A US multinational healthcare corporation. Provides mental health services to prisons and jails.
Centene Corporation is a multinational healthcare corporation headquartered in St. Louis, Missouri that provides healthcare services to government sponsored and commercial healthcare programs in the United States. Centene provides healthcare services to state "correctional" facilities in 16 states, including California, Florida, Massachusetts, Minnesota, Mississippi, New Mexico, Tennessee, and Vermont.
Centene operates in two segments: “Managed Care,” which provides healthcare to individuals, and “Specialty Services,” which provides healthcare services to state programs and prisons. The company’s “Speciality Services” segment accounts for 5% of its total $48.4 billion annual revenue.
Between 2014 and 2017, Cetene has rapidly grown, recording $15.7 billion in annual revenue in 2014 and $48.4 billion in annual revenue in 2017. In part, this growth is due to Centene’s strategy of mergers and acquisitions. In 2016, Centene acquired HealthNet for $6.3 billion, making Centene one of the largest Medicaid managed-care organizations in the U.S. In 2017, Centene acquired Fidelis Care for $3.75 billion, expanding Centene’s involvement in New York and adding over 1.6 million customers. In March 2018, Centene announced plans to buy Community Medical Group, a primary-care provider that operates 15 medical centers serving more than 70,000 patients in Miami-Dade County, Florida.
In March 2018, Centene acquired MHM, a provider of behavioral health, medical, and dental services to prisons, state hospitals, courts, juvenile facilities, and community clinics. MHM provides services in over 300 facilities in sixteen states, working with approximately 300,000 people who are incarcerated. In addition to its healthcare services to federal and state prisons, MHM offers community re-entry programs, caseload management, pharmaceutical/psychotropic management, and specialized mental health programming.
Through this acquisition, Centene also acquired Centurion Managed Care, LLC., a prison healthcare services provider, established as a joint venture by Centene and MHM in 2013. As of February 2018, Centurion has won contracts to provide medical and mental health care to seven states prisons, including a $500 million contract with Massachusetts, $232 million contract with Tennessee, and $142.9 million contract with Vermont. Centurion also manages healthcare in Minnesota, New Mexico, Florida, and Mississippi. In June 2018, the New Hampshire Department of Corrections re-awarded a contract to Centurion to provide medical and dental health providers to prisons.
Despite the fact that Centurion has only been operating a brief time in the prison health industry, serious complaints have already been lodged about its medical treatments. These complaints and lawsuits reflect a general decline in quality of services when healthcare to prisons is privatized and the main incentive is profit.
In 2016, three wrongful death lawsuits were filed against Centurion, including one in Tennessee, where an incarcerated person died from a brain hemorrhage after not receiving appropriate medical care. In 2015, two similar lawsuits were filed against Centurion for refusing access to the most effective Hepatitis C treatments in Minnesota and Massachusetts prisons. The lawsuit in Massachusetts notes that “over 1,500 state prisoners in [the state] have Hepatitis C, but as of the present time only three are being treated for it.” The suits seek injunctive relief for Hepatitis C screening and adequate treatment for prisoners who are HCV-positive.
As for MHM Services, complaints over inadequate quality of care have been repeatedly reported. In MHM-contracted facilities in Utah, Vermont, Alabama, Pennsylvania, Massachusetts, and Florida, deaths have occurred as the result of starvation, denial of necessary medication, neglect, and improper restraints. In all these instances, the families of the deceased have sued MHM and won, or are currently pursuing litigation against the company.
In 2014, Southern Poverty Law Center filed suit against the State of Alabama for MHM's failure to provide adequate care, medicating prisoners against their will, violations of the Americans with Disabilities Act and the Rehabilitation Act, and cruel and unusual punishment.
In Maryland, auditors found that inadequate staffing lead to a breakdown in treatment, including denial of medical services, untimely dispersal of medications, and issues with chronic care and screening. Tennessee auditors came to similar conclusions. Prison-advocates have also accused MHM of violating its contract terms in Missouri by failing to provide individual counseling, and substituting therapy with overuse of medications, though the state has yet to investigate.
In Pennsylvania, a 2010 investigation by the Human Rights Coalition discovered MHM was responsible for inadequate, often non-existent, and sometimes abusive treatment, denial of medications, and a lack of staffing, privacy, and inpatient treatment programs. For these reasons several state legislators and the Service Employees International Union opposed the renewal of MHM’s contract in 2014.
In 2012, prison-advocates have also accused MHM of violating its contract terms in Missouri by failing to provide individual counseling, and substituting therapy with overuse of medications, though the state has yet to investigate. In Maryland, auditors found that inadequate staffing lead to a breakdown in treatment, including denial of medical services, untimely dispersal of medications, and issues with chronic care and screening. Tennessee auditors came to similar conclusions.
In 2002, women prisoners at an MHM-contracted facility in Alabama filed a class-action suit against the company citing “inadequate medical and mental health care.” They won their case in 2007. However, former employees continued to charge that an enduring “culture of abuse” and systematic inefficiencies in care continue to exists.