Tuesday, August 31, 2010

Coventry Health Care Reports of a Consumer

There is a higher court than courts of justice and that is the court of conscience. It supercedes all other courts.
                                                                                    ~Mohandas Gandhi

Last week I opened mail from my attorney Paul Tucker. I have been receiving a a lot more mail from Mr. Tucker these past few months as my civil lawsuit against Coventry Health Care, Inc. of Bethesda MD grows close.

For many Americans wealth is an accumulation of riches. For me it is a single piece of paper, a notification that a Patrick W. Dowd will be deposed today at 1:30 p.m. as part of an oral examination in the civil action of Christine Stenger v. Carelink Health Plans Inc. of West Virginia and Patrick Dowd.

It was early November 2005, when I opened a puzzling letter addressed to me, certified mail from Mr. Dowd, former CEO of Carelink. "The" letter, as it has come to be known, shattered my world.


Mrs. Christine Stenger
163 Bello Vedere Avenue
Wheeling, WV 26003

Dear Mrs. Stenger,

The records of the Carelink Customer Service Operation (CSO) indicate that a phone call was received the morning of Thursday, October 27, 2005, from your home phone. The CSO representative who handled the call was under the impression that she was speaking with Dena Wildman of the West Virginia Insurance Commissioner's office based on the information you gave her, and the way you expressed the purpose of your phone call. It could be said that you attempted to misrepresent yourself as Ms. Wildman. Indeed, the CSO representative had no indication from you that you were not Ms. Wildman.

Please be advised that if you phoned the CSO representing yourself as Ms. Wildman, such behavior would be deemed fraud, and possibly a violation of state law which makes it a misdemeanor to "knowingly impersonate or purport to exercise any function of a public official, induce a person to submit to or rely on the fraudlent authority of the person." Further, such actions would be fraud under your HMO benefit plan, and grounds for termination. Section 4.1 of the HMO Evidence of Coverage (EOC) states that Carelink can terminate you, with at least 15 days written notice, if you participate in fraudulent or criminal behavior. We have handed this matter over to the State for investigation, and have confirmed with Ms. Wildman that the information you conveyed to the CSO representative was inaccurate and untrue.

This letter shall serve as a warning that any similar behavior by you in the future will be grounds for your termination. We have apprised you of your rights to contact the Department of Insurance to review your appeal, and we have informed you countless times that your appeal rights with Carelink regarding your request for a lefort graft have been exhausted.


Patrick W. Dowd

President and CEO, Carelink Health Plans, Inc.

cc Mary Jane Pickens, General Counsel, West VIrginia Insurance Commission.

A tragic mistake for Mr. Patrick W. Dowd.  He had targeted me, so he likely thought, so effectively, covering all possibilities that might trigger my termination. Dowd began to dig his own grave that day.

The O'Briens of West Virginia of whom I am a member, with a long history of the law, are not easily fooled by words. Dowd, I believe, unwittingly crossed the line as he accused me directly of fraud with his parting words: "any similar behavior by you in the future. " As I look back over five difficult years, tide turned that day in my favor.

Last night I raised my glass of Merlot, the first in many months, to Mr. Dowd. I held my glass high as I prayed for him, that he would today do the right thing.

I raised another toast to my brilliant, compassionate attorney, Paul Tucker. Two men soon to be adversaries in the courtroom. But I am rushing things. Today, at 1:30 p.m. at a conference room at the Albany International Airport Paul Tucker will depose Mr. Patrick W. Dowd, former CEO of Carelink Health Plans Inc of West Virginia.

Which way will the scales tip? Truth or fabrication?

If you enjoy drama and suspense with twists and turns, return each Tuesday. I have learned that the pen is mightier than the sword and mightier, at times, than a court of law.


Health Insurers Are Backing Republicans With Campaign Donations By 8:1 Margin

Insurers became the target of the White House’s attacks in the closing days of the health reform debate and so perhaps it’s no surprise that they’re “backing Republicans with campaign donations by an 8-to- 1 margin, favoring the party that’s promised to repeal President Barack Obama’s health-care overhaul if it wins back Congress.” Bloomberg’s Drew Armstrong has the scoop:

WellPoint, along with Coventry Health Care Inc. and Humana Inc., gave Republican candidates $315,000 from May through July, according to U.S. Federal Election Commission records. That compares with $41,000 given to Democrats by the three companies as the parties near November elections that will determine who controls the U.S. House and Senate next year.

While Republicans aren’t likely to win the large majorities necessary to override a presidential veto and repeal the health law Obama signed in March, they may be able to slow or stall its implementation, said James Morone, a political science professor at Brown University in Providence, Rhode Island. At the same time, the turn to strongly favor Republicans may anger Democrats who had been receptive to insurers’ concerns, he said.

The Wonk Room explains why insurers are donating to Republicans, the party devoted to repealing the individual health insurance mandate.

~Think Progress blog at http://thinkprogress.org/2010/08/27/insurers-gop/

There are over ninety comments to date to this article. My five year investigation into the workings of Coventry Health Care attest to the veracity of what you will now read. It may be extreme; then, again, there just might be kernels of truth.

P.D. says:

These people are so immoral, so evil. They will let people die in the streets. The Almighty Dollar is their God. They will people we love, we care about die because of the bottom line. I am getting some wine….
August 27th, 2010 at 6:05 pm

Hoodathunk (Man the Pumps!) says:

The HI companies aren’t satisfied with the mandate because they know it won’t survive. They know single payer is coming and they are terrified. Ten years from now HI companies will join the buggy whip boys.

August 27th, 2010 at 6:18 pm

bob h says:

Prior to HCR, the private health insurance industry was in a long-term death spiral, offering an increasingly unaffordable, inadequate product to declining numbers of customers. These political contributions are intended to get back to that happy state of affairs?

August 29th, 2010 at 7:00 am

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