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Archive for the ‘RFP, Request for Proposals’ Category

One might think the Jindal administration and the Office of Group Benefits (OGB) might have learned something from the Bruce Greenstein fiasco over at the Department of Health and Hospitals (DHH).

Greenstein, you will remember, was the DHH secretary when that $280 million contract was awarded by his agency to his former employer, CNSI.

That scenario could be repeated at OGB.

Even though Greenstein insisted he had established a “firewall” between himself and CNSI, it was subsequently revealed that Greenstein had hundreds of email and text message exchanges with his old bosses during the contract selection process.

That eventually led to Greenstein’s forced resignation and criminal indictment and a civil suit by CNSI the entire messy episodes are slowly making their way through the Baton Rouge District Court system.

Which brings us to OGB and its $35 million-a-year contract with Blue Cross/Blue Shield of Louisiana (BCBS) to administer OGB’s Preferred Provider Organization—a task that apparently proved somewhat daunting to BCBS during the first year of its contract, costing the contractor more than $3.1 million in performance penalties.

One of five contracts with the state totaling $1.2 billion, that three-year contract will end on Jan. 1, and OGB is currently accepting proposals for a new three-year contract.

OGB issued its request for proposals (RFP) on March 13, giving an April 20 deadline for proposals but that deadline was extended to April 30 in an addendum issued on Wednesday (April 22). OGB RFP

LouisianaVoice, however, has learned that OGB Administrator Elise Cazes has been put in charge of the evaluation committee which will make recommendations on awarding a winner of the new contract.

The problem? Cazes was appointed Group Benefits Administrator on June 23, 2014.

Cazes was previously employed by BCBS of Louisiana, raising the possibility of a conflict of interests. http://louisianavoice.com/2014/07/26/ogb-laying-of-24-more-blow-softened-when-ceo-assures-affected-employees-losing-their-jobs-not-like-losing-a-child/

She earns $106,000 per year in her current position.

Not only does she head up the evaluation committee, but she also was given the responsibility of naming other members of the committee. To date, the name of only one other evaluation committee member, OGB Interim Deputy Director Bill Guerra, has been revealed.

At the same time, LouisianaVoice has learned that BCBS in 2013 was fined more than $3.1 million for performance deficiencies in connection with its contract with OGB. BLUE CROSS PENALTIES

BCBS was paid slightly more than $32.2 million to administer the PPO plan for calendar year 2013, the first year of its current contract.

Under terms of its contract with OGB, BCBS could be fined up to $9.7 million for failure to meet a variety of standards. Those include:

  • General Standards (10 percent of total medical administrative fees): $3.52 million;
  • Data Submission Standards: $10,000 per day, or a maximum of $20,000;
  • Mental Health & Substance Abuse (MH&SA) Standards (17.5 percent of total medical administrative fees): $6.2 million.

The actual penalties imposed for 2013, according to OGB’s own report, and the breakdown included:

  • Average speed to answer phones (39 seconds against an industry standard of less than three seconds): $352,325;
  • Claims Accuracy: $352,325
  • Membership Identification Cards Timeliness: $352,325;
  • Data Submission Timeliness: $20,000 (the maximum amount allowed);
  • MH&SA Appeals: $528,487;
  • MH&SA Ambulatory Follow-Up: $528,487;
  • MH&SA Medical Integration: $528,487;
  • MH&SA Member Satisfaction Survey Score: $528,487

TOTAL: $3.19 million.

In explaining the deficiency report, OGB noted that the contract between BCBS and OGB “contains 26 performance goals (called service level agreements, or SLAs) related to customer service and claims processing. During 2013 Blue Cross experienced challenges in meeting a handful of these goals.”

The report indicated that “all issues” had been resolved and that OGB and BCBS were “fully prepared for excellent performance during the 2014 calendar year.”

But LouisianaVoice recently received the following email from a retiree which would seem to indicate otherwise:

“Here’s a laugh; Look at the insurance health cards my wife and I received thus far:

  • Received 3/6/15:  deductible—$300
  • Received 03/09/15: insured deductible—$600
  • Received (date unknown): insured deductible—$600
  • Received 03/20/15: insured deductible—$1800
  • Received 03/20/15: spouse deductible—$600
  • Received 03/27/15: spouse deductible—$600
  • Received 03/27/15: insured deductible—$1800
  • Received 04/04/15: insured deductible—$600. 

“Do I get to pick our deductible from these cards?  You can tell that BCBSLA and OGB are on top of this matter, right? I plan to make a personal visit to the OGB office probably next week and show them this trash and find out what our deductible(s) really are. Do you think they know? I will ask while I am (at the OGB office) for the real executive director at OGB (to) please stand up.

“Our online monthly premium is a different figure from the letter received in the mail today from OGB. I am ready for someone to figure out what’s going on, and do something logically and correctly.  Health insurance is a serious matter for people and they are playing with us. Everything needs to be corrected and cleaned up for all state employees (retirees and actives).

“OGB use to be correct on these technical matters and they had in the past straightened out BCBSLA for me several times on what was to be paid, etc. Now OGB has gone crazy too! I guess it’s from all the new executives at the top.” 

 

 

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What began as an 18-month $350 million contract with a San Diego firm with ties to former U.S. House Speaker Newt Gingrich has morphed into a 15-month $500 million agreement with the Office of Group Benefits OGB to administer the state’s prescription drug program for more than 220,000 state employees, retirees and dependents.

But details have emerged that raise questions about a possible conflict of interests involving a consulting firm retained by a teachers benefits program in Alabama and OGB in Louisiana which ultimately recommended awarding contracts to the same company by both states.

OGB’s contract with MedImpact was originally for $350 million and was to run from Jan. 1, 2014 through June 30 of this year but has been amended to $500 million and the terms shortened to March 31, which equates to an increase of about 74 percent.

Gingrich launched the Center for Health Transformation as part of an ambitious consulting and communications conglomerate to let consumers, not health maintenance organizations (HMOs), choose their doctors, medical treatments and hospitals. http://hl-isy.com/Products-and-Services/Pharmacy-Benefit-Evaluator/PBE-Abstracts/2012/MedImpact

But Gingrich failed to reveal that his idea would be financially beneficial to drug manufacturers, health insurers and other health care professionals who paid up to $200,000 annually to participate in the center’s operations.

MedImpact was one of those companies.

Gingrich’s taking money from organizations and then using the weight of his name to advance their interests was described as “a massive financial conflict of interest” by Sid Wolfe, director of health research for the watchdog group Public Citizen. http://www.washingtonpost.com/wp-dyn/content/article/2007/06/10/AR2007061000484.html

Even former Congressman Billy Tauzin of Louisiana has entered the picture as co-chair of Medicine Access and Compliance Coalition (MACC), an assortment of health care providers who advocate lower drug prices through the federal 340B Program. http://www.huffingtonpost.com/2013/08/13/billy-tauzin-drugs_n_3719468.html

Section 340B of the Public Health Service Act requires pharmaceutical manufacturers participating in the Medicaid drug rebate program to provide outpatient drugs at discounted prices to taxpayer-supported health care facilities that provide care for uninsured and low-income people. http://www.aha.org/content/13/fs-340b.pdf

Despite the magnitude of the MedImpact contract, it is the company’s connections to Buck Consultants, hired by the state to select the winner from among four proposals for that contract, which appears more than a little questionable.

OGB’s Notice of Intent to Contract for the Pharmacy Benefits Management (PBM) service, obtained from the Division of Administration (DOA) nearly four months after requested by LouisianaVoice—and then only after we filed a lawsuit against DOA—says, “Representatives of Buck Consultants, OGB’s actuarial consulting firm, provided assistance to the (selection) committee throughout the review and evaluation process.”

Buck Consultants, readers may remember, figured prominently in the controversy over DOA’s mishandling of OGB and the dissipation of more than half of OGB’s $500 million reserve fund.

Commissioner of Administration Kristy Nichols told a legislative committee that Buck Consultants had recommended that the state lower premiums for members of OGB, a move that led directly to the evaporation of the reserve fund. Communications between Buck and DOA obtained by LouisianaVoice, however, refuted Nichols’ claim.

Four firms submitted proposals to administer the prescription drug program for OGB. They were CVS Caremark, Express Scripts, Catamaran and MedImpact. CVS was disqualified because of sanctions imposed on the company in January of 2013 by the Center for Medicare and Medicaid Services (CMS).

Catamaran was the previous contractor but the company and the state have been involved in extended litigation which is expected to continue at least through June 30 of this year.

“As indicated in the Buck report, the proposal submitted by MedImpact has been determined to be the most advantageous to the state…,” said the Notice of Intent to Contract. “Accordingly, the committee recommends that the contract …be awarded to MedImpact.”

The connections between MedImpact and Buck, a global human resource benefit consulting firm that is part of the Xerox conglomerate, however raise conflict of interests issue—a relationship that LouisianaVoice traced back to the awarding of a contract to MedImpact in 2010 to administer the pharmaceutical benefits program for Alabama public school teachers, retirees and dependents through the state’s retirement system.

The Alabama Public Education Employees’ Health Insurance Plan (PEEHIP) board members, lacking pharmacy specialty training, retained Buck Consultants in late 2009 and early 2010 to handle the entire process, including writing the request for proposals (RFP), receiving and scoring the RFPs and making a recommendation for a contract.

Buck handled the entire process and gave the board the choice of contracting with MedImpact which was named by Buck primary contact person Michael Jacobs as having the best of several proposals submitted. The entire recommendation to the board took up a single paragraph in the board minutes.

The employee for the Retirement System of Alabama (RSA) who negotiated and signed the contract between the state and MedImpact later admitted in deposition that he had been involved in a relationship with a female representative of MedImpact.

But it was the relationship between Buck, Jacobs and MedImpact that warrants a closer look.

Even as he was contracted by RSA to issue, receive and evaluate the RFPs, it turns out that Buck, unbeknownst to Alabama officials, was simultaneously under a $50,000 contract to MedImpact. BUCK DEAL WITH MEDIMPACT

Jacobs, in a Dec. 23, 2009, letter to MedImpact Vice President of Business Development Bryan Boda, noted that the term of the contract was from Dec. 24, 2009, through Feb. 28, 2010, but upon written notice, “will be extended for an additional term, as mutually agreed to by both parties.”

Attached to that letter was a description of the scope of services to be provided by Buck which, among other things called for Buck to:

  • Provide MedImpact with marketplace information without disclosing anything to identify MedImpact’s proposal;
  • Collect competitor information, utilizing the internal proprietary Buck database of vendor information and drawing upon Buck’s “extensive data base” on PBM industry practices as well as outside public sources;
  • Develop a competitive employer marketplace analysis;
  • Present its final report during a final meeting with MedImpact at its (MedImpact’s) corporate headquarters.

It should pointed out that attorneys for three Alabama pharmacies excluded from participation in the prescription drug program for the teachers found it necessary to obtain the letter of agreement between Buck and MedImpact from Buck after MedImpact refused to provide the information.

The discovery of the contract between Buck and MedImpact during the time Alabama was in the process of selecting a prescription drug administrator for PEEHIP immediately raises the question of whether a similar arrangement existed between the two during the time Louisiana was selecting an administrator for OGB’s prescription drug benefits program.

An email to Buck Consultants posing that question was not answered.

MedImpact also refused to divulge what it was paying for prescription drugs, revealing only what it was charging Alabama. In one case, attorneys for the three pharmaceutical companies did obtain a document showing that MedImpact paid about $26 for an amoxicillin prescription but charged the state $96.

That, of course, also raises the question of how the billing is done by MedImpact for OGB. Does MedImpact pass along a 300 percent mark-up to OGB at a time when the state is, for all practical purposes, broke? MedImpact calls itself a transparent company but like our “transparent” governor, it has not been forthcoming thus far with details about what it pays for prescription drugs or about its contract with Buck Consultants.

And at the other end of the spectrum, it appears that not nearly enough hard questions have been asked by officials—either in Alabama or Louisiana.

After all, how can it be considered an acceptable practice for Buck Consultants to contract with a state to issue an RFP, evaluate the proposals and make a recommendation to award the state contract to a firm already contracted with Buck Consultants for Buck to collect competitor information?

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Some things never change when it comes to doing business with the State of Louisiana.

Several business owners have, over the past couple of years, told LouisianaVoice they would never bid on a state contract because, they said, the bid process and contracts are rigged, or at least weighted, heavily in favor of pre-selected vendors.

Now, three separate sources have come forward to offer specifics that support that claim as it regards a request for proposals (RFP) for renewal of an existing $75 million contract.

One of our very first stories under the LouisianaVoice banner was the manner in which Gov. Bobby Jindal went about privatizing his very first state agency, the Office of Risk Management (ORM), throwing nearly 100 employees out of work in the process.

Now we learn the story of F.A. Richard & Associates (FARA), the Mandeville company the state initially paid $68 million to take over as third party administrator (TPA) of ORM has taken yet another interesting twist.

Well, make that two interesting twists—including a third violation of the original contract between the Division of Administration (DOA) and FARA and now it seems there may be a strong case made for bid manipulation on the part of the state.

The reason we said the state initially paid $68 million is because eight months after that 2011 takeover, FARA was back asking—and getting—an amendment to its contract which boosted the contract amount by exactly 10 percent, or $6.8 million, bringing the total cost to just a tad under $75 million. An obscure state regulation allowed a one-time amendment to contracts for up to (drum roll, please)…10 percent.

Then, less than a month after the contract was amended by that $6.8 million, FARA sold its state contract to Avizent, an Ohio company, which kept the contract for about four months before it sold out to York Risk Services Group of Parsippany, New Jersey.

Last month, it was announced that Onex Corp., a Toronto-based private equity firm, had finalized a deal to acquire York for $1.325 billion.

In each case, the name FARA was retained “for branding purposes,” according to one former FARA employee, but there was no getting around the fact that the state’s contract was—and is—being shifted from one company to another until the latest deal that placed in the possession of a foreign corporation.

The original contract with FARA stipulates that the contract may not be sold, transferred or re-assigned without “prior written authority” from DOA.

LouisianaVoice, of course, made the appropriate public records request for that “prior written authority” right after it was sold the first time—to Avizent. After the usual delays in responding, DOA finally sent us an email which said no such document existed.

So, now we a contract the very specific terms of which have openly violated not once, not twice, but three times and the state has remained silent on this point.

Jindal, in case you need a reminder, is the same Louisiana governor who only last Friday criticized President Obama of “flaunting the law” in his executive action granting amnesty to illegal immigrants.

But as bad as the contract shuffling might be, ongoing efforts to rig the bidding process for a renewal of the five-year contract in FARA’s favor would appear to be far more serious.

Three separate sources—one employed by DOA and the other two former employees of first ORM and, after ORM was privatized, FARA, said that FARA had been requested to assist in drafting a new RFP in such a way as to guarantee that FARA would retain the contract.

Both former FARA employees, interviewed separately, said a staff meeting of FARA employees was held in Lafayette last April and again in May. On both occasions, they said, FARA management assured them that the company had been asked to assist ORM in drafting the RFP and that FARA was certain to win renewal of the contract, which expires next July 1.

“We were all told to update our resumés so they could be used in beefing up FARA’s proposal,” said one of the former employees.

If true, that would constitute bid rigging in almost any law book and should prompt an immediate investigation. This would be an ideal opportunity for someone to awaken East Baton Rouge District Attorney Hillar Moore to see if he is up to performing his duties.

Wasn’t that, after all, the basis for the investigation of Bruce Greenstein and the $189 million contract to his former employer, CNSI? That was the investigation that led to his nine-count indictment for perjury.

Having said that, if there are any other business owners who have had unpleasant experiences in bidding on state contracts, or who feel they have been shut out of the process through favoritism we would love to hear from you. Our email address is: louisianavoice@yahoo.com or louisianavoice@cox.net

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If anything at all can be taken from the 100-plus pages of grand jury testimony of Bruce Greenstein, it’s that Greenstein’s memory lapses and his reluctance to adequately answer repeated questions about his role in the awarding of a major contract to his former bosses taxed the patience of members of the grand jury who were forced to listen to his verbal sparring with prosecutors for hours on end.

But in the end, there was no smoking gun, although Greenstein, former Louisiana Department of Health and Hospitals (DHH) Secretary, on several occasions during his testimony said an agency-wide memorandum cautioning DHH employees to avoid contact with bidders on the $189 million contract during the selection process did not apply to him.

Though grand jury testimony is normally secret, several perjury counts returned against Greenstein in the nine-count indictment were based on his grand jury testimony so it would be subject to discovery in order for Greenstein to prepare his legal defense and therefore would be public.

Greenstein also admitted he initiated what has come to be known as “Addendum No. 2,” which was crucial in allowing his former employer, CNSI, to qualify to submit proposals for the contract, which it ultimately won in mid-2011. The contract was cancelled in March of 2013 when it became known than the FBI had been investigating the contract since January of that year.

During his testimony, it was revealed that Greenstein had maintained constant contact with a friend at CNSI, Vice President of Government Affairs Creighton Carroll and that the frequency of those contacts increased dramatically during Greenstein’s interviewing for the Louisiana job and during the formulation of Addendum No. 2.

In the first five months of 2010, for example, there eight total contacts consisting of texts and phone calls between the two men. In June of, however, just before he began the interview process for the DHH position, there were 75 contacts. From July through January, there were 864 contacts, including 227 in January of 2011 alone, when “the whole Addendum 2 stuff was going down,” according to Assistant Attorney General Butch Wilson. “Before you take office,” Wilson said, “we have not even a dozen contacts with Mr. Carroll. And after you take office, we have a total…of 2,882 communications. How do you explain that?”

“He is a prolific texter,” Greenstein replied.

Further into the questioning, Wilson was still trying to reconcile Greenstein’s testimony before the Senate and Governmental Affairs Committee in which he claimed he had no contact with CNSI officials during the bidding process and the facts to the contrary as revealed by the thousands of text messages and telephone calls between Greenstein and CNSI.

“…Four months after a very important conversation with your friend and former employer, Mr. (CNSI co-founder and President Adnan) Ahmed, and you tell Sen. (Karen Carter) Peterson (D-New Orleans) there were no vendor conversations regarding the RFP (request for proposals) after it was released,” Wilson said. “And you admitted a minute ago that that conversation with Mr. Ahmed definitely involved the RFP. So that was not an accurate statement, was it?”

“I did not make it at the time thinking it was an inaccurate statement,” Greenstein said.

Greenstein’s memory appeared to grow progressively worse as the questions became more pointed.

“Do you recall a meeting with DHH officials and DOA (Division of Administration) people, specifically (then-Commissioner of Administration) Paul Rainwater and (DHH Assistant Secretary) J.T. Lane…where you had a meeting regarding the emails that had been found? Do you remember that meeting?”

“I don’t.”

“You don’t remember that meeting with Mr. Lane and Mr. Rainwater and several other people in between your testimonies before the Senate?”

“I don’t remember it.”

“Do you recall being explicitly asked by folks at the meeting from both DHH and DOA, ‘Is this all there is?”

“No.”

“I’m going to ask you again,” said Wilson. “Are you sure?”

“I don’t remember having a meeting with Paul Rainwater about these emails.”

At one point during Greenstein’s testimony, it was revealed by Wilson that Greenstein supposedly agreed to a letter of recommendation on behalf of CNSI to his counterpart in Arkansas. He cited a Feb. 5, 2013 email from Carroll to DHH executive counsel Steve Russo which said, “As you know, B.G.—which I believe probably means Bruce Greenstein—has agreed to a letter of recommendation…to the Arkansas Department of Human Services on behalf of the CNSI, which was also trying to get a contract for a (sic) MMIS (Medicaid Management Information Systems) system in Arkansas, correct?”

The letter subsequently went out over Undersecretary Jerry Phillips’ signature, Wilson noted, asking “Whose idea was that?”

“I can’t remember who wanted to sign it,” Greenstein said. “I know that I didn’t want to sign that.”

“Then why does Creighton say, ‘As you know, B.G. has recommended a letter of recommendation’?”

“I probably said that when asked about a recommendation,” Greenstein said.

“Your friend asked you to help his company…get more business and you said, ‘I will do that,’ right?”

“I didn’t say I will do that.”

“Well, if you said yes, why is Jerry Phillips sending out a letter?”

“Well, it’s not Bruce Greenstein on the letter.”

“I’m going to ask you pointblank. True or false: this letter that was rewritten and signed by Jerry Phillips, you directed him to do that?”

“I do not remember that,” Greenstein said.

“How could you not remember that?”

“Because I don’t remember that.”

“That’s hard to believe, Mr. Greenstein,” Wilson said. “I mean, this reference is clearly a discussion that you had with Creighton Carroll regarding this letter that he sends to your department that he, or someone from CNSI, wrote that is then minimally changed and signed by not you, but your under-secretary.

“Jerry Phillips didn’t show you this letter before he sent it out?” Wilson asked.

“I can’t remember seeing…I don’t remember seeing it.”

“It just looks to me like between Creighton’s comment here about ‘B.G. has agreed to a letter of recommendation’—and that was on Feb. 5th and the letter was issued on Feb. 14th, nine days later—this was almost sounds like cold feet. The former letter he sends is for your signature, but in nine days, now it’s got Mr. Phillips’ …signature on it.”

[The Arkansas Department of Human Services, in July of that year, disqualified CNSI from participating in the bidding on its system as a result of the Louisiana investigation and resignation of Greenstein.]

Wilson also questioned the propriety of allowing CNSI to bid on the contract to process Medicaid claims for DHH. Brandishing a letter dated Dec. 7, 2010, from the Charlotte, N.C., law firm McGuire-Woods, he said the firm was representing CNSI in a major financial default case that threatened to bankrupt the company—a full six months before the CNSI contract was signed.

“Were you ever aware of the fact that they were basically in receivership with BOA (Bank of America) at the time they were bidding? Were you ever informed of that? Were you ever told that, as a matter of fact, their line of credit had been restricted by Bank of America to the extend they could not spend money unless they got prior approval from BOA? Did Mr. Carroll and Mr. Ahmed ever tell you about the troubles, the clear financial troubles that the company was having at the time they were trying to get this money from this bid?

“Should that have been disclosed to DHH?” Wilson asked.

“That’s a good question,” replied Greenstein.

Further into Greenstein’s testimony, he was asked if he was told to resign or be fired.

“I was told to resign,” he said.

“Were you specifically told by the administration officials that you had lied to them?”

“No.”

“They just said, ‘Get out’?”

“Actually, it was Paul Rainwater—when he was in the Chief of Staff’s office.

“And did Paul ever say, ‘Bruce, you lied to us’?”

“No.”

“You are sure about that?”

“I don’t remember it.”

“You tried not to tell the Senate that CNSI had won (the contract),” Wilson said. “You didn’t tell the Senate about communications with CNSI regarding Addendum No. 2. You didn’t tell the Senate about hundreds of communications with Carroll. You did not tell DHH and DOA officials about communications with Carroll after they asked you if there was anything else, although you say you don’t recall that meeting.”

At one point in the questioning, this time from Assistant Attorney General David Caldwell, it appeared there would be a link established between the events surrounding the contract and Gov. Bobby Jindal’s office, but the line of questioning ended almost as abruptly as it started.

Referencing the date of Jan. 10, 2011, Caldwell said, “I see some calls from Bruce Greenstein’s work cell back and forth between you and Timmy Teepell. What did Timmy have to do with…was he was with Division of Administration or the governor’s office at that time?”

“At that time I think he was with the Chief of Staff for the governor,” Greenstein said. [Teepell never worked for DOA].

“Do you recall what he was talking to you about?” Caldwell asked.\

“I have no idea,” replied Greenstein.

“Was he talking to you about that amendment [Addendum No. 2] of this particular contract?”

“Probably not.”

“What involvement did Mr. Teepell have in this process? What information did he have about the DHH contracts? Because I think that maybe even Mr. Ahmad said in the paper that he had gone over to the governor’s mansion to talk to him, right? I’m just trying to get a sense as to how much involvement people within the governor’s office might have had.”

Caldwell also singled out a series of communications between Greenstein and Alton Ashy, who was the lobbyist for CNSI. “Was he trying to push this amendment for CNSI, this Addendum No. 2?”

“Yeah, I mean, he should have been… but he had a lot of other business at DHH as well.”

Caldwell later noted that Greenstein at one point had asked DHH Chief of Staff Calder Lynch specific questions about Ashy, saying, “A company I know wants to hire him” and that Lynch had responded, “Not that it’s terribly helpful or relevant, but we can speak offline.” Offline could, for example, mean speaking by phone rather than leaving a paper trail of emails.

“How did you come to get involved with recommending a lobbyist on CNSI’s behalf? I don’t understand how all that went down.”

Caldwell also grilled Greenstein on his intervention on behalf of CNSI when it became apparent that CNSI was unable to make good on its required bond for the contract. “Did you have discussion with (DHH executive Counsel) Steve Russo in which it was discussed whether you could wait until the contract was signed to call for the bond to be posted?”

“I don’t remember a conversation like that.”

Greenstein and Caldwell sparred over the refusal to allow Greenstein to communicate with Russo after the investigation was initiated. “DHH wouldn’t allow me to talk with my own attorney,” Greenstein complained.

“Is he your personal lawyer?” Caldwell asked.

“He represented the secretary in many proceedings…he reiterated many, many times…that he was my attorney and we have attorney-client privilege.”

“Let me explain to you why he doesn’t want to talk to you,” Caldwell said. “There’s all these things in your deposition where you have said that people said something or they didn’t say something—and I will tell you right now, it is directly contradicted by what those people have said. [Caldwell hinted at but never actually said that Russo was—and is—paid by the State of Louisiana and represents DHH but not any DHH personnel once they come under investigation for or charged by the state with wrongdoing].

Later, Caldwell brought up boasts by CNSI officials that they had political influence with Greenstein’s office. “Are you aware that they constantly threw it around that they had influence on the ninth floor and this is how they were going to get the contract?”

“No,” Greenstein replied.

Even though Greenstein maintained that he pushed for Addendum No. 2 as a means of opening up the bidding process to more vendors in the hopes of obtaining the best deal possible for the state, Caldwell noted that when another bidder, ACS, requested an extension of the proposal deadline, “Bruce said no,” according to an internal DHH email.

After the attorneys took their shots, individual members of the grand jury had their turn at asking questions of Greenstein and the mood of the grand jury was best summed up by one member near the close of testimony who said:

“Sir, I just have two questions. How are you being transparent when you can’t recall anything and secondly, when you sit down with your children and you explain your part in Louisiana history, what will you tell them?”

For those with lots of time on your hands, here is a link to the full transcript of the grand jury testimony: http://www.auctioneer-la.org/Bruce_Greenstein_Grand_Jury_Testimony.pdf

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You have to love the Division of Administration (DOA) and the Office of Group Benefits (OGB). Their concern for the 230,000 state employees, retirees and dependents is surpassed only by their arrogance.

Saying “We heard the financial concerns of our members and Legislators,” Commissioner of Administration Kristy Nichols made the self-serving announcement that OGB has decided to delay the effective date of changes arbitrarily (and illegally) implemented to medical and pharmacy plans from Aug. 1 to Sept. 30. OGB RELEASE

Here is the information provided on the OGB web site: https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A4D344D6A45794E533551524559334E6A4D32

Never mind that State Rep. John Bel Edwards (D-Amite) told Nichols and OGB CEO Susan West back on Sept. 25 that they were flirting with major litigation and the threat of having to refund millions of dollars to OGB members who were hit with benefits changes which were illegal until such time as a rule could be adopted. Here is the link to video clips of that hearing: http://youtu.be/ct652tBa8Mc.

Except for Edwards who said the move was illegal. He requested and obtained an Attorney General’s opinion that agreed with him.

            Nichols, as is her custom, was not going to promulgate rules at all in implementing the new rates members would have to pay for prescriptions even though the law requires advertisement and public hearings on such changes. Instead, the administration, facing a shrinking OGB reserve fund because of its repeated premium cuts, plunged ahead, the law and state employees be damned.

The premiums were reduced so that the state would enjoy a similar reduction in the 75 percent of premiums it is required to pay for health coverage of OGB members. Gov. Bobby Jindal and Nichols cut the rates by nearly 9 percent despite a report from Buck Consultants which stated flatly that it never made such actuarial advice.

Pursuant to testimony given in the Sept. 25 hearing by the Joint Legislative Committee on the Budget (JLCB) in which Kristy said Buck Consultants had recommended a premium reduction, Edwards requested a copy of the actuarial recommendations.

            “I still have not received any actuarial recommendations for the 2013 and 2014 premium reductions at OGB,” Edwards said Tuesday. “Nor have they told me that such recommendations do not exist. Clearly, they do not.”

The OGB web site does contain a request for proposals (RFP) for an actuarial that is dated Sept. 26: https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A4D774E4445794D793551524559334E444531

The Baton Rouge Advocate said the refunds the state must now make to OGB members who were overcharged in the form of out-of-pocket expenses will come to nearly $4.5 million and is expected to be refunded within 60 days.

http://theadvocate.com/news/10718472-123/group-benefits-change-announced

Getting the refunds for the overcharges won’t be a walk in the park if past experience with the OGB pharmaceutical benefits administrator is any indication. “Members who incurred increased pharmacy costs between Aug. 1 and Sept. 29 based on exclusions must submit an appeals form to MedImpact,” said the news release from OGB, adding that Blue Cross and Blue Shield of Louisiana (BCBS) will reprocess claims for members who incurred increased medical costs through their providers during that time period. There is an appeals form for MedImpact on the OGB web page, but it appears to apply only to prescriptions that were rejected or denied by pharmacies in August and September: https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A4D344D6A45794E693551524559334E6A4D33

If members incurred costs that were not submitted through a provider, they must submit an appeal request form to Blue Cross and Blue Shield,” the release said. “The forms can be found on the OGB website at www.groupbenefits.org.”

Edwards said the burden should not be placed on state employees and retirees to file appeals on overpayments. “Group Benefits has the claims information and they should be required to make the determination of who is owed what and it should be Group Benefits that takes the initiative on this,” he said.

Of course, by placing the onus on employees and retirees, DOA is counting on members being unfamiliar with the process or uninformed about the refund program altogether. If they do not file appeals for refunds, no refund will be made and the state will not have to repay victims of the overcharges. “That’s why Group Benefits should be the one responsible for seeing to it that everyone who was overcharged because of its illegal actions in implementing the changes in the first place should get those overcharges refunded,” Edwards said. “The members should not be held responsible for the illegal actions of Group Benefits and DOA.”

Here are links to the after-the-fact DOA Emergency Rule declaration: http://www.doa.louisiana.gov/doa/Presentations/Emergency_Rules_-_Office_of_Group_Benefits_9-30-2014.pdf and DOA’s Notice of Intent: http://www.doa.louisiana.gov/doa/Presentations/Ordinary_Rule_-_Office_of_Group_Benefits_10-01-2014.pdf

The clumsy attempt at circumventing the law is just another in a long line of embarrassing episodes perpetrated by the Jindal administration as the governor pays less and less attention to the home front in his quest for the Republican presidential nomination, leaving the job of running the state to appointees equally unqualified as he to run so much as a snow cone stand.

Nichols typically ignored the threat of litigation in making the announcement just as the administration ignored the law in implementing the changes, even disagreeing in that Sept. 25 hearing on the necessity of publishing the proposed changes and conducting public hearings.

And West even attempted to justify the changes by pointing out to retirees and active members that she must pay the same premiums as they. She apparently failed to consider the fact that most state employees and certainly most retirees do not make her $170,000 per year salary.

The Retired State Employees Association (RSEA) threatened a lawsuit, challenging the administration’s contention that it could use the emergency rule (employed repeatedly by the administration during Jindal’s nearly seven years in office) to make changes in the medical and pharmacy plans.

Nichols was not even around for the conclusion of that Sept. 25 JLCB meeting, having stepped out of the committee room ostensibly to take an “important” phone call. In reality, it turned out she stepped out permanently to take her daughter to a boy band concert in New Orleans where she watched from the comfort of the governor’s luxury box at the Smoothie King Arena (see the snow cone stand reference above).

“Let’s hope that the legislature will continue to exercise oversight on this issue to drive more changes in the plans whereby the out-of-pocket cost increases of OGB members are reduced and (so that) the state will share in the cost of restoring the system’s soundness,” Edwards said in a prepared statement.

 

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