Tuesday, November 4, 2008

Carelink Health Plan Inc Loses in Federal Court

Tuesday's Tirade
No More Deadly Delays



But then there's West Virginia, where more than 24% of adults under age 65 don't have health insurance. In that state, employer-based insurance premiums account for nearly 20% of a person's paycheck, and nearly 20% of those surveyed in the state have said they couldn't see a doctor because it was too expensive to do so. The state ranks 44th out of 51 (including Washington, D.C.) in terms of overall health care, the Fund says.

A Harris poll compiled on behalf of the U.S. Chamber Institute for Legal Reform shows that five of the 10 states whose legal environments are seen as most inhospitable to business are also among the seven lowest in median income, according to the latest Census Bureau statistics. The five: West Virginia, Mississippi, Arkansas, Louisiana and Alabama. Forbes.com, 2008 and 2007
in Pictures: The Best and Worst States to Get Sued In

There will soon be a very public accounting of my HMO, Carelink Health Plans, Inc of West Virginia at a trial in the Ohio County Circuit Court in Wheeling West Virginia. Carelink did not appeal the decision of federal Judge Frederick Stamp to remand my civil lawsuit to the Circuit Court. See links for documents unitedforjustice.blogspot.com.


Any surprise here? No, given the arguments of Judge Stamp in response to Carelink's request, it was predictable. As one studies this case, there really was nothing to refute. Corporate Legal was silenced.

As one can well imagine, with the negative climate in this state already, there will be a tsunami of outrage against Carelink and anyone who supported their corrupt ways. A public trial by an impartial jury of my peers. It does not get any better in this climate where way too many of the most vulnerable have been denied our rightful health care benefits. West Virginia is a small state...we all know each other.


I remain baffled that Carelink Health Plans, Inc. by their many outrageous actions have dug their own grave. What follows is a reference to only a few of the ruthless behaviors towards me:



On November 1, 2005, CEO Patrick Dowd, knowing that I live with what many psychiatrists would define as a severe mental illness, accused me of fraud in an effort to terminate me. See links to documents in unitedforjustice.blogspot.com.

In the fall of 2005 and again in the spring of 2006, Carelink Quality Control Supervisor Carolyn Westfall, stopped an internal investigation of the unjust actions of a key appeals official of Carelink.

I was not permitted to subpoena former Carelink CEO Patrick Dowd to testify about his alleged discrimination at my Administrative Hearing before Judge Jack DeBolt on August 10, 2006. That one is a little twisted: I was discriminated by Careink and the West Virginia Insurance Commission against even questioning Dowd under oath about his alleged discrimination.

And, most foolhardy of all possible actions, Carelink blocked all contacts with me, a paying subscriber, for months and then established a unique policy whereby I could only speak about health issues with the supervisor of customer service. Oops, some real harm was done when that supervisor went on vacation and I needed immediate attention for serious health problems.


Christine Stenger vs. Carelink Health Plans, Inc of West Virginia and Patrick Dowd (former Carelink CEO) may put a national spotlight on how ruthless one HMO can be. I am told that many across this country have waited for a case like this to go to court. Believe me. I will do all in my power to bring the media with me.

My attorney Paul Tucker of Bachmann, Hess, Garden and Hess and Coventry attorneys will begin to depose witnesses in preparation for the civil lawsuit against Carelink Health Plans. It is then that volumes of records I meticulously kept over three and a half years will be made available. It is damning information supported by physicians and clergy of the Catholic Diocese of Wheeling Charleston who have played a significant role in my success to date.

Best of all, there will be many subpoenas. This time Carelink cannot run and hide as they did in my administrative hearing. Yes, likely there will be contradictory testimonies, but there is no real concern here either. There has been a pattern of deceit that began in May in 2005 through the present. Yes, Carelink and Coventry Health Care, Inc. have dug their own grave.

Irony or providence? Ohio Country juries are noted for awarding some of the highest damages in the United States.

Irony or providence? The woman scorned is the daughter of a man of integrity who committed suicide in 1965, in large part, because of injustice in health care.

Dale Wolf

Irony or providence? This case will be tried at a time when the general public is denouncing high executive pays like that earned by Coventry CEO Dale Wolf, in a $32 million salary packing in 2004?

A tsunami of outrage? That’s a very interesting thought.


Tuesday’s Tale
Mother Jones Speaks Out

Note: Mother Jones is an independent nonprofit whose roots lie in a commitment to social justice implemented through first rate investigative reporting.

HMO Pays Staffers to Drop Sick People

Virtually all the Democrats running for president have endorsed health care proposals that maintain a major role for private insurance companies. Much of their rhetoric suggests that if we could just get everyone health insurance, then all will be well. But the debate continues to ignore the horror stories like the one reported in the L.A. Times Friday.


A private insurer paid $20,000 in bonuses to an underwriter for dropping coverage for sick people, including a hairdresser who was half way through chemo treatments for cancer. She was left with $200,000 in medical bills as a result. Meanwhile, the company, Health Net, saved $35 million by cutting off 1,600 people who had made a major medical claim. Built into the system were performance bonuses for employees who dropped the most and the sickest patients. The widespread practice suggests that Americans need a lot more than an insurance card to guarantee access to medical care when they most need it.

Comments:
HMO/PPO's s/b abolished. They provide no services. Doctors and other health care providers could easily submit claims via computer to one central health care payment computer, just like an income tax return. The central computer could reimburse the filer within seconds directly to bank accounts. Post-audits could be made by computer, then, selectively, by human auditors. Cheating health care providers would be maximally punished. The one payer would negotiate how much it will pay for Rx's. Today's system is fraught with politics, begs for scams, and has almost nothing to do with our national health. Rod Ruguer

So what is new? This has been going on since the inception of insurance. And they only want to insure the healthy and young. Many of us in healthcare, have seen the results of this on both ourselves & our pts.Yet most of Americans just want to scream about socialized medicine. That is, until it happens to them. S.D. Huff

Health care even when you have it, is a laugh. My last job went from an 80/20 plan to 60/40. That is not care of any kind. It’s what private equity firms do to a company. That was before the layoff.Universal health care cannot include the hmo's and ppo's of today and it must include dental also. You can tell a person is part of the working poor by their teeth! Cherry Crum

And the REALLY EVIL thing? Those same companies are very actively "consulting" China and India to adopt their "obviously superior" healthcare model. 2007

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