A whistleblower lawsuit that has been hidden from public view for nearly three years claims a private contractor paid hundreds of millions of dollars to provide healthcare to prisoners in Delaware covered up deficiencies in care that neglected, maimed, and caused undue suffering to people imprisoned by the state.
Now, Delaware’s Attorney General is joining that whistleblower lawsuit against the state’s former prison healthcare provider, according to recently unsealed court filings.
Centurion was paid some $200 million by the state over three years to provide primary healthcare and mental health services to more than 4,000 prisoners in Delaware ending in 2023. At the time, Centurion was a subsidiary of Centene Corp, a Fortune 25 company and the nation’s largest insurer for the country’s Medicaid program.
Both companies are named as defendants and did not reply to multiple requests for comment through their media and investor teams as well as legal counsel over multiple days.
The lawsuit accuses the business of falsifying records, propping up mental health programs they knew were accomplishing nothing, funneling prisoners toward addiction to and covering-up staffing shortages in a way that denied prisoners adequate healthcare.
“It needs to change,” said Christopher Craig, a prisoner at Howard R. Young Correctional Institution who has spent 31 years in Delaware lockup. “It has gotten worse and it needs to be fixed.”
Horror stories told by prisoners, lawsuits filed on their behalf and at least one government report have for years painted correctional healthcare in Delaware as broken and the cause of suffering.
But this lawsuit is unique.
It was filed in 2023 by two former mental healthcare providers employed by Centurion at Sussex Correctional Institution under a special form of litigation designed to incentivize people to point out fraud perpetuated against the government.
Since its filing, the lawsuit has remained hidden from public view under a court-ordered seal while the office of Delaware Attorney General Kathy Jennings investigated the allegations and eventually decided the state would intervene in the litigation as the defrauded party.
Jennings office declined comment citing the pending litigation. The Delaware Department of Correction, which oversees the delivery of healthcare by private companies, is not named as a defendant and also declined comment.
The state joining the lawsuit represents a remarkable endorsement of the allegations and what prisoners and their families have said for years: the common business model for prison healthcare in Delaware and the United States generally anticipates and prolongs suffering for profitability.
“Centurion’s business model is premised on profit reaped through the denial of basic healthcare and behavioral healthcare required by government contracts,” the lawsuit states.
Centurion enters after scandalous divorce:
State officials hailed Centurion entrance into Delaware’s prisons as a reform as the state divorced its prior, scandal-ridden healthcare provider Connections Community Support Programs Inc.
After years of lawsuits, complaints by prisoners and outside medical providers, Delaware terminated its contract with Connections early. Eventually, the once politically connected non-profit was also sued for defrauding government through drug treatment programs administered outside of Delaware’s prisons. That lawsuit was settled.
At the time, then Department of Correction Commissioner Claire DeMatteis said Centurion would be more professional and better staffed than Connections.
Centurion was selected over other bidders under three-year, extendable contracts that would pay the company $47 million annually to provide basic healthcare services in the prison and $21 million annually to provide mental healthcare as well as drug and alcohol abuse rehab programs.
Centurion operated under the common model for healthcare in American prisons. They bid a certain amount to provide the service; they are paid by taxpayers in monthly instalments and whatever money is left after healthcare is delivered is the company’s profit.
And despite prisoners being financially destitute, Medicaid does not pay for their healthcare unless they are hospitalized for more than 24 hours. Critics say this setup incentivizes shortchanging care, especially expensive specialty care and care that requires an outside doctor.
The company’s basic task is to employ healthcare professionals to provide primary care inside prisons: to make diagnosis and treatment plans, manager prisoners’ medication, provide what care is possible inside the prison and refer people to outside specialists when needed.
The mental health contract is similar and mandated the company administer special programs for substance use disorders which are often linked to a person’s eventual release from prison.
The contract included provisions outlining minimum staffing levels, basic training and qualifications for staff, requirements for the administration of rehabilitation programs that prisoners and provisions for officials to withhold payment if the company didn’t adequately perform these tasks.
The lawsuit states that these contractual agreements were “lies” by the company.
“Centurion’s assurances about the treatment and rehabilitation it would provide were false, and it conspired to conceal these shortfalls from the Department of Correction,” the lawsuit states.
The whistleblowers’ allegations:
Deneen Rayne and Jamie Basara, the two whistleblowers who instigated the lawsuit, both worked for Centurion as substance abuse counselors at Sussex Correctional Institution near Georgetown.
They were part of what was known as the Road to Recovery program, a rehabilitation program that judges order some prisoners to complete during their sentence.
The lawsuit cites their observations to label the program as fraud:
The program was designed to have a minimum staffing of counselors and managers but was never properly staffed, the lawsuit states. Required training wasn’t completed. To create an appearance of compliance, employees would be shifted around when corrections supervisors would visit.
Assessments were completed without meeting with prisoners. Supervisors ordered that one-on-one counseling be skipped in favor of group work to maintain appearances. Some group sessions had no counselor and were led by the participants.
What was supposed to be regimented counseling work became prisoners completing worksheets on their own. And generally, the lawsuit states that medical records, staffing records, assessment documents, participation records were all fabricated to create a “charade” of compliance.
Brian Whiteside is a prisoner at Howard R. Young Correctional Center. He has struggled with addiction, overdosed in prison and participated in the Road to Recovery Program.
“It is not a program,” he said in an interview. “It is a money grab.”
He said the contractor employees did not follow the rules for how the program is supposed to work, mental health counseling that is supposed to come with the medication is sparse and the result is many participants return to prison after or die of an overdose on the outside.
“It was a joke. There is no accountability. The process doesn’t work,” he said.
The lawsuit also includes Rayne and Basara’s observations about the delivery of general healthcare.
It states sick calls were not attended to in a timely and that they had to pester correctional staff to pressure their higher-ups to attend to ailing prisoners. One prisoner with colon cancer couldn’t get an outside colonoscopy, would regularly soil himself, flies hovered around him and his sick call went unanswered for two weeks, the lawsuit states.
The lawsuit tells the story of one prisoner whose cancer caused him to deteriorate, but he could not get proper help until he was hospitalized and believed by the plaintiffs to have died. The lawsuit claims officials let him deteriorate to shift the cost for palliative care onto Medicaid through an extended hospitalization.
“Centurion’s strategy across the state of Delaware was to deny inmates the care they needed in an effort to shift financial responsibility onto Medicaid when inmates became seriously ill and required hospitalization,” the lawsuit states.
The lawsuit also accuses Centurion of causing addiction by putting prisoners who were not suffering from a substance abuse problem onto addictive drugs designed to treat opioid conditions. It claims a prisoner with a heart condition and another suffering from schizophrenia had their prescribed drugs withheld in favor of opioid abuse medications.
“Inmates were told repeatedly the drugs they needed were too expensive,” the lawsuit states.
Big money stakes:
The lawsuit states that Rayne and Basara were both “constructively terminated” in September 2022 after they complained about failures in care. They filed their lawsuit about a year later under what is known as the Delaware False Claims and Reporting Act law.
The law is modeled after a similar federal law that incentivizes whistleblowers to point out individuals or companies that make false claims aimed at defrauding the government. It awards the whistleblowers a percentage of spoils if the lawsuit is successful. In this case, the whistleblowers could receive up to 25 percent of the proceeds.
Litigation under the False Claims Act classifies whistleblowers like Rayne and Basara as “relators” and the state as the plaintiff.
After the lawsuit was filed under seal in September 2023, civil attorneys under Jennings, the state’s top legal officer, began an investigation into the allegations to answer whether the state would join the lawsuit.
Washington D.C.-based attorney Reuben Guttman represents Rayne and Basara and is considered an expert in this type of litigation. He said the government choosing to intervene generally tells the court that the allegations are “material” and “important.”
“You have a lot of private vendors that have come into the (prison) healthcare area and offered the quick fix. Quite frankly, there is no quick fix,” Guttman said. “It is an unfortunate situation, and it is important that the state has stepped in and is taking on these defendants.”
The lawsuit seeks three times what the court may rule as the amount of damages the government sustained because of the fraud as well as the “disgorgement” of all money resulting from the company’s “wrongful conduct.”
State records indicate Centurion was paid $206 million over the course of the contract.
Centene sold off its prison healthcare business in 2023 at what court records indicate was a fire sale price. And there is an ongoing, separate court fight in Delaware’s Chancery Court over who has to pay still-growing costs associated with claims of malpractice and negligent care from when Centene owned the business.
Centene, a publicly traded company, has argued that the terms of the sale means the business’ buyer, a private conglomerate of construction and government contracting businesses owned by a Texas family, should have to pick up the bill.
The Sullivan Brothers Family of Companies accused Centene of obscuring the scale of the negligence claims against the business before the sale and twisting the purchase contract’s language in an unfair attempt to pin costs associated with those long-running medical negligence claims on them.
Why care?
Prisoners are stripped of their freedom for a period of incarceration by a judge, but are not sentenced to medically suffer or potentially die at an earlier age due to neglect. The U.S. Supreme Court has also interpreted amendments to the U.S. Constitution to imbue those imprisoned with a right to basic healthcare and humane conditions.
And the cost to provide care for people in prison is one of the largest borne by society in today’s carceral system − totaling well more than $50 million a year from state coffers in Delaware.
And while this lawsuit is unique because of the state’s involvement, the allegations are not new for Centurion or Delaware prison healthcare providers before or after.
The allegations follow a similar narrative told by prisoners in interviews with DelawareOnline/The News Journal as well as large-scale litigation against Centurion, VitalCore Health Strategies, the current healthcare provider, and Connections before those two.
In 2023, the local chapter of the ACLU sued Centurion and VitalCore accusing the contractors of understaffing and delaying basic and outside care and consultation to the point of permanent health consequences. It seeks to represent every prisoner that has been incarcerated while those two have worked for the state.
That lawsuit is ongoing. It comes after a host of other lawsuits and settlements regarding Delaware’s prison healthcare that continue to trickle in against Centurion and providers all the way back to Connections.
In February, the insurer for the now bankrupt Connections settled a prison healthcare lawsuit filed all the way back in 2020 by the family of a 35-year-old man who died of what his lawsuit described as violently obvious opiate withdrawals after a day and a half of being jailed on driving charges.
Whiteside, a prisoner at Howard R. Young, said the system remains disjointed, people don’t receive the care they need and he fears that it is designed to discourage people from seeking care. He said the system leaves people feeling “defeated, deflated and overwhelmed.”
“If you want healthcare you have to fight,” he said. “You have to advocate for yourself. You have to put multiple sick calls in and most people get tired of the process,”
He said people on the outside should care because prisoners are not sentenced to suffer medically and that prison is supposed to include rehabilitation.
“Prison is not supposed to be easy, not supposed to be comfortable,” he said. “But the punishment is being away from our families.”
Contact Xerxes Wilson at (302) 324-2787 or xwilson@delawareonline.com. Delaware prisoners may also contact Xerxes Wilson on the GettingOut app.
Source: https://www.aol.com/articles/state-backed-whistleblower-suit-claims-082033236.html
