Former employee here. I made a connection with a CMS person I worked with while at Centene.
They've asked for all of the dirty details. They've given me some dirt as well. Should I spill the beans?
14 replies (most recent on top)
Nothing is going to happen. They will just pay some political figure and make it all go away. CMS is just an audit to see how much hush hush money has to be paid. Sarah and Drew are going to be in charge and making millions for many years to come.
Don’t like how things are in the company? Then go work for another company.
They need to cut cost by laying people off, so their bonus doesn’t get affected. They were all in Tampa a few weeks ago. You think they flew commercial? Ate breakfast and lunch at the cafeteria? Ate dinner at Chik fil a? That trip easily cost them 200 grand.
Get used to it, or just leave
No shams? What would you call the 1+ billion dollars set aside to settle with states for Medicaid fraud? What about the neglectful provider networks that cover even fewer providers than is even indicated on the provider tool? Operating on as little man power as possible, no matter what the cost? How about outsourcing customer service to a company that provides neglectful service, causing members to call in several times a day to try and find someone to help them, only to give up because it's just too damn hard? Agents who yell at the members and hang up on them routinely? Do you really think that is not by design? What would you call the hugely increased bonuses for the top 3% of the company while the rest of us, who do the day to day grind, have lost our bonuses? Or those of us moved to salary now, where they can demand longer hours for no extra pay, and not up your salary by a single penny to compensate for the increased workload and time away from family? How about members who spend hours on the phone trying to get claims paid that are supposed to be paid automatically, but somehow, someway, all of a sudden even though they have been paid properly for years, the system is now broken or their costshares have gone up exponentially, WITHOUT WARNING? Not on a small level, either. A huge, huge amount of claims, resulting in catastrophic unplanned money owed by our members, many of whom are low income and waffle between Medicaid and Marketplace. Their premium goes up and their customer service experience is tanked. All of that earns this FOR PROFIT company money. Sure, there is overhead, but it's a whole lot less than it used to be. And yes, there are some really great people who care a lot about the people we serve. Unfortunately, they are going against a system that is designed to stiff fist all the money it can.
Nothing shady? Give me a break. I see shady stuff every day in my job with Centene. Much of it turns my stomach. Yes, I am looking for a new job, but where will our members be when the people who care are gone and only the money hungry clowns are left?
2cnl+1srdjj1G
Im the OP. CMS could do a massive audit, but that doesn't have anything to do with my post. I made the relationship...period. THE AREA IS NOT ONLY BEING AUDITED, BUT ARE ON THE VERGE OF A CORRECTIVE ACTION PLAN. They've been non-compliant for some time.
As someone mentioned, there is not massive power, but enough power to shake this one particular area. How about you talk to your colleagues and not this thread.
There’s nothing shady. We have gobs and gobs of administrative overhead, process and over site. That you seem to not know this is indicative of your role at the company. There are ridiculous checks and balances following the money all the way from the premiums to CMS reimbursement. Frankly, if were any further up our arses we’d need to consider them family and charge rent.
There are a lot of great people at Centene, including leadership. None are perfect but nobody is going out of their way to run some sort of scam or sham on CMS or our members.
The speculation around here is ridiculous.
I don't think it is unreasonable to think this person has a contact at CMS. They said the connection was made during their time doing their job, but not what their job was. I've talked to many people at CMS over the course of my career. It doesn't mean conversations with them would go anywhere, or that they have the ear of anyone even remotely important. Their CMS contact can even work there and be aware of investigations going on against a carrier, without being part of them in any way. This sounds more like a gossip session than anything else.
It wouldn't surprise me in the least if Centene were being investigated by CMS, though. There is a lot of shady isht going on, and my guess is that CMS and other government agencies are already aware of much of it. It has only been less than 2 years since London and her cronies have taken over, and these big investigations take time.
So stupid. What’s more alarming is how many people are just as d-mb and buy into this cra. You can barely spell CMS.
CMS more than has the ability to do a massive audit of Centene's business practices if they wanted to. I think this poster is full of sh**.
The amount of corruption in Centene should be exposed. I vote to tell CMS everything!
Tell them everything! He'll, I will if you don't!
I believe you because this is too far-fetched to make up.
You guys are funny! No one cares ro make things up for attention. I said we have become cool. And with Centene being the common denominatior it has come up. I'm sorry, but are CMS employees so high on the totem pole that they're untouchable! What an id--t!!! Lol
You must be interested because you responded.
Talk is cheap. This isn’t TikTok where you can inflate your view counts with attention seeking headlines.
No random person from CMS is going to ask for details like that. But do go on, keep stirring the pot.
Don't hold loyalty to a dirty company who's done so so many people dirty...spill the tea!
Yep. Why hesitate. Centene would betray you in a heartbeat.