Tuesday, September 14, 2010

Coventry Health Care Worst Practices

Tuesday’s Tirade

“Women are like teabags. We don't know our true strength until we are in hot water!”
                                                                                            ~Eleanor Roosevelt

There are tears in my eyes as I write today’s blog. Lack of public education regarding the nature of mental illness can result in abusive behavior to the mentally ill. Endured over many years it may cause irreparable harm. It is costly to all parties involved.

People who have identities that society values negatively are said to be stigmatized. Stigma is a reality for people with a mental illness, and they report that how others judge them is one of their greatest barriers to a complete and satisfying life. Society feels uncomfortable about mental illness. It is not seen like other illnesses such as heart disease and cancer. Due to inaccuracies and misunderstandings, people have been led to believe that an individual with a mental illness has a weak character or is inevitably dangerous. Mental illness can be called the invisible illness. Often, the only way to know whether someone has been diagnosed with a mental illness is if they tell you. The majority of the public is unaware of how many mentally ill people they know and encounter every day.

Why does stigma surround mental illness?

We all have an idea of what someone with a mental illness is like, but most of our views and interpretations have been distorted through strongly held social beliefs. The media, as a reflection of society, has done much to sustain a distorted view of mental illness. Television or movie characters who are aggressive, dangerous and unpredictable can have their behavior attributed to a mental illness. Mental illness also has not received the sensitive media coverage that other illnesses have been given. We are surrounded by stereotypes, popular movies talk about killers who are "psychos," and news coverage of mental illness only when it related to violence. We also often hear the causal use of terms like "lunatic" or "crazy," along with jokes about the mentally ill. These representations and the use of discriminatory language distort the public’s view and reinforce inaccuracies about mental illness.

What are the effects of stigma?

If you became physically ill, you would go to a doctor. Once you got better you would expect to get on with life as usual. Life, however, does not always fit back into place for people diagnosed with a mental illness. Everyone has the right to fully participate in his or her community, but individuals struggling to overcome a mental illness can find themselves facing a constant series of rejections and exclusions.

Due to stigma, the typical reaction encountered by someone with a mental illness (and his or her family members) is fear and rejection. Some have been denied adequate housing, loans, health insurance and jobs due to their history of mental illness. Due to the stigma associated with the illness, many people have found that they lose their self-esteem and have difficulty making friends. The stigma attached to mental illness is so pervasive that people who suspect that they might be mentally ill are unwilling to seek help for fear of what others may think. Spouses may be reluctant to define their partners as mentally ill, while families may delay seeking help for their child because of their fears and shame.

How do we erase stigma?

We can battle stigma when we have facts. We all have times when we feel depressed, get unreasonably angry or over-excited. We even have periods when we think that everything and everybody is out to get us and that we can’t cope. For someone with a mental illness these feelings become enveloping and overwhelming. There is no particular way to develop a mental illness. For some people, it occurs due to genetic factors in their family. Other causes may relate to environment stressors such as experiences or severe child abuse, war, torture, poverty, loss, isolation, neglect or abandonment. Mental illnesses can also occur in combination with substance abuse.

No matter people develop mental illness, there is usually some form of help available which will help them to improved health and a productive life. The support of family, friends and employments is also critical.

                                                        ~Mental Health Works.ca, Mental Health Facts

Tuesday’s Tale
Worst Practices: Coventry Health Care

2008 revenues: $9.9 Billion

Customers: Over 5 million

Spending on Federal Lobbyists $40,000 thus far in 2009

2007 Total Revenue of $9.87953 billion Net Income of $626.09 million.

2008 Total Revenue of $11.91365 billion Net Income of $381.89 million.

CEO (former): Dale B. Wolf $9,047,469 (Total compensation for 2008). (You might want to know about the $34 million payment package Wolf once "earned" I believe in 2004.) Wolf carried a base salary of $965,000 in 2008, and earned just over $1.9 million in stock awards. His "other compensation," which amounted to $486,447, included transportation on the company's airplane, a company match retirement savings plan and a company match 401(k) plan.

Cancer Patient Denied Coverage for life-prolonging drug

In 2007, Coventry refused to cover the costs of a doctor recommended drug for cancer patient Mary Casey, saying it is experimental. Casey suffers from adenoid cystic carcinoma, a rare form of cancer. She had surgery and radiation two years ago, but the cancer had spread to her lungs. Her doctor prescribed a drug called Tarceva, which is approved by the Food and Drug Administration to treat some forms of lung and pancreatic cancer; it is still being tested for other types of cancer. The drug costs $3,600 a month ‐‐ more than the Casey family can manage. "Because Ben and I both work, we don't qualify to get the drug for free," Casey said. "They say it's experimental. It will always be experimental for my cancer because it is so rare." Her doctor said she needs a drug to - survive, but her insurance company refused to pay for it. KMBC's Bev Chapman has the story of a cancer patient who made a difficult decision this week. Mary Casey said she's never wanted to make her health problems a topic for public discussion, but that's exactly what has happened. "It's kind of like David versus Goliath, but you have to keep fighting," Casey said. (Hey, that’s how I feel.)
[KMBC‐TV, Kansas City, 5/10/07]

Investors sue Coventry, claiming securities violations. Pension fund says insurance executives made $46 million in improper stock sales

An institutional investor has filed a class‐action lawsuit against Bethesda insurance company Coventry Health Care, claiming company executives violated federal securities laws and that a "scheme" enabled the executives and others to realize $46 million in stock sales, causing plaintiffs and others to suffer "economic loss." The complaint was filed in U.S District Court in Baltimore by Plumbers Local N. 98 Defined Benefit Pension Fund, represented by Coughlin Stoia Geller Rudman & Robbins, a San Diego law firm with an office in Washington, D.C. Named as defendants are former Coventry CEO Dale B. Wolf, CFO Shawn M. Guertin and Corporate Controller John J. Ruhlman. The suit seeks redress for the plaintiffs, including damages to be determined at trial. Attorneys at Coughlin Stoia could not be reached for comment. Coventry executives did not return a phone message. The complaint against Coventry alleges that from Feb. 9, 2007, to Oct. 22, 2008, the defendants made "numerous positive statements" regarding the company's financial condition, business and prospects and that these statements were "materially false and misleading because defendants failed to disclose" adverse facts. [Gazette.net, 9/1/09] and [PR Log, 9/9/09]

North Kansas City Hospital filed a lawsuit against Coventry Health Care. The hospital is suing
Coventry Health Care for $5 million. The lawsuit claims Coventry has underpaid the hospital for medical services. [KMBC, 10/16/06]

"When I arrived at Coventry eight years ago, my goal was simply for Coventry to be known as a well‐run business," said Allen F. Wise. Source: The Free Library

Carelink Health Plans, Inc. of West Virginia, a subsidiary of Coventry is being sued for
discrimination against a person with disabilities. [Health Insurance Betrayal Newsvine]

In 2007, Coventry was fined $264,000 by Medicare because they unlawfully marketed plans to seniors and the disabled. “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.” [Business Publications Resource]

In 2007, Coventry was selected by West Virginia’s Public Employees Insurance Agency as the Medicare Advantage Plan to provide health insurance to retirees. [Red Orbit]

Coventry’s Rising Insurance Costs Leads to Bad News for Retirees and Creates controversy in WV

Maryland‐based Coventry Health Care is increasing its monthly per‐enrollee rate for handling Medicare Advantage by 37 percent, from $163 to $223, as of July 1. It also plans to stop managing such privately run portions of the government health program for seniors at the end of this year. West Virginia's health care program for public employees decided Thursday to end subsidies for retirees, starting next year with all new hires, and was promptly told to expect a lawsuit. American Federation of Teachers‐West Virginia President Judy Hale vowed to sue following the vote by the finance board for the Public

Employees Insurance Agency. "It's one of the things that helps us recruit teachers, retain teachers," said Hale, whose group continuously battles for pay raises, with mixed results. "It's outrageous in light of teacher shortages ... We will settle this in court."

[ West Virginia Gazette]
Prepared by USAction.org

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