.2B MedicAid fund. Currently managed by THE STATE, administration fees (taken out of the fund) currently run 4-8% annually, with a 10% high a few years ago. By the contract signed, the "privitized" administration fees to be removed will run atleast 12% and perhaps as high as 18%. That is monies diverted from the program to pay the new administrators (private insurors). The best way to keep costs down is to remove the profit motive. THe State has no need to run a program "at a profit." An insurance company must to keep the shareholders at bay. The new insurance administrators will get 15% of that $4.2B fund...plus these companies will NOT be ready "to go" by the 1st of the year. Many of the contracts have not even been written and/or subm
itted to providers for negotiations.
Higher administration fees mean lower reimbursements for providers and more denials of coverage for clients. The companies chosen to be administrators have rather well documented histories of law suits against them for a variety of MedicAid violations.
Branstad like "managed care" because it is private. It has no track record of saving money or being more efficient ANY WHERE! It's Terry's final "flippin' the bird" at public sector unions and human services. His boy Chuck Palmer has a rep as being "Terry's henchman" and is not viewed favorably by many human services workers/providers across the state.
If you don't wanna believe Branstad is a vindictive prick.....look at this and the UI President appointment issues and tell me what you see.....based on facts.
 
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Nail all of them. If they use private emails to do government business.
They should all be forced to resign.
If they send secrets on their emails they should go to jail.
 
This whole move to privatization stank from the start. Probably why Branstad crammed it through without input except from lobbyists.
 
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Yes, we should all just pay for their expensive emergency room visits and hospitalizations through higher hospital fees instead.
I guess either way we end up paying for them - doesn't really matter if it is through the ACA or through inflated rates. Unfortunately we now have inflated rates and ACA to pay for...
 
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