Jackson Jambalaya

My usual cynical prediction: they get paid based on how much service they deny.

You are an incredible journalist Kingfish. The best in the metro.

This is the story. I believe they are making A LOT more denying the Medicaid/Medicare rolls.

The HealthCare bill is a license to drop a great number of folks that
should be on the rolls.

The requirements are so outlandish that they are driving folks away from what WAS supposed to keep people unable to afford healthcare, healthy.

What is ironic is the result of all of this will be (we will soon see) further impoverishing and hurting working (barely making it) families who want to keep their families healthy.

But how do you shift the families who really want to keep their families healthy from the others who are abusing the system?

Which entity is a party to the injunction? If the injunction was issued before the corporate name change, then the new corporation should not be protected by the injunction. Please check on this and see if this helps you get around the injunction. This company is a piece of shit for what it is doing to disabled children in our state.

Seems odd that how much a vendor is being paid is somehow a trade secret. Where do you draw the line on that one? Anyone selling anything to the state could make that argument. I can understand how they'd want it kept quiet during the bid process, but after the contract is let?

Something's funny about this one. Has the bidding process been remotely competitive, or do these guys have the inside track every time? They're on their third four year contract? Why four years? Lots of unanswered questions here, and I suspect that someone's brother in law is on the payroll somewhere for this to be so obviously rubber stamped by the state with no way for anyone to check it. Another example of health care dollars that can be saved. Good job, KF. Bill Billingsley

Way back in the day I once worked for Mississippi Medicaid. Could not believe who was in charge at the top implementing programs that come always from neighboring States. Now who is Holland trying to convince himself or me that he doesn't know about THE TOP CONTRACTORS and now the scary part, he may not know. Thank You Kingfish.

" Records furnished to public bodies by third parties which contain trade secrets or confidential commercial or financial information shall not be subject to inspection, examination, copying or reproduction under this chapter until notice to said third parties has been given, but such records shall be released within a reasonable period of time unless the said third parties shall have obtained a court order protecting such records as confidential."


Actually, it is ridiculous that it takes a court order for a company to be able to protect such information in MS.

http://www.medicaid.ms.gov/bids.aspx

3.14.2 Confidentiality of Proposals and Contract Terms
After award of the contract, all Offeror’s proposals, including those terms bid in the Business Proposal,
are subject to disclosure under the State’s Access to Public Records Act and the Federal Freedom of
Information Act. Information specified by an Offeror as proprietary information shall be available for
disclosure as provided by State statute.
In the event that either party to this agreement receives notice that a third party requests divulgence of
confidential or otherwise protected information and/or has served upon it a subpoena or other validly
issued administrative or judicial process ordering divulgence of confidential or otherwise protected
information, that party shall promptly inform the other party and thereafter respond in conformity with
such subpoena to the extent mandated by State law. This provision shall survive termination or
completion of this agreement. The parties agree that this provision is subject to and superseded by
Miss. Code Ann. Section 25-61-1, et seq. regarding Public Access to Public Records.

7:40 AM: BS. If anything,the judge should've redacted all trade secrets. There is also no excuse whatsoever for taxpayers not being allowed to know how much the state pays this contractor. I'm sorry, I know better than to believe "trust us" regardless of whether the governor is a Democrat or Republican.

Prices would be exempt from release under FOIA exemption 4 at the Federal level, so it would be reasonable to assume the same at the state level. While I agree certain aspects of the contract should be made available to the public (as in how they are paid), specific pricing information should not be released, and simply assuming that because it a taxpayer requesting the information as opposed to a competitor and should be disclosed is incorrect. Certain aspects of business should be protected in order to facilitate fair and open competition and ensure and adequate number of competitors. Anyone wanting detailed price information should apply to be a government auditor.


http://www.justice.gov/oip/exemption4.htm

According to the web site, seethespending.org, EQHealth Solutionas has been paid, since December of 2003, $50,142,547.48 by Mississippi Medicaid.

And I'll add, I bet you can find the total value of the contract if you look hard enough. Those things are usually widely publicized.

First of all, I shouldn't have to go to Seethespending.org to find out. Medicaid works for us as does that vendor. Period. Medicaid refused to divulge that information. I have looked before on Seethespending's website for HSM and EQ. Gee, considering I made the first mention of that site out of all the media in town and they advertise on my website, I might actually know about that site and how to use it.

In fact, I'm on it right now and guess what, I enter EQHealth Solutions in vendor and nothing comes up, Even spaced out EQ and Health and nothing came up.

The ONLY way I found anything was to list ALL Medicaid vendors then dig through it, obviously a bug in the system. That page claims EQ received $3,231,258 in 2009 and $3,865,941 in 2010 in fiscal year July 1 2009 to June 30, 2010. That makes it approximately $7 million. However, that is what Seethespending states, which for our purposes, I can not take as final authority and in my opinion, that is the state's responsibility to its taxpayers.

Although I didn't post the seethespending.org info, I'll respond by saying Medicaid/the state has a legal obligation to protect that information, as documented in the information I've posted earlier (reference the 8:07 post from the request for proposal).

Had to dig up to page 80 to get this one for 2009 fiscal year: $6,772,430. Nice jack.

We respectfully disagree then as I do not consider the total amount paid by year to be proprietary information and you damn well know its not. If it were how much paid per service or review or the formula used to calculate fees that would be one thing but the aggregate on an annual basis is different altogether and is not a trade secret.

You do business with the public, you have to tell how much we pay you annually.

$6,772,430. Nice jack.


Depends on their profit margin. Obviously the procuring authority felt it was reasonable at the time of the award and provided the best value. Maybe you should turn your attention there if you suspect foul play.

So do you want the entire contract as your original blog post stated, or only annual dollar amounts. Obviously annual dollar amounts should be available and are easily determinable within a certain margin of error, even if you only have the total contract and the term of the contract. If that's all you want and you've been able to find that information posted already, as you seem to have just posted, why waste additional taxpayer dollars with a request to Medicaid?

Depends on their profit margin.

Since you brought it up be big enough to share with us what margin percentage you'd be willing to live with paying this vendor.

... why waste additional taxpayer dollars with a request to Medicaid?

Providing public records in never a waste of taxpayer dollars. That is a weak dodge used by those who have something to hide and/or see no problem with keeping information from the taxpaying public.

"Since you brought it up be big enough to share with us what margin percentage you'd be willing to live with paying this vendor."


Unfortunately, I have no say in the matter. Even if I knew what their margin is, I have no more ability to comment on the fairness of it or their performance as those who are blindly saying they are being paid too much and not performing, with no facts to base their opinions upon. As long as it is in line with what the competitors bid and they are adequately performing the work, I'd have to say it is reasonable and the procuring authority made a justifiable award. Please explain to me what facts you've used to form your opinion it is not reasonable.



"Providing public records in never a waste of taxpayer dollars. That is a weak dodge used by those who have something to hide and/or see no problem with keeping information from the taxpaying public."

It is if the information desired is already available, which appears to be the case.

I posted the $50mm dollar figure from SeeTheSpending.org. All I did was input EQHealth, and "all dates" as the search parameters. There was nothing mystical about the search. There were some 80 or so payments beginning in December (I think) of 2003.

"$50,142,547.48" - hey - that's almost enough to finance another beef plant! ;-)

I was at a Health Dept meeting last week where someone mentioned we needed some data to project the future cost of something, and I pointed out Medicaid has those numbers and could easily provide the number of patients or procedures (I forget the exact details) per year. I was told they had approached Medicaid which refused to provide the state Dept of Health the numbers they need to project future costs for the DOH. Very unusual.....

Also, I thought United Health Care was now taking over CHIPs in MS, and handling all the denials (that may be a separate program).

GREAT JOB!!!
Keep diggin - I bet the dirt goes all the way up to the top of DOM. Sad day for Mississippians when a Louisiana "non-profit" company is raping our taxpayers and further disabling our children! SHAMEFUL

Interesting that 11:41am brings up United Health Care......

UHC administers Medicaid's CHIP program. HSM's former Medical Director, Joseph Blackston - MD and JD is now the Medical Director for UHC Mississippi.

Coincidence?????

Sniff, sniff....I smell a JD on this board, and I ain't talkin' bout KF. Maybe one that is on the payroll for UHC or Medicaid or this Q company? Somebody is working awfully hard to defend a boatload of secrecy.

The problem with seethespending is you have to trust the data, and I don't. So any number supplied by that website (and not to slight them, they get their #s from the state, which is who I don't trust) is questionable at best, and not the Word of God.

But thanks for trying, 9:51.

Maybe you should have your sniffer checked, could be plugged up from sniffing in the wrong places. All I'm pointing out is a few limited, broad facts as they relate to this "general area" amid wild speculation, apparently stemming from someone being unable to obtain obviously protected information (from the original blog). Best I can tell, that request was generated as a result of the company in question denying claims of families of children with downs syndrome. I sympathize, and that is the real issue that needs to be investigated and determined to be right or wrong. Instead, it appears to have spun into a financial witch hunt, and now all of a sudden they are "screwing the taxpayer", although there has yet to be anything presented that would justify that claim. Forgive me if I've offended anyone, but I have no connection to any of the parties involved, including the state of Mississippi (other than being a life-long resident) just a desire to educate the masses once in awhile when ignorance appears to be prevailing on a particular subject. Seems most people on here have convicted this company of gouging taxpayers based solely on the fact they exercised their right to protect sensitive competetive information. Like I said before, if there is something going on, then the procuring authority should be looked at first. Have a great day....
:-)

Well, well, well, lets knock this down one at a time.

wild speculation, apparently stemming from someone being unable to obtain obviously protected information

There was no "wild speculation" as you put it. Its also not obviously protected information as the court order was silent on annual fees paid to HSM. No one accused anyone of doing something wrong, just found it very curious a company was fighting to keep the people from learning how much they get paid and asked why the Division is so eager to interpret a court order broadly in their favor.

Best I can tell, that request was generated as a result of the company in question denying claims of families of children with downs syndrome. I sympathize, and that is the real issue that needs to be investigated and determined to be right or wrong.

Wrong. If you'd read my entire post, which you clearly did not do, I stated I first inquired about HSM's funding 4 years ago, long before that hearing last week. pay attention.

Instead, it appears to have spun into a financial witch hunt, and now all of a sudden they are "screwing the taxpayer", although there has yet to be anything presented that would justify that claim.

What financial witch hunt? ASKING HOW MUCH WE PAY A CONTRACTOR IS A WITCH HUNT??? I probably would have never made that post if Medicaid and HSM had refused to answer some simple basic questions. No one has accused them of screwing the taxpayer either. My motivation is the same as the Seethespending people: to find out where the money goes.

Seems most people on here have convicted this company of gouging taxpayers based solely on the fact they exercised their right to protect sensitive competetive information.

Once again you are putting words in my mouth as well as others. No one has convicted them or accused them of anything. I'm sorry, how much they are paid is NOT sensitive competitive information no matter how much you spin it that way. Its our damn money. period.

Found this on Medicaid's website:

Contract for $20 million for two years

"Found this on Medicaid's website"

First of all, glad you were able to find it at the link I posted earlier.......

Found it on different page smartass.

Now, to address your other items, I will say, based on the "go get'em" posts we've seen, there does appear to be a bit of wild speculation going on here. The problem appears to be laziness all around (including your research into the basis of them protecting their information). The company...the simple thing to do is say everything is protected. Run it up the flag pole and see if it flies. It takes very little time and effort, and minimal expense. From there, it is up to someone else (I'm not familiar with who in the state arena, but at the federal level a FOIA liason ) to counter and say they agree or disagree and state that some of the information is in fact not protected and releasable. Is it the department of Medicaid or the Court...I'm not really sure, but the fault doesn't appear to lie with the company, but the Government at some level. Likely laziness on the Division of Medicaid's part if I had to guess. They really don't sound like they care to put much effort into it from what I've seen here. Likely though, as you have already stated, the reason for the initial request is to obtain detailed pricing information, and once the effort was made to deny that, the original requestor did not pursue it further. That's the way these things usually play out.

Regarding speculation, we've seen several posters come on here and pile on that the taxpayers are getting ripped off (those would be the folks convicting and accusing, although you have definitely insinuated there is something to hide). I realize you said you inquired into this four years ago, but it appears there was nothing to see back then. Either way, press on, your doing a "damn" fine job. My point, you shouldn't fault a company for following standard business practices allowed by law. If anyone should be pressed, it should be the division of medicaid. Until then, the subtle hints regarding the company seem to have the uneducated readers jumping to conclusions that are a bit premature. Like I've said before, all I'm doing is encouraging you to focus your energy in the proper direction for now, until facts dictate you do otherwise.

Yeah, the link itself was actually found on the linked page I posted, if you want to get ticky about it ;-).

Laziness?


Go fuck yourself.

Quite the poetic "white flag" of surrender.

Why is HSM or whatever its called, exempt from MS Accountability and Transparency Act (MATA) of 2008?

Hey 2:06 and 3:33:
> Have you ever dealt with HSM?
> Do you know what horrible tactics these people utilize to deprive our most vunerable citizens from needed services?
> Have you ever had to meet their ridiculous paperwork requirements - 10 pages TYPED on THEIR forms just to request services?
> Have you ever had to jump through their hoops?
> Have you ever dealt with their "One Day Timeframe for Additional Information" which is sent via fax on Fridays at 4:59pm?
> And, If you didn't respond in time, your case was suspended and you had to start all over again on behalf of your patient?
> Have your ever spent hours of your personal time finding research and evidence-based practices to quote inorder to justify your request to care for your patient; only to be mocked and denied services?
> Have you ever had to work so hard to convince an anonymous reviewer why your patient needs 60 minutes instead of 30 minutes of services once a week? Only for the reviewer - who has never met your patient, tell you that your patient can't pay attention to you for more than 30 minutes?
> Have you ever had to explain to a cargiver that HSM did not approve services because it's not necessary for their loved one to be able to...
communicate wants/needs?
swallow their food?
hold their head up?
sit up?
roll over to prevent bedsores?
walk?
go to the bathroom instead of a diaper?

HAVE YOU EVER DONE ANY OF THE ABOVE?????? IF NOT, THEN YOU HAVEN'T DEALT WITH HSM!

Would you want YOUR quality of life DICTATED by this company that HIDES legitimate information? I think not!

Actually I think this Louisiana Company's tactics may be another way of keeping the Great State of Mississippi DEAD-LAST in the measures of morbidity, disability, quality of life, and access to healthcare - all of which would be self-serving for LA!

Now I'm sure you HSM BL0-jobbers will spit up instead of suffocate at the reality of it all!

On the nosey, 7:49. We need far less - not more, as Obamacare would have us suffer - bureaucracy in health care. If the unnecessary people between the provider and the patient could be removed, the cost of health care would doubtless be reduced. We don't need a clerk - or a desk bound physician who hasn't seen a live patient in years - telling the people who are putting their hands on the patient what to do based on how much it costs. The bureaucracy that's been put in place to keep the cost of health care from going up has caused the cost of health care to go up faster and further than it would have if it had been left alone. Put the doctor back in charge of taking care of the patient. Bill Billingsley

Tell it, 7:49. Aside from the money and secrecy issues here, please do not lose sight of the fact that this company is causing lasting and irrevocable harm to many, many disabled children through its denial of services. The practices of this company are just pure evil, and they know what they are doing to these children. I really don't know how these people sleep at night.

Who is this Blackston person? Is he the guy with a son at St. Andrews?

DITTO WITH 10:27 pm.

Any healthcare person that works for HSM and has any integrity should not be able to sleep at night!!! How could they: especially what providers witness on a daily basis...

Sounds like a great investigation for MSNBC.

Great point Bill. Folks seem to be missing where the fault actually lies and are unable to see that the root cause of the problem is the program and regulations themselves that have been put in place by the government.


Regarding the post at 7:49, I'm sure it is a conspiracy not only by the Louisiana company but the state of Louisiana itself to ensure Mississippi is ranked 50, so Louisiana can preserve a prestigious ranking of 49. Some of you folks are just plain quacks.

"If the unnecessary people between the provider and the patient could be removed, the cost of health care would doubtless be reduced."

That is soooooo wrong. If someone else is picking up the tab, then the provider has an incentive to bill for as much as he can.

People with so little grasp of how health care works should not be blathering about "Obamacare."

1:14, if you know so much more than I do about how the health care system works just sign your name to your next post and I'll be glad to educate you as to why your comment is wrong. Bill Billingsley

Oh, so my comment is wrong only if it's signed?

Funny how your signature doesn't make your comments one bit smarter.

No, but it at least shows that I'm brave enough to stand behind what I say. Frankly, unless you feel equally strong about your position I'm not inclined to waste a lot of time blathering about it. Suffice it to say that I've spent 35 years or so in various aspects of the health care delivery system, and I think I know how it works better than you do. But, as my daughter used to say, thanks for playing. Bill Billingsley

Don't know about you 1:14PM, but I am smart enough to take my dental insurance premiums to my dentist and negotiate a plan directly with them. Stop your reliance on the government and do it yourself. It is much more liberating. Also, in this regard, if folks want health care why not do the same for your family doctor. Health insurance should be for catastrophic occurances, not for colds.

1:14 First visit to our planet? You sure don't seem to know anything about hos physicians actually get paid.

BB: Try adding this one for some variety: "Next contestant please!" ;-)

I'm very happy for BB that he has a job where he doesn't have to stay anonymous online.

The rest of us should just keep our mouths shut, apparently.

But since all he's got is alleged authority and a signature to support his claim, his argument amounts to "does not!"

Centene

Magnolia Health Plan

111 East Capitol St
Suite 450
Jackson, MS

This company has got a piece of the Medicaid pie also. This pie has been split with UHC and they will send case managers to various facilities for concurrent revew. They will also have offices in Yazoo City and a few other areas.

Medicaid will definitely change their game plan in January 2011.

Letters will soon be sent and requesting Medicaid recipients to choose eithe UHC or Magnolia Health Plan. If no response, a computer will make the decision for you.

Check it our KF :-)

Why am I not surprised?

Nov. 13 @ 3:21 is describing the new MississippiCAN program.
So beginning Jan 1, 2011 certain Medicaid beneficiaries will have to choose between MHC or UHC to coordinate all their care.

One of the targeted groups is (drumroll please)...... "Disabled Child Living at Home".

Within this new program, beneficiaries services will ONLY be paid to providers that are members of these two Networks. What happened to Medicaid's own policy that gives beneficiaries the "Freedom of Choice of Providers"????

Dr. Robinson, why don't you find another population to pick on?