A healthcare company hired to manage a program for elderly Texans as part of a broad privatization plan was fined more than $1 million by the state in the past year over mounting complaints that included delayed or denied medical care. According to The Dallas Morning News, Evercare of Texas, a unit of Minnesota-based UnitedHealth Group, has been under fire by some powerful Texas lawmakers over its management of preventative and long-term care for the state’s most vulnerable. The news started a four-part investigative series last month.
Last February, the Texas Health and Human Services Commission fined Evercare $645,890 after a flood of complaints that doctors weren’t accepting Evercare soon after the expansion of Texas’ Star Plus program. That plan uses an HMO model to deliver acute and long-term care for elderly and disabled Medicaid patients. A month later, the commission fined Evercare another $70,725 for payment and service infractions. The most recent fines, totaling nearly $400,000, were in reaction to mounting complaints about the North Texas program.
Evercare is part of a vast expansion of healthcare outsourcing that state officials believe is saving the state millions of dollars. Since 2003, the state has paid Evercare and other UnitedHealth units more than $1.2 billion to provide managed care to more than 255,000 Texans under four programs. Texas is near the bottom among the 50 states in per-capita spending on health and human services, but it is a leader in outsourcing these functions to private contractors.
Source: Associated Press
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