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Con Care

The contract to provide medical care for the state's prisons changes hands

Correction: City Paper erroneously reported that the state’s prison medical contract was awarded to Wexford Health Sources as of January 2011. In fact, the contract was not awarded; on Dec. 15 the State Board of Public Works voted to extend the existing contract, held by Correctional Medical Services, for an additional six months while the state rebids the contract.

After an unusual behind-the-scenes battle, state officials have chosen a new company to oversee medical care for Maryland prisoners. Wexford Health Sources Inc. of Green Tree, Pa., won the $312 million contract in November, but the incumbent company, Correctional Medical Services (CMS) of St. Louis, protested the contract award twice, according to a Wexford spokesperson.

“We have been awarded the contract,” Wendelyn Pekich, Wexford Health Source’s director of marketing and communications, said in a phone conversation. “Unfortunately it has now been appealed twice by CMS. It’s within their rights—we understand that. It’s between them and the state.”

State corrections officials and CMS spokespeople have kept mum about CMS’ multiple challenges to the contract award, neither returning reporter’s messages nor giving any comment. A Sept. 17, 2010, letter from the Department of Public Safety and Correctional Services’ (DPSCS) director of procurement services to CMS thanked the incumbent company for its bid but said it “was not selected for contract award.”

The state Board of Public Works was originally scheduled to vote on the new contract on Nov. 3, 2010, but the item was withdrawn. On Dec. 1, that body, which must approve nearly all state contracts, voted without discussion to revise the existing contract for one month, at a cost of $13.9 million. Nearly $11 million of that is going to Wexford, which currently oversees “utilization management” in the system. The company acts as a check on the doctors by monitoring who gets what treatment and sometimes denying certain care. CMS’ award was $340,000.

Prison health care is a controversial—and expensive—part of the Maryland DPSCS’ budget. In the 1990s, the previous provider, Prison Health Systems, had trouble with regulators. The contract was broken into five pieces—medical care, utilization management, mental health, dental, and pharmacy—in 2005. That year CMS took over the medical care component, which is the largest part of the contract, amid protest by the American Civil Liberties Union. Soon after that, state auditors found that CMS had not hired enough skilled professionals to fulfill its contract, and was actually underbilling. A 2007 state audit found “several significant areas of noncompliance,” and a state auditors’ review of those findings released in April 2010 found that there were still problems (“Prison Medical Care Has a Ways to Go,” The News Hole, citypaper.com, April 5, 2010). At that time, the whole system, serving some 23,000 inmates at a cost of about $150 million per year, had only one medical doctor. Even inmate deaths could not be properly reviewed.

In the new contract, if or when it’s finally ratified, Wexford will serve as both the medical provider and the utilization reviewer. Pekich says that situation is “not unusual.”

Ken Fields, CMS’ spokesman, did not return several calls and e-mails from City Paper over several weeks.

As of Dec. 2, Pekich said she still had not gotten word about the status of CMS’ protests (subsequent calls were not returned). “We are moving forward,” she says. “The longer they drag this out in court, the more it costs Maryland taxpayers, the more it causes the workers to be unsure about their jobs.

“We’re ready to start on Jan. 3.”

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