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Mobtown Beat

Medical Muddle

The state's prison health contract back out for bid

The state of Maryland is rebidding several contracts to provide health care to prison and jail inmates after preliminarily awarding a key component to a new vendor last fall, and neither state nor corporate officials are saying why.

Wexford Health Sources of Pittsburgh was told by state officials last fall that its $331 million, three-year bid had been accepted on the Medical Care and Utilization Management Services contracts, according to Wexford spokesperson Wendelyn R. Pekich (“Con Care,” Mobtown Beat, Jan. 5). The inmate medical care contract is the main medical services contract for the state’s inmates. The incumbent Medical Care contractor, Correctional Medical Services (CMS), of St. Louis, protested the bid award, but later withdrew its protest. The Utilization Management contract, for oversight of the doctors and pharmacists in the system, is currently held by Wexford. Hiring the same company for both contracts is a common practice, Pekich says.

The Board of Public Works, composed of the governor, comptroller, and state treasurer, was originally set to ratify several prison health contracts on Nov. 3, but the items were withdrawn from the agenda without explanation. Then on Dec. 15, the board voted to extend the existing contracts for six months, “with three one-month renewal options in order to complete a new procurement,” according to the board’s minutes.

Pekich says Wexford received a “notice of intent” in September saying the state was going to award them the new contract. CMS protested the award, but withdrew its protest in November, she says. “Then on Dec. 13 the state said we’re holding everything” to rebid, Pekich says. “The pharmacy [request for proposal] is already out. I won’t be able to fill you in on this because it’s a live contract. Nobody will want to talk.”

State officials and corporate spokespersons have kept quiet about the contracts for months. Numerous calls and e-mails to the Department of Public Safety and Correctional Services have gone unanswered. CMS spokesperson Ken Fields—often quoted in the media—did not return messages left during the final nine weeks of 2010. Reached by telephone on Jan. 12, he confirmed that the contract was being rebid but had no further comment. “I think you really need to talk to the state’s people,” he said. “It’s their process.”

Prison health care is a controversial and expensive part of the Maryland Department of Public Safety and Correctional Services’ 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 ACLU. 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 of 2010 found that there were still problems (“Prison Medical Treatment Has a Ways to Go,” The News Hole, April 5, 2010).

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