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A directive to craft a request for proposals (RFP) in such a way as to favor a specific vendor during a meeting of top administrative officials in 2010 may have violated the state’s bid laws and opened the door to charges of bid-rigging, according to a former State Senator who spoke with LouisianaVoice on Wednesday.

That meeting may also have been instrumental in the decision by then-Commissioner of Administration Angéle Davis to resign her position in early August of 2010.

Former State Sen. Butch Gautreaux (D-Morgan City), who was the State Senate’s representative on the Office of Group Benefits (OGB) Board of Directors, told LouisianaVoice that the meeting was held to discuss an RFP from vendors to provide health care coverage to state workers in northeast Louisiana.

Gautreaux said he was told by then-OGB Executive Director Tommy Teague that he (Teague) was directed by Timmy Teepell to “write a tightly-written RFP” so that only one company could meet the bidding criteria.

Teepell was Gov. Bobby Jindal’s Chief of Staff at the time of that meeting. Besides Teague and Teepell, also in attendance at that meeting were Jindal’s Executive Counsel Steve Waguespack who would succeed Teepell as Chief of Staff, and Davis.

Teague, contacted Wednesday by LouisianaVoice, confirmed the substance of Gautreaux’s story, though he said he was by now somewhat vague as to who was in attendance. “That happened so long ago,” he said, “but the gist of what he says is correct.”

Davis announced her resignation on June 24, 2010, though she stayed on until Aug. 8 when she was succeeded by Paul Rainwater. Teepell resigned in October of 2011.

The vendor that Teepell was most likely referring to was Vantage Health Plan of Monroe which currently holds two separate contracts with OGM worth a combined $53 million.

One of those contracts, for $45 million, is a one-year contract to provide a health maintenance organization (HMO) and hospitalization provider network plan and runs from Jan. 1, 2013 through Dec. 31 of this year. The second, for the same time period, is for $8 million to provide a Medicare Advantage plan for eligible OGB retirees. That plan, similar to ones offered by Peoples Health and Humana in South Louisiana, would be available only to those retirees eligible for Medicare. Retirees hired prior to 1986 and who have never worked in the private sector long enough to qualify for Social Security would not be eligible for the latter plan.

Vantage Health Plan has held 11 state contracts in all, totaling nearly $325 million at least as far back as former Gov. Mike Foster’s second term. The first, for $6.7 million, was for three years, from July 1, 2000, to June 30, 2003, to provide medical services for active and retired plan members.

Under Foster and into former Gov. Kathleen Blanco’s term, Vantage held two contracts: one for $46 million that ran three years, from July 1, 2003, to June 30, 2006 to provide an HMO program, physician and hospital provider network, and a one-year contract, from July 1, 2006 to June 30, 2007, was for $30 million to provide HMO services for state employees.

In Jindal’s first year in office, 2008, OGB issued a $9.925 million contract that ran for 30 months, from July 1, 2008, through Dec. 31, 2010, for Vantage to provide a Medicare Advantage plan for eligible retirees.

The following year, a $20 million contract for only 10 months—from Sept. 1, 2009, to June 30, 2010—was awarded to Vantage to provide an HMO plan to OGB members.

In 2010, Vantage received its biggest contract for $70 million for only 22 months, to run from July 1, 2010 to Aug. 31, 2012 for an HMO plan. That contract was one of four contracts with Vantage totaling $161 million that overlapped between July 1, 2010 and June 30, 2013.

Other contracts included:

  • One running from Jan. 1, 2011 to Dec. 31, 2012 for $14 million for Medicare Advantage plan for eligible retirees;
  • One for $10 million for only three months, from Sept. 1, 2012 to Dec. 31, 2012 for a medical home HMO plan for members;
  • One for $65 million for two years, from July 1, 2011 to June 30, 2013 for an HMO plan.

The obvious question is: Why Vantage?

For openers, Vantage and its officers have been active in writing checks for state politicians.

Gary Jones, president of Vantage, has personally contributed at least $20,000 to state politicians since 2003, including $10,000 to Jindal and $5,000 to former Gov. Blanco.

Michael Ferguson, a director of Vantage Holdings, Vantage Health Plan’s predecessor, gave $4,000 to state office holders, including $1,500 to Rep. Frank Hoffman (R-West Monroe) who serves as vice chairman of the House Health and Welfare Committee; Matthew Debnam, also a director of Vantage Holdings, $1,000 to Hoffman, and Terri Odom, also a Vantage Holdings director, $500 to Hoffman.

But it is Vantage Health Plan itself that is the biggest player in lining the pockets of state politicians.

Vantage, since Jan. 1, 2003, has kicked in no less than $61,900 to candidates. These include $1,000 to Jindal, $2,000 to former legislator Troy Hebert who now serves as director of the Office of Alcohol and Tobacco Control (AGC), $1,500 to House Speaker Chuck Kleckley (R-Lake Charles), $16,000 to Insurance Commissioner Jim Donelon and $5,000 to Sen. Mike Walsworth (R-West Monroe), among others.

While these contributions are all legal, they do raise the recurring issue of influence buying at all levels of government. And it is the $70 million contract in 2010 that raises the issue of possible bid-rigging. And while there may well have been no such attempt, if Teepell did indeed issue instructions to Teague to craft the RFP in such a way that only Vantage would meet the bid criteria, then the administration crossed a serious legal line for which it must be held accountable.

It was subsequent to that 2010 meeting and only weeks before the contract was awarded that Davis submitted her resignation and Teague was gone the following year on April 15, 2011.

This claim should spark investigations by the Inspector General’s office, the Attorney General, the East Baton Rouge District Attorney’s office and the U.S. Attorney’s office—the latter because federal Medicare funds were involved in several other Vantage contracts.

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Former Department of Health and Hospitals (DHH) Secretary Bruce Greenstein has been indicted by the Louisiana Attorney General’s Office on nine counts of perjury stemming from a lengthy investigation of his involvement in the awarding of a $183 million contract to a company for which he once worked.

Greenstein is accused in four counts of lying under oath to the Senate and Governmental Affairs Committee during his confirmation hearings of June 8 and June 17, 2011 and five counts of lying to an East Baton Rouge Parish Grand Jury on June 3 of this year.

Greenstein was appointed head of DHH in September of 2010 and was terminated by the governor’s office on May 1, 2013 when it was learned that the FBI had begun an investigation of the state’s contract with Client Network Services, Inc. (CNSI) as far back as January, 2013 when records of the state’s contract with the company were subpoenaed.

When the FBI probe became known in late March, Jindal immediately cancelled the CNSI contract and Greenstein announced his “resignation” a short time later, though he was allowed to remain on the job until May 1.

The indictment that came down on Tuesday (Sept. 23) is the first time that it was revealed that Greenstein did not resign, but was terminated and apparently allowed to announced that he had resigned.

There was no immediate word of the status of the federal investigation of CNSI and Greenstein but legal observers said Tuesday that pressure will most likely be applied to Greenstein to cooperate with the investigation.

Assistant Attorney General David Caldwell said that while the indictment is for perjury, “it really stems from the entirety of the activity in the awarding of this contract” and the grand jury will remain empaneled to do additional work on the case.

At his confirmation hearings, Greenstein first refused to tell legislators who had won the contract to provide Medicaid billing services for the state but under unrelenting pressure and scolding from legislators, as well as threats of his not being confirmed, he finally admitted that CNSI, his old employer from Washington State, was awarded the contract.

Greenstein, however, insisted that he had built a “firewall” between himself and the selection process and had not intervened in the deliberations, nor had he had any contact with CNSI officials.

It was subsequently learned from emails and text messages subpoenaed by the committee that he had had thousands of text messages and hundreds of phone calls from CNSI officials during the bidding and selection processes.

It was also learned that Greenstein had learned that CNSI was initially not qualified to bid on the contract and that he had added addendums to the bid requirements that made the company eligible.

Counts 1and 2 of the indictment cited his testimony under oath in a response to a question from Sen. Rob Marionneaux that he did not know if CNSI was unqualified under the original request for proposals and became eligible only after the addendum was added to the bid specifications.

Counts 3 and 4 involved his responses to Sen. Karen Carter Peterson about his emails to and from CNSI founder Adnan Ahmed relative to the addendum that made CNSI bid eligible.

The remaining five counts, all for lying to the grand jury, involved charges that he lied about email communications with CNSI, about a directive to DHH personnel forbidding contact with bidders and whether or not the directive applied to Greenstein himself, about his false testimony regarding legal advice he said he received from DHH staff attorney Stephen Russo, and his false testimony regarding his confrontation with DHH and administration officials prior to his June 17 Senate testimony and their efforts to learn the truth about his contacts with CNSI.

Interestingly, none of the counts was for bid-rigging or public corruption, leaving observers to speculate while waiting to see what other charges might be forthcoming as the grand jury continues its investigation.

For the full text of the indictment, go here: INDICTMENT

Of course, he has not been convicted of any of the charges as yet but if prosecutors are able to flip Greenstein, things are going to get pretty interesting around the State Capitol and in Washington State in the coming weeks and months.

And it’s not very likely that he will take the full brunt of the charges if he has committed any wrongdoing. That is, if he can implicate others further up the line.

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If further evidence is needed that Kristy Kreme Nichols and Susan West are trying to shovel water with a pitchfork in their efforts to put a good face on the looming changes in the Office of Group Benefits (OGB), LouisianaVoice has learned of more developments that aren’t very pretty and which are sure to only intensify the confusion and indecision accompanying the pending open enrollment period that begins on Oct. 1 and runs through Oct. 31.

And now you can add another name to the mix—that of newly hired (at $106,512 per year) Group Benefits Administrator Elise Cazes, formerly an executive with Blue Cross/Blue Shield of Louisiana, which serves at the OGB third party administrator for OGB’s preferred provider organization (PPO).

Nichols, meanwhile, keeps churning out all those happy face news releases—some even written by Gov. Bobby Jindal’s communications officer Mike Reed but published in the Baton Rouge Advocate under her byline—in an attempt to assuage the concerns of some 230,000 state employees, retirees and dependents now covered by OGB.

But now, in addition to the administration’s losing credibility with its rosy assurances in Louisiana, OGB customer service efforts appear to be coming unraveled in California—and perhaps even Florida—at a cost of $1 million to Louisiana taxpayers.

A week ago, we told you about the state’s $1 million contract with Ansafone of Santa Ana, California, and Ocala, Florida (okay, we first said it was Answerphone of Albany, New York and that the contract was for $2 million, but our IT (I’m Telling) source in Nichols’ office was incorrect on those points).

At any rate, the state hired Ansafone to hire 100 persons in California and another 100 in Florida to man phone banks to field questions from OGB members. Not only was it absurd (not to mention heartless) to fire two dozen OGB employees recently because there was “not enough work” for them, but to then pay an out-of-state firm to hire phone bank employees in California and Florida—employees completely unfamiliar with OGB’s proposed coverage plans—was nothing less than insulting, not to mention shortsighted and yes, stupid.

To illustrate our point, we received word today (Thursday) out of California of what can best be described as a monumental disaster in the making. The preparations being made in Santa Ana have all the clearheaded thinking of a sack of rats in a burning meth lab, to paraphrase a line from Two and a-Half Men.

It seems that the job fair for prospective employees to man the phones more closely resembled a cattle call, a term normally used to describe open auditions for movie and television parts. That’s where actors and actresses (in this case prospective telephone service representatives) show up en masse for auditions (job interviews).

Except in this case there were no interviews of any of the 80 or so applicants who showed up. Instead, they were shown a video presentation that passed for orientation at the end of which they were all congratulated on their new jobs. No interviews, no screening, no background checks. Hired.

There followed six days of “training,” that consisted of the reading of handouts distributed to the new employees. “They read to us verbatim from a two-inch-thick document,” said one of the hires who asked that his name not be revealed. “Half of those there kept falling asleep.”

He said the OGB representative, Elise Cazes, asked for feedback from the new employees, some of whom failed to return for the second day of “training.”

“It was not until our first day on the phones that they told us the information they had tried drilling into us was wrong,” he said, adding that they were told to instead use “the knowledge base on the computer.”

He said the problem with that was the knowledge base, which contains a dozen or so links “only comes up when there is a call coming through,” making it impossible to access the data in advance.

“If I take a call, I like to be able to answer questions without having to put him on hold while I search for the proper link to access so the caller does not think I don’t know what the hell I’m doing,” he said.

“I expressed my concerns about this and I asked for printouts of the correct information. I thought they were serious when they said they wanted feedback. I was wrong. Wednesday was my day off and I was called at home and told the client no longer wanted me on the project.”

The “client,” he said, was OGB and the directive came from Cazes.

At least you have to give her credit: she certainly learned quickly that dissention is not tolerated by Jindal and his hand puppets.

Our source said the people Ansafone and OGB have answering insurance plan questions “are grossly unprepared for the questions that plan members have or are going to have with open enrollment begins. The slapped everything together,” he said.

“My last day there (Tuesday) they were still purchasing computers and setting them up. They ran out of room and had to set up in a warehouse with no air conditioning,” he said. “They were running fiber optic cable and wires everywhere.

“I feel bad for these people who are going to be calling. They’re (OGB and Ansafone) are doing everything on the fly. The system is middle school at best. There are going to be dropped calls, incorrect answers and a multitude of other problems,” he said.

He said members who do not select a plan or who do so incorrectly will be automatically defaulted to the Pelican HRA 1000 plan which is the least desirable of the four plans OGB will offer next year.

As you read this, keep in mind that Ansafone’s web page somewhat prophetically contains its “five Star Recipe for Customer Service Failure.” http://www.ansafone.com/five-star-recipe-for-customer-service-failure/

Oops. Looks like that page has been taken down since we called attention to it last Friday. Perhaps Ansafone took one look at the OGB open enrollment plan and saw customer service failure in the cards. And a million bucks can cause you to compromise on otherwise strongly held principles.

Nevertheless, the recipe is was so rich in irony that we can’t resist giving you the three main ingredients again:

  • A “tablespoon of no communication.”
  • A “dash of not caring.”
  • “4 ounces of empty promises.”

OGB members may wish to start a check list to keep score on the accuracy of that recipe just for the fun of it.

The legislature is scheduled to review the OGB Health benefits in the Joint Legislative Committee on the Budget on Friday (Sept. 19) and in the House Appropriations Committee next Thursday (Sept. 25).

Additionally, OGB has scheduled a series of meetings throughout the state during October to answer questions about the open enrollment.

https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A497A4F4445794D793551524559334D6A4531

The information OGB has supplied for annual enrollment leaves many questions unanswered.

One reader has compiled a list of questions that need to be answered before making an informed choice. The questions that should be posed to OGB during these hearings are as follows..

  • The flexible benefits guide for 2015 is not on the website.  Are the IRS maximums of $2500 still applicable?
  • The benefit comparisons do not include any mention of laboratory and radiology services. Are these subject to the deductible? Also, what are the co-pay and/or co-insurance amounts for each plan?
  • Annual mammograms are currently covered with no charge for OGB members. Will this continue? What about pathology for well women pap-smears?
  • Are the co-insurance amounts computed on the contract rate for in-network providers? What about the co-insurance computation for out of network providers—is this on the contract rate or provider charges?
  • Are the listed deductibles for in-network providers a separate amount from the listed deductible for out of network providers? Example, is the total deductible for in-network and out-of-network providers for Pelican HRA 1000 $2000 + $4000 for $6000 deductible? Is this the same answer for all plans?
  • For Out-of-Pocket Maximums (OOPM), once the OOPM is reached, are all services/benefits covered at 100%? Are the OOPMs for in-network providers a separate amount form the listed OOPM for out-of-network providers? Example, is the total OOPMs for in-network and out-of-network providers for Pelican HRA 1000 $5,000 + $10,000 for $15,000 OOPMs? Is this the same answer for all plans?

The problem is the only ones who might have an interest in the OGB open enrollment and the options offered are state employees.

And state employees who ask questions are subject to being teagued.

Ah, but there is a silver lining.

All the meetings, including the legislative committee meetings, are scheduled during the work day which makes it difficult, if not impossible, for many state employees and teachers to attend.

So it appears your jobs are safe for now even if your medical coverage is not.

Whew! That was close!

 

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Two audit reports released this week by Legislative Auditor Daryl Pupera’s office focus on documentation of expenses related to hurricane recovery and costs incurred by the state for vacant office space in downtown New Orleans as part of a costly incentive package to induce Saints owner Tom Benson to keep the NFL team in New Orleans

The first indicates that the Governor’s Office of Homeland Security and Emergency Preparedness (GOHSEP) has invoices for more than $49 million in exceptions, or undocumented expenses by disaster recovery specialists in the perpetual recovery efforts of hurricanes Katrina, Rita, Gustav and Ike.

The other, which we first wrote about in February of 2013, smacks of the kind of political back scratching for which Louisiana has become famous: the state’s capitulation to New Orleans Saints owner Tom Benson as part of a costly incentive package to induce him to keep his team in New Orleans. Part of that package included the state’s leasing of office space in his Benson Towers office building at inflated rental rates, a deal that appears to border on financial irresponsibility.

The report says that auditors evaluated 4,476 expense reimbursements totaling $711 million submitted by disaster recovery “specialists,” and found 665 “exceptions” totaling nearly $49.6 million.

Pupera explained that the questioned expenses do not necessarily indicate fraud or mismanagement but rather a need for more thorough documentation and justification for the invoices. “The money has been allocated but because it’s federal money, we want to be sure that all invoices are adequately justified before they are paid so we won’t have the feds coming back later and asking for their money back,” he said.

He said the exceptions fall into five different categories: contract work ($42.56 million), force account labor ($3.8 million), force account equipment ($1.3 million), materials ($1.8 million) and rented equipment ($88,000).

Other questionable costs included:

Expense reimbursements of $6.6 million which exceeded cost estimates;

Expense reimbursements of $22.7 million not supported by invoices, receipts, lease agreements, contracts, time records, equipment logs, inventory records of other documentation;

Purchases and contracts totaling $11.6 million which did not comply with federal and state procurement requirements;

Expense reimbursements of $11.6 million which did not comply with federal and state procurement requirements;

Expenses of $2.1 million in work which did not comply with FEMA regulations and guidelines;

Duplicate, omitted and/or miscategorized expenses of $5.7 million.

Pupera said once issues raised by auditors are addressed by GOHSEP, most of the expenses will be properly documented for payment. “There may still be some exceptions at the end, but a large majority are expected to be justified,” he said.

Benson purchased the 26-story Dominion Tower in September of 2009 and re-named it Benson Tower. He made the purchase after entering into a generous—to Benson—agreement whereby the state gave away the store to keep the Saints from moving to San Antonio.

One of the stipulations, which expired a couple of years ago, called for visiting teams’ players, coaches, and support staff to pay state income taxes on one-sixteenth on their annual salaries (because they played one of their 16 regular season games in New Orleans, thus earning a 16th of their income in the state). Once that money was received by the Louisiana Department of Revenue, the department immediately issued a check for an identical amount payable to Benson.

Another obligates the state to pay Benson a cool $1 million whenever the NFL awards a Super Bowl to New Orleans.

Benson Tower is located across the street from the Mercedes-Benz Superdome. As part of the deal struck between Benson and the state, the Jindal administration agreed to a 20-year lease of some 325,000 square feet of office space at $24 a square foot for various state agencies, some of whom were paying as little as $12 a square foot before being forced to move to Benson Tower in 2011.

At the outset, the state’s obligation was about $7 million a year, $2.4 million more than the $4.6 million the state was paying before the move.

Included in the Benson Tower purchase was a 60,000-square-foot plot encompassing a one-block section of LaSalle Street and part of what once was the New Orleans Centre shopping mall. That facility is now known as Champions Square where Saints tailgate parties are held. Anheuser Busch, makers of Budweiser Beer, has exclusive rights for beer concessions at Champions Square after striking a deal with the Louisiana Stadium and Exposition District (LSED), also known as the Superdome Commission.

Benson, the seven LSED members (each of whom is appointed by the governor) and their families, businesses and business associates, the Mercedes-Benz Superdome management firm, and Anheuser-Busch distributor Southern Eagle Sales & Service combined to contribute more than $203,000 to Jindal campaigns between 2003 and 2012.

Prior to the Benson Tower deal, the average cost per square foot for state agencies leasing office space in New Orleans was $17.66. In 2012, the first full lease year in Benson Tower, the cost per square foot was $23.78. Rent at the building is tied to the consumer price index and today the cost per square foot is $25.10.

The Louisiana Attorney General’s offices were never relocated to Benson Tower because of a lack of 24-hour access to parking facilities.

The $7.4 million now being paid does not include $625,000 being paid by the state for 24,900 square feet of vacant office space in the building. That amount bumps the state’s annual rent up to $8 million per year.

The audit report said a survey of current listing information on available office space in New Orleans, the range for lease rates is $16 to $22 per square foot, including parking, or an average of $19 per square foot.

Accordingly, for the 347,849 square feet of Benson Tower, including the 24,872 of vacant office space, the state is paying an average of almost $2.1 million per year in excess rent to Benson.

And the state is locked in until 2025—an additional payment in excessive rent of at least $23 million during the remaining life of the agreement, although the lease agreement could be extended beyond 2025, according to Mark Moses, director of the State Office of Facility Planning and Control.

In his response to the audit, Moses said the Saints were “an import part of Louisiana’s culture as well as an economic driver for New Orleans and the rest of the state.”

He said the incentive package delivered to Benson with appropriate wrapping and bows “saved the state more than $280 million in addition to adding nearly $400 million in revenue expected to be generated over the life of the agreement.”

Moses also said the number of parking spaces included in the lease rate should be included with comparing Benson Tower rental rates with market rates in New Orleans.

“Commercial Class A buildings typically include one to two parking spaces per 1,000 square feet under lease,” he said. “Based on the approximate 323,000 square feet of space under lease (the auditor’s office gives the area as 348,000), the standard commercial lease rate would include between 323 and 646 parking spaces. The rental rate for Benson Tower, however, includes 900 parking spaces in the Superdome garages.”

He added that additional parking is also available for $50 per month in the state-owned Health Education Authority of Louisiana (HEAL) garage a block from Benson Tower.

Moses also pointed out that the audit report’s comparisons of market rates failed to mention that most commercial leases of Class A buildings including “pass through language,” which requires tenants to pay a proportionate share of operations and maintenance expenses that exceed base year expenses established in the lease. Pass through rates, he said, can vary depending on operating and maintenance expenses for individual buildings and according to occupancy rates. Benson Tower, he said , does not include pass through language in its lease with the state.

 

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Remember less than two weeks ago (Aug. 14, to be precise) we wrote that members of the Louisiana Office of Group Benefits (OGB) should prepare themselves for health insurance premium sticker shock? http://louisianavoice.com/2014/08/14/nichols-pens-op-ed-on-soundness-of-ogb-even-as-legislative-fiscal-office-prepares-members-for-premium-sticker-shock/

Well, LouisianaVoice has obtained new information that indicates we weren’t entirely accurate in our portrayal of what’s in store for some 230,000 state employees, retirees and their dependents.

The reality is much worse.

Much worse indeed, particularly for state retirees.

To recap briefly, we told you in that Aug. 14 posting about the report of the Legislative Fiscal Office on pending major changes in medical coverage for state employees and retirees. Some of those anticipated changes provided in the Legislative Fiscal Officer Report, authored by Legislative Fiscal Officer John Carpenter and Legislative Fiscal Office Section Director J. Travis McIlwain, include:

  • An increase in premiums state employees and retirees pay for health coverage;
  • Significantly increase the out-of-pocket maximum for all health plan options;
  • Increasing deductibles for all health plan options;
  • Increasing co-pays 100 percent for those proposed health plans with co-pays;
  • Increasing the out-of-pocket maximum for the prescription drug benefit by $300 from $1,200 to $1,500 per year, a 20 percent increase;
  • Requiring prior authorizations for certain medical procedures;
  • Eliminating the out-of-network benefit for some health plan options;
  • Removing all vision coverage from the health plan options.

OGB Report_July 2014 FOR JLCB

The latest premium increase of 6 percent will go into effect on Jan. 1 is on top of a 5 percent increase implemented on July 1 of this year.

State Treasurer John Kennedy, on the heels of the Legislative Fiscal Office Report, penned an op-piece in the Baton Rouge Advocate in which he advised state employees to be careful to not break a leg as the increased premiums and co-payments “could cost you a month’s pay. http://theadvocate.com/home/10028534-123/gues-column-changes-mean-problems

The changes mentioned thus far are, of course, mostly the result of that $7.2 million—and growing—consulting contract awarded to Alvarez & Marsal which was charged with sniffing out $500 million in state savings over the next five years—something Gov. Bobby Jindal apparently felt his highly-paid cabinet appointees were incapable of accomplishing.

Of course Jindal’s plan for saving $20 million a year through the privatization of OGB has been less than a smashing success as the agency has hemorrhaged red ink to the tune of $16 million more per month than it receives in premiums since the Blue Cross Blue Shield of Louisiana takeover on Jan. 1, 2013.

BCBS is paid by the state on the basis of enrollees. The initial rate beginning in January of 2013 was $23.50 per OGB member per month. Today, that rate is $24.50 and in January, it will go to $25.50 per member per month.

But now LouisianaVoice has obtained information from deep within the inner sanctum of BCBS that OGB is planning even more drastic changes. So, in effect, OGB members are about to be hit with a double whammy, or in more chic vernacular, the perform storm, designed to force retirees out of OGB coverage and into Medicare.

And OGB is completely complicit in this portentous plan.

The sweeping changes are scheduled to be mailed to employees and retirees on Sept. 15 but we have the gist of the plan now.

First of all, all current plans are going to disappear, especially the one that are geared toward retirees. The PPO, or Preferred Provider Organization plan, currently has four levels: Active, Retiree No Medicare, Retiree with Medicare and Retiree 100 (a supplemental program designed for retirees with high medical costs. This program requires a separate premium and currently is only available through the PPO plan).

Now, though, there will be only four plans and none will have levels geared toward retirees, meaning that retirees will be paying more out of pocket. This is the method by which Jindal, through OGB, plans to push retirees to drop their OGB coverage and switch to only having Medicare.

Such a move, of course, would drastically reduce the amount the state would be required to pay BCBS, thus reducing the monthly deficit currently being experienced by OGB. The premium increase next January, along with the reduced benefits would cut that deficit more as the administration grapples with the can of worms it opened by turning over the third party administrative duties to BCBS.

But even worse, state employees who never worked in the private sector prior to April 1, 1986, do not qualify for Medicare. State employees hired after that date began paying into Medicare. Moreover, state employees who never worked in the private sector do not qualify for Social Security benefits. http://www.treasury.louisiana.gov/Lists/SiteArticlesByCat/DispForm_Single.aspx?List=c023d63e%2Dac65%2D439d%2Daf97%2Dda71d8688dff&ID=101

Commissioner of Administration Kristy Nichols, try as she might, was unable to put much positive spin on OGB’s status in her recent op-ed column. http://lapolitics.com/2014/08/nichols-ogb-prepared-for-changing-world-of-health-care/

Nor was the self-serving op-ed piece by OGB board member Scott McKnight in Tuesday’s Advocate particularly reassuring. http://theadvocate.com/home/10088672-123/guest-commentary-ogb-changes-helping

(Is it just us, or do the administration and BCBS suddenly seem terribly eager to launch a media blitz to convince us against overwhelming evidence to the contrary that what they’re planning to roll out at the approaching  open enrollment is in the best interest of state employees and retirees? An even better question is do they really believe we’re stupid enough to buy into their empty promises?)

Second, and probably the most inane change is the renaming of all the plans from HMO (Health Maintenance Organization), PPO and CDHP (Consumer Directed Health Plan, formerly High Deductible Plan, changed to CDHP to make it sound more appealing) to confusing names like Magnolia Local, Pelican HRA, etc.

That tactic would appear to simply create confusion for elderly members.

But even more duplicitous is the provision that all OGB members must choose a new plan for the 2015 year during the upcoming open enrollment. If not, then they will automatically be placed in the HRA plan which is the worst of the four plans OGB will offer next year. It is a high deductible plan with have no coordination of benefits with any other coverage.

The big concern here is for members who have moved but never updated their addresses with their Human Resources departments or with OGB. If they don’t get the notices mailed out on Sept. 15 and fail to choose a plan or if they are incapacitated in nursing homes and have no family watching out for them, they will automatically be dispatched to the HRA plan.

HR officers will become responsible for retiree maintenance. Accordingly, retiree records definitely need to be updated in employees’ and retirees’ respective HR offices. But with all the closures and privatizations, many retirees and/or HR offices do not know who will have the retiree maintenance. Several other changes include dependent verification and late applications. All these changes will have to be made with an antiquated electronic enrollment system designed and maintained by the same OGB IT staff that was recently consolidated under DOA and which no longer belongs to OGB.

Further complicating matters is Jindal’s gutting of OGB staff to the point that the office now has only a handful of employees taking phone calls from members. So the administration has suggested that BCBS get its employees to handle the spillover calls.

But while OGB representatives are authorized to offer advice to members on what plans they should choose, BCBS employees are not. So, BCBS is hiring about 20 temps to take phone calls from members regarding the plan changes for 2015. These temps will, in all probability, simply refer callers back to OGB, which would appear to be a poor way to communicate with members about such important changes.

How bad is the HRA plan? Well, for openers, and deductibles will increase from modest amounts to thousands of dollars, the economic effect of which could be devastating to employees and retirees alike.

Lest anyone forget, it was Jindal who pushed the privatization of OGB, even jettisoning Tommy Teague as executive director of the agency when he didn’t jump on board the privatization train. It wasn’t enough that Teague had taken OGB from a $60 million deficit to a $520 million surplus, Jindal insisted the move, which included putting more than 150 OGB employees out of work, would save the state $20 million per year. The plan thus far has proved a complete fiscal disaster.

State Rep. John Bel Edwards (D-Amite), who is an announced candidate for governor in the 2015 election, agrees.

“The OGB fiasco is proof positive that privatization for the sake of privatization is foolish,” he said. “A reserve balance that recently exceeded $500 million is half that now and bleeding $16 million per month due to mismanagement and budget chicanery, and the ultimate price will be paid by state retirees and employees through higher premiums, higher co-pays, higher deductibles, and higher co-insurance in exchange for fewer benefits, more forced generic drugs, and more preclearance of needed treatments and other changes that make crystal clear that the OGB beneficiaries will pay more for less.”

In an effort to prevent unwanted surprises in health care coverage following the upcoming enrollment period, it is important to remember three important things:

  • All members should immediately update their addresses with their HR departments or with OGB;
  • Make certain that elderly retirees, retirees in nursing homes, etc., have updated addresses;
  • Make certain that all retirees on Medicare have sent an updated copy of their Medicare cards into OGB.

These are three things that are critical to state employees and retirees as the 2015 plans changes approach.

 

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The seventh floor of the Bienville Building on North 4th Street in Baton Rouge became a beehive of activity recently when employees of a temporary personnel service moved in to begin shredding “tons of documents,” according to an employee of the Louisiana Department of Health and Hospitals (DHH).

DHH is headquartered in the Bienville Building and the source told LouisianaVoice that the shredding, undertaken “under the guise of being efficient and cleaning,” involves documents that date back as far as the 1980s.

“The significance of this is that this is occurring in the midst of a lawsuit (that) DHH is filing against Molina in relation to activities that go back to the ‘80s,” the employee said. “Everyone is questioning the timing. Westaff temporary people have been in the copy room of the seventh floor for approximately two weeks now, all day, every day, shredding documents.”

https://www.westaff.com/westaff/main.cfm?nlvl1=1

The employee said so many documents were being shredded “that the floor is full of dust and employees have been ordered to clean on designated cleaning days” and that locked garbage cans filled with shredded documents “are being hauled from the building daily.”

LouisianaVoice submitted an inquiry to DHH that requested an explanation “in light of the current litigation involving DHH, Molina and CNSI”—two companies the agency contracted with to process Medicaid claims.

CNSI (Client Network Services, Inc.), which replaced Molina as the contractor for those services in 2011, had its $200 million contract cancelled by the Jindal administration after allegations of contact between then-DHH Secretary Bruce Greenstein and CNSI, his former employer, during the contract selection process. Investigations by the Louisiana Attorney General’s and the U.S. Attorney’s offices ensued but little has been heard since those investigations were initiated. Meanwhile, CNSI filed suit against the state in Baton Rouge state district court in May of 2013, alleging “bad faith breach of contract.” http://theadvocate.com/home/5906243-125/cnsi-files-lawsuit-against-state

Molina, meanwhile, was reinstated as the contractor to process the state’s Medicaid reimbursements but last month the state filed suit against Molina Healthcare and its subsidiary Molina Information Systems, alleging that the state paid Molina “grossly excessive amounts” for prescription drugs for more than two decades because the firm engaged in negligent and deceptive practices in processing Medicaid reimbursements for prescription drugs.

Prescription drugs account for about 17 percent of the state’s annual Medicaid budget, the lawsuit says.

The state’s lawsuit says that Molina has processed the state’s Medicaid pharmacy reimbursement claims for the past 30 years but from 1989 to 2012, Molina neglected to adhere to the state formula for payments and thereby committed fraud and negligence, violated the state’s consumer protection and Medical Assistance Programs Integrity laws. http://theadvocate.com/news/business/9579038-123/la-sues-medicaid-drug-payment

Olivia Watkins, director of communications for DHH, told LouisianaVoice by email on Wednesday that the Division of Administration maintains a contract with Westaff for temporary workers which can be used by different state departments. “DHH requested temporary workers through the existing contract to assist with various projects, including shredding,” she said.

A search of LaTrac, the state’s online directory of state contracts, failed to find either Westaff or Molina listed as contractors among either its active or expired contracts.

“With regard to the shredding,” Watkins said, “those documents that were shredded were old cost reports, statements and facility documents that were outside of their document retention period (anywhere from 5-10 years). The files being shredded were in no way related to the department’s previous contract with CNSI.”

Watkins, while denying any connection to the CNSI contract, failed to mention whether or not the shredded documents involved Molina’s contract or the state’s litigation against the company even though the LouisianaVoice inquiry specifically mentioned both companies.

In June of 2002, the nation’s largest accounting firm, Arthur Andersen, was found guilty of unlawfully destroying documents relating to the firm’s work for its biggest client, the failed energy giant, Enron.

And while that conviction was eventually overturned, the damage from its actions doomed the company and it ultimately shut its doors for good.

In the weeks leading up to the Enron collapse, Andersen’s Houston practice director Michael Odom presented a videotaped talk—that was played many times for Andersen employees—on the delicate subject of file destruction.

In that video, Odom said that under Andersen’s document retention policy, everything that was not an essential part of the audit file—drafts, notes, emails and internal memos—should be destroyed immediately. But, he added, once a lawsuit was filed, nothing could be destroyed. Anything could be lawfully destroyed, he advised Andersen employees, up to the point when legal proceedings were filed (emphasis ours). http://www.mybestdocs.com/hurley-c-rk-des-law-0309.htm

“If it’s destroyed in the course of the normal policy and litigation is filed the next day, that’s great,” he said, “because we’ve followed our own policy, and whatever there was that might have been of interest to somebody is gone and irretrievable.”

In a matter of days, Andersen’s Houston office began working overtime shredding documents, according to authors Bethany McLean and Peter Elkin in their book The Smartest Guys in the Room (The Amazing Rise and Scandalous Fall of Enron).

Perhaps the DHH shredding had nothing to do with the CNSI contract with DHH or with the litigation filed by CNSI over cancellation of its contract.

And it may be that the shredding was in no way connected to the Molina contract, even though Watkins failed to address that specific question by LouisianaVoice.

It could well be, as Watkins said, the document destruction was purely a matter of routine housekeeping.

But the timing of the shredding flurry, coming as it did only days following the July 10 filing of DHH’s lawsuit against Molina, and DHH’s murky and adversarial relationship with the two claims processing contractors do raise certain questions.

And Watkins’ assertion that the shredded records consisted of “old cost reports, statements and facility documents,” the dates of which fall within the time frame of the allegations against Molina, would seem to make those questions take on even greater relevance.

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One of the most frustrating things in writing about this administration is obvious wrongdoing is reported and nothing is done.

In Bobby Jindal we have a governor who is constantly bitching about Washington in general and the Obama administration in particular while turning a blind eye to corruption, profiteering and ethical violations within his own administration.

You would think that the man who, upon taking office in 2008, said, “We have zero tolerance for corruption” would make at least a token effort to keep his house in order.

Instead, he gutted the enforcement authority of the State Ethics Board, ran off members of the board, and commenced to allow his political pals to run unchecked.

The sordid episode of State Police Superintendent Mike Edmonson and the manner in which he was allowed to increase his state pension by nearly 70 percent is just the latest in a sorry laundry list of loose enforcement of ethics rules in this administration.

We have already written about some of these:

  • Board of Elementary and Secondary Education (BESE) member Kira Orange Jones simultaneously serves as executive director of Teach for America (TFA), which in turn, has been issued contracts worth more than $3 million with the Department of Education (DOE) since she became a member of BESE in 2012. BESE is the governing board for DOE and as such, must approve all contracts with the department.
  • The resignation of the vice chairman of the Louisiana Board of Ethics only weeks after the Tribune, a newspaper serving the African-American community of New Orleans published a story in its May/June 2013 issue headlined “Kira, Kira on the Wall” which explained Schneider’s own conflict of interests in ruling on an Aug. 21, 2012, conflict of interest decision about Orange Jones.
  • BESE President Chas Roemer consistently votes on issues concerning charter schools even though his sister, Caroline Roemer Shirley, is executive director of the Louisiana Association of Public Charter Schools which much apply to BESE for approval of charters and other matters concerning charter schools, including funding.

And while we have not written about it, BESE member Walter Lee of Mansfield, who recent retired as Superintendent of DeSoto Parish Schools, is currently under investigation for allegations that he billed both the school board and BESE for travel expenses to and from BESE meetings in Baton Rouge and for lodging while in Baton Rouge.

Now, thanks to public records we belatedly obtained from the Division of Administration, we learn that another BESE member’s company has reaped more than $1.5 million from contract work his company performed on behalf of a dozen South Louisiana school boards and the Recovery School District in 2013 and 2014.

Hunt Guillot and Associates (HGA) of Ruston previously held two state contracts since Hurricanes Katrina and Rita that together totaled more than $38 million. The latest, for $20 million, expired on June 30 but is expected to be renewed.

Jay Guillot, of the 5th BESE District, is an HGA partner.

The HGA contract is with the Louisiana Office of Community Development for “grant management activities for infrastructure and other projects undertaken as a result of damages incurred as a result of Hurricanes Katrina/Rita and to a lesser extent, as a result of Hurricanes Gustav/Ike,” the contract details contained on the state’s LaTrac web page which lists active and expired state contracts and contractors.

Though the funds to pay HGA are federal funds allocated through the Community Development Block Grant (CDBG) program, the company’s contract is with the state and the state cuts the checks to HGA from the state’s CDBG funds.

Much of HGA’s work involved other branches of parish governments but in our search of records we found no fewer than 138 billings to school boards and the RSD totaling $1.58 million since January 2013. Of that amount, 17 separate invoices totaling $488,000 (30.9 percent of the total billed) was for the RSD.

The Department of Education has responsibility for the oversight of RSD and cannot be considered separate entities for purposes of say, a lawsuit against the RSD. At the same time, BESE is the governing authority over DOE, thereby creating a straight line of authority between BESE and the RSD as well as the dozen school boards for whom HGA also performed work.

School boards for whom HGA performed services and the amounts billed from January of 2013 through May of 2014 are as follows:

  • Plaquemines: 17 billings for $342,726;
  • Cameron: 16 invoices, $227,126;
  • St. Tammany: 16 invoices, $142,598;
  • Orleans: 17 invoices, $116,507;
  • Jefferson: 17 invoices, $97,598;
  • Calcasieu: 16 invoices, $64,813;
  • St. Charles: 14 invoices, $56,390;
  • St. Bernard: 12 invoices, $29,539;
  • Terrebonne: three invoices, $9,202;
  • Lafourche: four invoices, $2,968;
  • Washington: five invoices, $2,222;
  • Lafayette: one invoice, $50.

Incredibly, with only a month left in its contract, HGA managed to allocate just enough work to almost exhaust the contract amounts for eight of the parish school boards and the RSD.

The last billing made available to us was for work done through May 25, 2014. Following are the total amounts billed through May 25 (with a month remaining on the contract) with the total allocated under HGA’s contract for the corresponding parish in parenthesis:

  • RSD: $786,988 ($817,567);
  • Orleans: $237,766 ($255,519);
  • Jefferson: $205,748 ($205,750);
  • Plaquemines: $831,968 ($826,970);
  • St. Bernard: $195,996 ($196,877)
  • St. Tammany: $377,372 ($382,863);
  • St. Charles: $147,763 ($148,353;
  • Calcasieu: $112,295 ($116,171);
  • Cameron: $629,750 ($639,031).

Section 1113 of The Louisiana Code of Governmental Ethics prohibits public servants and their family members from entering into certain transaction. That section says:

  • “No elected official or public employee or member of such public servant’s immediate family, or legal entity in which he has a controlling interest shall bid on or enter into any contract, subcontract, or other transaction that is under the supervision or jurisdiction of the public servant’s agency.

That’s plain enough but for those wanting further clarification: “controlling interest means any ownership in any legal entity or beneficial interest in a trust, held by or on behalf of an individual or a member of his immediate family, either individually or collectively, which exceeds 25 percent of that legal entity.”

We do not know for certain what Guillot’s percentage of ownership is but inasmuch as his name is listed as a partner on the company letterhead we would assume he would meet that criterion.

And while the HGA contract is not specifically with DOE or BESE, the $1.5 million in work done for the local school boards and the RSD seems at best to skirt the edge of a conflict of interests for Guillot.

 

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