Federal authorities schedule more depositions for Sentara executives; Medicaid contract winners still pending

by | Apr 3, 2024

Federal authorities will re-question Sentara Healthcare executives amid a False Claims Act probe, as decisions on Florida’s Medicaid contracts face delays.

Federal authorities were granted permission this week to re-depose executives from Sentara Healthcare, a potential recipient of a Florida Medicaid Managed Care contract, as part of an ongoing investigation under the False Claims Act.

The U.S. Attorney’s Office and the Department of Justice are jointly investigating Sentara’s adherence to requests for documents and testimony concerning their market rate filings. The motion to re-despose was predicated upon allegations that Sentara only partially complied with such requests, prompting the government to pursue legal measures to ensure full compliance, as first reported by Virginia Lawyers Weekly.

A point of contention levied by the defendants was Sentara’s argument against further depositions of its executives without new authorization from the Attorney General, following the discovery of additional documents after the initial depositions.

The court ruled that the additional depositions were justified due to the incomplete provision of documents by Sentara. The court additionally decided to seal certain documents while making others public, aiming to protect sensitive information.

In 2023, a federal lawsuit was filed against Sentara Healthcare alleging that false statements were made in their 2018 and 2019 rate filings for ACA plans in Virginia. The legal action is contingent on whether the alleged misrepresentations led to improper federal payments to Optima — the name Sentara previously went by — in the form of subsidies.

Last month, The Capitolist reported that a federal judge has ordered additional testimony from executives of Sentara.

Sentara was alleged to have withheld 8,000 pages of relevant information until after key testimonies were given. While the company claims these documents did not contain new information, federal attorneys argue they were essential to case deliberations and should have been shared earlier.

According to court documents, Judge Elizabeth K. Dillon in Roanoke, Virginia ordered former Optima CEO Michael Dudley and Optima chief actuary James Juillerat to provide sworn testimony in the case within 60 days of the ruling.

“In June 2023, the United States noticed that Sentara was relying upon documents that had not been previously produced to the government,” reads Dillon’s order. “According to the government, the new records contain “important details requiring further investigation,” including additional sworn testimony from Dudley and

Meanwhile, Florida’s Agency for Health Care Administration (AHCA) is currently engaged in the process of re-procuring Medicaid managed care contracts, a routine procedure that occurs every six years and is essential for the continued operation of the state’s Medicaid program.

The re-procurement process, which involves contracts worth billions of dollars, determines which healthcare providers will manage Medicaid services for the state. A final decision on the recipients of the lucrative contracts was expected to be made late last month, though an announcement has been inexplicably delayed.

An inquiry submitted to AHCA regarding the delays and Sentara’s potential role in them went unanswered.


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