Coventry Health Care Wars against Regulation

Tuesday’s Tirade
Fraud at High Corporate Levels

"There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest.” ~Elie Wiesel

On April 3, 2009, BILL MOYERS interviewed WILLIAM BLACK on the Bill Moyers Journal on PBS. WILLIAM BLACK is a bank regulator and author of the book, “The Best Way to Rob a Bank is to Own One. It was a disturbing conversation about the financial bailout of large financial corporations using America’s money.

WILLIAM BLACK describes the present economic crisis as driven by fraud. He made it “clear that calculated dishonesty by people in charge is at the heart of most large corporate failures and scandals, including, of course, the S&L.”

BILL MOYERS: But is that true? Is that what you're saying here, that it was in the boardrooms and the CEO offices where this fraud began? Black responds, “ Absolutely.”

WILLIAM BLACK: Fraud is deceit. And the essence of fraud is, "I create trust in you, and then I betray that trust, and get you to give me something of value." And as a result, there's no more effective acid against trust than fraud, especially fraud by top elites, and that's what we have. They involve deceit, which is the essence of fraud.

BILL MOYERS: So you're suggesting, saying that CEOs of some of these banks and mortgage firms in order to increase their own personal income, deliberately set out to make bad loans?

WILLIAM BLACK: Yes.

BILL MOYERS: How do they get away with it? I mean, what about their own checks and balances in the company? What about their accounting divisions?

WILLIAM BLACK: All of those checks and balances report to the CEO, so if the CEO goes bad, all of the checks and balances are easily overcome. And the art form is not simply to defeat those internal controls, but to suborn them, to turn them into your greatest allies. And the bonus programs are exactly how you do that.

The Bush Administration essentially got rid of regulation, so if nobody was looking, you were able to do this with impunity and that's exactly what happened.

BILL MOYERS: You're talking about significant American companies… Is it possible that these complex instruments were deliberately created so swindlers could exploit them?

WILLIAM BLACK: Oh, absolutely.

BILL MOYERS: So if your assumption is correct, your evidence is sound, the bank, the lending company, created a fraud. And the ratings agency that is supposed to test the value of these assets knowingly entered into the fraud. Both parties are committing fraud by intention.

WILLIAM BLACK: Right, and the investment banker that — we call it pooling — puts together these bad mortgages, these liars' loans, and creates the toxic waste of these derivatives. All of them do that. And then they sell it to the world and the world just thinks because it has a triple-A rating it must actually be safe. Well, instead, there are 60 and 80 percent losses on these things, because of course they, in reality, are toxic waste.

BILL MOYERS: You're describing what Bernie Madoff did to a limited number of people. But you're saying it's systemic, a systemic Ponzi scheme.

WILLIAM BLACK: Oh, Bernie was a piker. He doesn't even get into the front ranks of a Ponzi scheme...

You must read the transcript of this enlightening interview. The truth is very painful to read and it’s frightening to consider the possible consequences once this truth becomes public knowledge. The link is http://www.freewebs.com/courageoffaith/Corruption%20and%20Fraud%202009%203%203%20Moyers.pdf

Fraud, I believe, is at the heart of the operation of Coventry Health Care, Inc. of Bethesda MD and likely other large health plans. It suggests wholesale greed. Brazen transgressions. Fraud. Misrepresenting oneself falsely. Does it not? Read on.

The alarming news about our financial institutions creates wider, serious implications for the health care industry. Consider a few of the injustices I uncovered during my four year investigation of Coventry and you might just connect the dots. Did Coventry executives knowingly set into place policies that harm the consumer? Awfully suspicious.

Let’s take a quick tour of some of the fraudulent activities I have uncovered within Coventry Health Care Inc, the former "Darling of Wall Street."

“Coventry Health Care Inc. and Humana Inc., two of the largest providers of U.S.-subsidized health plans, were fined by Medicare for improperly marketing the policies to the elderly and disabled. Coventry, based in Bethesda, received a civil penalty of $264,000, while Louisville, Ky.- based Humana will pay $75,000, according to Medicare officials. State health regulators and patients have told congressional committees that elderly people who aren’t competent, can’t read or don’t speak fluent English have been pressured into joining the plans, known as Medicare Advantage.” ~The Reluctant Regulator

An investigation into the questionable activities of Appeals Dept Head Patrick Quinn was filed away with no consequence to Quinn.

Patrick W. Dowd, former, CEO of Carelink, falsely accused me of fraud, someone who lives with a mental illness, someone who might be especially vulnerable to tactics such as this bizarre accusation.

Carelink CEO Cosby M. Davis, III provided partial information to insurance Regulator NCQA and based on the volunteer information was awarded a rating of excellent in December 2007. Not only did West Virginia Insurance Commissioner Jane Cline accuse Carlink of egregious deeds committed in the appeals process during 2005, but Carelink was ordered to radically change the way they executed their business. This was December 14, 2006 and Carelink has defied this Final Order.

How long will America permit this outlandish activity by health care plans? How much longer will we individuals stand quietly by as others lose their benefits and sometimes their lives?

Calculated dishonesty? What a messy situation!


Tuesday’s Tale
Violence in America

PITTSBURGH – A 911 call that brought two police officers to a home where they were ambushed, and where a third was also later killed during a four-hour siege, was precipitated by a fight between the gunman and his mother over a dog urinating in the house.

The Saturday argument between Margaret and Richard Poplawski escalated to the point that she threatened to kick him out and she called police to do it, according to a 12-page criminal complaint and affidavit filed late Saturday.

When officers Paul Sciullo III and Stephen Mayhle arrived, Margaret Poplawski opened the door and told them to come in and take her 23-year-old son, apparently unaware he was standing behind her with a rifle, the affidavit said. Hearing gunshots, she spun around to see her son with the gun and ran to the basement.

"What the hell have you done?" she shouted.

The mother told police her son had been stockpiling guns and ammunition "because he believed that as a result of economic collapse, the police were no longer able to protect society," the affidavit said.

Friends have said Poplawski was concerned about his weapons being seized during Barack Obama's presidency, and friends said he owned several handguns and an AK-47 assault rifle. Police have not said, specifically, what weapons were used to kill the officers.

By JOE MANDAK, Associated Press Writer Joe Mandak, Associated Press Writer – Sun Apr 5, 4:25 pm ET

In the last month alone there have been seven incidents of multiple murders, leaving forty-eight people dead. These incidents are not isolated. In the latest incident, a sick mind took the lives of three police officers in Pittsburgh PA. The accuser remains in the mental ward of the jail at this time.

Wake up, America! Take note of these senseless killings and begin to question a health care system in crisis. Why is the mass murderer so enraged? Does this type of rage fester within other Americans, awaiting something to snap?

It is too early to tell if many of the killers in the recent massacres were mentally ill. But history tells a tragic story of the ravaged mind of the mentally ill. One incident after another. The killers at Columbine and Virginia Tech? They were mentally ill individuals who needed a great deal of help and it was denied them. Denied by health plans? Nothing would surprise me.

This is a dangerous time. Anger grows as we learn of the fraudulent activities of large financial institutions which have left many destitute. Today we learn about secret, illegal activities to grow wealth of a few. Tomorrow the spotlight will be on health reform.

Soon Americans will be furious to learn of the degree of fraud within the health care industry. There will be very disturbing information revealed about the greedy operations of health plans. We all will cry for swift justice for those who are frustrated by health plans to care for the mentally ill and the elderly, society's most vunlerable.

Do not be shocked by the mass murders that have increased in 2009. It’s beginning to be a weekly news item, is it not? The sad news? If greed were not part of the corporate picture in health care, some of these killings may never have happened.

We’ve got to figure a way to deal with this senseless violence.