Last year, health insurer giant Centene Corporation acquired Health Net; it is now one of the largest providers of Medicaid, Medicare Advantage and other government-sponsored and commercial programs in the country, boasting a membership of 12 million subscribers nationwide. But the company appears to be tone-deaf to the mushrooming opioid crisis; it routinely discriminates against policyholders in need of addiction treatment. Such discrimination is not only inhumane, it is dangerous and illegal.
According to their website, Health Net’s mission is “to help people be healthy, secure and comfortable,” an endeavor that sounds virtuous, but doesn’t really explain the company’s true goals. Centene’s site is a bit more descriptive about the company: “We are committed to improving the health of the community through health insurance solutions for the under-insured and uninsured, and through specialty services that align with our focus on whole health,” the company states. “Centene provides health plans through Medicaid, Medicare and the Health Insurance Marketplace and other Health Solutions through our specialty services companies.”
Does Centene mean that they will only cover specialty services that align with their focus of whole health? What is whole health? Whether mental health and addiction treatment services align with their focus is unclear, but based on the actions of Health Net, it appears not.
A Decade of Abuses
Health Net has been at the epicenter of controversy and lawsuits for nearly a decade, ranging from security breaches to discrimination against people with addictions and several health care providers. In 2009, a computer disk drive containing up to 1.5 million consumers’ financial and private health information mysteriously went missing. After being forced to pay relatively small fines and penalties for the breach, the same thing happened again in 2011, this time placing nearly two million consumers at risk, when more server drives went “missing” from company California and Arizona data centers.
Last year, Health Net was investigated by the California Department of Insurance and the Department of Managed Care after leaders of 118 treatment centers alleged that they had not received payment for services provided to Health Net policyholders. The plaintiffs maintained that by not paying the bills, Health Net was limiting their policyholders’ access to treatment—a form of discrimination against people with mental illnesses and/or addiction issues.
According to the Addiction Treatment Advocacy Coalition (ATAC), Health Net’s history of inhumane business practices is pervasive. In 2008, a New Jersey Federal Judge found the company guilty of obstruction of justice. The judge ruled that the company used ‘scorched earth’ litigation tactics to avoid admitting underpayment of out-of-network providers by using a database purposely skewed in favor of insurance companies. In 2009, the judge ordered Health Net to pay a stunning $261 million in penalties and compensation to the patients.
The 2009 ruling was just another example of discriminatory business-as-usual for the health care behemoth. Health Net targeted other vulnerable patients; in 2008, a California judge ordered the company to stop the controversial practice of canceling sick policyholders off their plans, and to pay more than $9 million to a breast cancer patient dropped in the middle of chemotherapy. Not exactly what one would call “helping people be healthy, secure and comfortable.”
Despite losing numerous legal cases and paying stiff fines, Health Net remained undeterred in their pursuit of profit over necessary care. The ATAC alleges that the merger with Centene Corporation was made possible by Health Net’s failure to pay legitimate bills of hundreds of addiction treatment providers since August 2015. And the beat goes on—in 2017, a well-regarded teen drug and alcohol program in California reports it is struggling to keep its doors open due to Health Net’s failure to pay bills dating back to 2015.
Health Net has made its priorities clear. Rather than pay for needed mental health and addiction treatment covered under their plans, company policy is to discredit the entities that provide those services. In 2016, Health Net launched an unprecedented investigation into insurance broker practices, out-of-state insurance policy procurement, compliance requirements and addiction treatment centers’ documentation of medical necessity. ATAC President Stampp Corbin stated of the action, “Health Net has stopped payment for services already provided and it’s unconscionable.” Vice President of ATAC Joan Borsten added, “There are bad players in every industry, but this dragnet is too broad.” She added that some treatment centers coalition report being owed $1 million or more by Health Net for residential or outpatient care.
Insurance fraud is a problem that should not be tolerated on any level, and the loosely-regulated addiction treatment industry has had its share of bad apples. The persecution of reputable and certified treatment centers that are compliant with state and local regulations, however, is incomprehensible, vicious. America is in the grips of an opioid epidemic, and burdening quality health care providers with onerous paperwork and spurious accusations is a dangerous distraction. Facilities that face unnecessary and lengthy audits and litigation waste valuable time and resources that could be spent on treating patients. Everyone loses—the state, the local community and the individual patient.
Humanity at Stake
The opioid crisis is now a national emergency, according to President Trump and the Commission on Combating Drug Addiction and the Opioid Crisis. The epidemic threatens individuals, families, communities and the very fabric of this country. Skyrocketing rates of opioid addiction and fatal overdoses has strained state and local resources, the facilities dedicated to treating patients, and communities intent on saving lives. Wasting time and money persecuting top-flight health networks that are dedicated to helping people overcome addiction is inhumane, even immoral.
Unfortunately, for a handful of unethical businesses, the crisis is about money and not lost lives. According to Modern Healthcare, Centene CEO Michael Neidorff is one of the highest paid health insurance executives, raking in nearly $23 million in 2016. More than $13 million of Neidorff’s earnings were from stock award and stock option values. But aren’t we all stakeholders in eradicating the opioid crisis? Sadly, it seems the return on investment—the health of our nation—has no value to certain folks.
About Sovereign Health
Sovereign Health is a national leader in the treatment of addiction, mental illness, and co-occurring behavioral health disorders. Using evidenced-based medicine and measurement-based care, we provide the highest standard of care from assessment to discharge through our highly experienced, professionally licensed staff. We specialize in the treatment of alcohol and drug addiction, trauma, mental illness, eating disorders and other conditions. We accept most major insurance plans and financing is also available through MyTreatmentLender.com. If you or a loved one is struggling with addiction, please call our 24/7 helpline today.