Sunday, November 05, 2006

Amerigroup Fined

Last week, as reported by Bloomberg, and the Associated Press (here through ABC News), "Amerigroup Corp, which manages government health ploans for the poor, must pay at least $144 million in damages for wrongfully denying coverage to pregnant women eligible for Medicaid, a jury found. The jury today awarded the plaintiffs, which included the U.S. and Illinois governments and a whistleblower former employee, $48 million. That amount will be tripled under federal law." This is "the eighth-largest jury award of any trial in 2006, according to data compiled by Bloomberg."

According to the AP, "Federal and state prosecutors as well as a whistleblower said that while marketing its services in Illinois, Amerigroup avoided pregnant women and others likely to run up high doctor bills. That cheated the government, which was subsidizing the company to market its services evenly among all low-income patients regardless of whether they were pregnant or had costly illnesses, the attorneys said."

AP also reported that " Jurors saw a videotape in which one executive said he always sought out 'the healthies' when signing up patients for the HMO. Jurors also saw a number of e-mails in which company officials spoke positively about limiting the number of pregnant women enrolled."

That's some kind of health insurance, that seeks out "the healthies," and tries to avoid anyone who might actually have medical bills. This shows how far the concept of managed care, at least the commercial version of it, has sunk, from managing care to make it more efficient to figuring out ways to discourage anyone who might actually need care from enrolling.

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