Prior Employee who left on own (not RIF here.
Has anyone been approached by a law firm this week? I have an investigator in my DMs who is investigating Elevance operations for Stockholders questioning the financial practices for a possible violations for a class action lawsuit?
I haven't responded yet but I was almost wanting to say "How about a class action lawsuit on how sh---y they are to employees?"
Should I respond?
@OP I did too & was wondering the same thing!
@10 You should read the text in the lawsuit. It says that ELV failed to alert shareholders that Medicaid cost trends would be increasing. Internally people knew Medicaid trends were artificially low...so common sense that means internally they knew that trends would increase when the PHE ended.
The actuarial practice (primarily leadership) has gone to S$%& in the last 10 years.
@10v Oh the headwinds! My question is how can it be a headwind when you had ample warning PHE was gonna end. Sounds like leadership buried their heads in the sand.
@v7 there is nothing to whistleblow. Because of the PHE these members were legally allowed to stay on Medicaid.
Our company did nothing illegal related to this but they were stupid not to see the inflated enrollment as anything but temporary.
@rc+1k27prf6s True for all LOB for 2020-2021 but commercial trends returned to pre-COVID by 2022-2023. Medicaid trends stayed low throughout the PHE. Internally in our company it was openly discussed as being due to discontinuation of redeterminarions. Somebody is going to make big money as a whisteblower.
So the CFO, who said in a town hall, I have no healthcare knowledge so I carry a little notebook to write down questions, and the IT VP who came from a sneaker company weren’t up to speed on healthcare trends? How shocking!! And the person in charge of ethics at Elevance might not have been able to assist, perhaps due to her past allegedly questionable record with Medicaid in Illinois. Google “When McKinsey Comes to Town; The Hidden Influence of the world’s most powerful consulting firm” and Felicia Norwood. It is a good read and made The NY Times best seller list. Maybe the law firm can consider whether there is a fundamental issue with vetting of the senior leadership overall..
@ky lots of our members didn’t use their benefit, irrespective of Medicaid status because lots of providers around the country weren’t conducting wellness visits or screenings unless it was life threatening during Covid. Most insurance companies made billions during covid for this reason.
@ky perfect person to talk to the law firm listed
@kv Agreed - I worked in Medicaid analytics until recently. There were reports showing that during the PHE a high % of people on the Medicaid rolls weren't using their benefits at all (a much higher rate compared to pre-COVID times). These were people on Medicaid who had moved or gotten a job or gone on a spouses' insurance and were just not using their Medicaid benefit. But they weren't taken off the Medicaid rolls because that process was suspended due to the PHE. It was not a surprise internally that the PMPM cost for Medicaid jumped up after the PHE ended - it is just not what people at the top wanted to hear or say publicly. But plenty of people internally knew. I was a junior level analyst and I knew.
I worked with members of the actuarial team in 2023. It was Very Well Known among the actuaries that the suspension of redeterminations was causing Medicaid PMPMs to be artificially low. I hope that comes out in this class action suit.
@a8 they should be speaking with people who worked in appeals, bet anyone working in appeals has a lot of evidence on claims being paid incorrectly
To the OP, it couldn't hurt to respond to see what kind of info they're looking for.
@a9 Same message I received. This is wild.....Love how the Shareholders are so upset about the money they lost then the employees who were ki-ling themselves daily putting in work that was never ever enough. I am so glad I left that place and went to the Provider side. Yeah, I think I am going to give them a call; I read the lawsuit on their site and it revolves around Medicaid (which I was heavily involved in). Interested for sure.
Here is what I got
I am an investigator with the Law Firm of Bernstein Litowitz. We are a national law firm which specializes in class action suits, specifically securities fraud. We are working on a shareholders' suit against Elevance.
I understand that you are a former employee of Elevance and would like to speak with you about your experience there.
Please feel free to email me at emily.shanny@blbglaw.com with a telephone number and a good time to contact you, or if you prefer, you may call me directly at 212-554-1902 to discuss this further.
Thank you for your time, and I look forward to speaking with you.
Emily Shanny
Senior Investigator at Bernstein Litowitz
I received a call a few months back...said they were beginning an investigation for not paying claims appropriately. Sent them some information on the GA foster care drama.
i would love to have a chat with them!!