Mouser said there is a 25% referral requirement. Requirements that are completely legal and not going anywhere. SNP departments have to refer to humana owned pharmacy. They encourage push back and aggressive sales tactics are rewarded.
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@jh Here is the Ethics hotline phone number and email address. But in all honesty I am not sure if you can trust them.
Humana's ethics hotline can be reached by calling 1-877-5-THE-KEY or by visiting www.ethicshelpline.com. It provides a confidential and anonymous way for employees, contractors, and third parties to report concerns, ask questions, and get answers about ethical issues.
Phone: 1-877-5-THE-KEY (1-877-584-3539)
Website: www.ethicshelpline.com
Email: ethics@humana.com (for specific questions)
@c2 they aren’t getting a choice because we aren’t given a choice.
We are being told to refer to center well medical group if members doctors are no longer in network. How are they not dropping doctors to refer to their own group? Something is shady and unsure who to report. Someone said ethics line but is it in house ethics?
I seem to recall a Director of Operations (DB initials) in Service Fund bragging about an algorithm he had wrote to always have CenterWell flow to the top to have recommended by call center.
I also recall upon hearing this asking him and his VP BH initials (at the time but since retired) if all this has been ran by legal. They both said yes that it had been ran by legal department.
There were other things besides just that that seemed shady such as how RX Rebates would no longer be reported on BBS (bulletin board system), which I had questioned on calls. Eventually I was pressured to resign. I had asked even begged to be allowed to rescind my resignation.
But the same Director DB and VP BH wouldn't let me rescind. I took it to HR but they were of no help.
I tend to agree with the previous poster; something here is not right.
I also believe that anti-kickback & stark laws are in violation here.
This definitely needs to be investigated and lawsuits put in place and senior level employees in the know prosecuted.
Here’s the kicker, patients have to be given a choice and if they aren’t it’s a violation of anti- kickback and Stark laws. There’s a definite financial incentive for members to be steered towards Centerwell pharmacy, centerwell home health and Centerwell providers! Unless there’s a quality network and a cost savings for members, these steerage tactics are a slippery slope. Call the Ethics hotline.
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