Medicaid provider target of lawsuits
Subsidiary granted five-year contract
New Mexico’s newest Medicaid provider has a connection to multiple lawsuits alleging improper care in the state’s prison medical system.
Western Sky Community Care, a subsidiary of the St. Louis, Mo.based Centene Corp., was one of three organizations selected by the New Mexico Human Services Department this month for a fiveyear Medicaid contract known as Cenntennial Care 2.0.
Several Centene subsidiaries have participated in the health care industry in New Mexico in recent years: Celtic Insurance Co. offered an individual PPO plan to New Mexicans in 2016; Health Net Federal Services, a managed care contractor for Tricare, began covering U.S. military personnel in New Mexico earlier this year; and Centurion Correctional Healthcare of New Mexico LLC, a joint venture between Centene and the Virginia-based MHM Services Inc., which won the state’s prison medical services contract in May 2016.
Centurion has been the subject of at least 17 lawsuits since it began its contract, according to a recent investigation by the Santa Fe New Mexican. Court records show that the suits include allegations of improper care and wrongful death.
In a statement, Centene’s senior vice president and chief communications officer Marcela Manjarrez-Hawn said the company had “inherited a program that had a significant amount of staff vacancies and backlogs of patients to be seen.”
“While we are named in several of the complaints referenced in the recent article, many of these issues manifested prior to our entering the market,” said Manjarrez-Hawn in the statement. “We employ a dedicated team of clinical operations auditors that performs routine audits at our facilities and is an integral component of our continuous quality improvement initiatives. Finally, Centurion’s contract with the New Mexico Corrections Department includes clinical and operational performance measures that are audited by NMCD.”
A spokeswoman for the Human Services Department said the state had no comment.
In addition to Western Sky, the state also selected Blue Cross Blue Shield of New Mexico and Presbyterian Health Plan to administer its Medicaid program beginning in 2019. Two companies, United Healthcare and Molina Healthcare, which had previously administered the program alongside Blue Cross Blue Shield and Presbyterian, were not awarded the new contract.
About 675,000 people are insured through Medicaid in New Mexico, according to the Human Services Department, roughly one-third of the state’s population.