This week's cover story: Lawsuits have been waged against Wexford Health Sources, a for-profit medical corp. that has been tasked with the healthcare needs of most of the incarcerated people in IL prisons for the past decade. ✍️ plz_CLARify
in Illinois prisons. The district judge ruled against IDOC and Wexford, declaring them to have been “deliberately indifferent” to incarcerated people’s psychiatric needs, primarily through their failure to sufficiently staff mental health units. But the appeals court reversed that decision, writing that the state and Wexford “took reasonable steps” to fix many of the problems—including the staffing issues—the plaintiffs raised in the lawsuit.
Though the company rejects this characterization, attorneys who’ve sued Wexford argue that Wexford’s contract with the state introduces incentives for it to spend as little money as it can on care. “Their business model is to receive a flat amount of money and then profit off of any money that they are not forced to spend,” said Sarah Grady, formerly the lead attorney at the Prisoners’ Rights Project at the civil rights firm Loevy & Loevy in Chicago.
Utilization management is the process private medical companies like Wexford use to determine whether a procedure is medically necessary, and whether to pay for it or not. Wexford said that when it used utilization management in Illinois, its approvals for off-site care were above 80 percent, though it did not provide data for theDuring its decade-long contract, Grady said Wexford had numerous “gatekeepers” who worked to prevent off-site care from happening.
The skepticism the company advises clinicians to have of their patients extends into their treatment recommendations. In the documents, Wexford advises that because many patients have substance use disorders, doctors should think twice before prescribing pain medication. Also, they explain, physical therapy is “often abused” by incarcerated patients, and they warn doctors to be cautious when giving a patient a prosthetic limb.
Wexford denied these allegations and declined to comment on the specifics of the company’s utilization management policy. In 2019 the Illinois Department of Financial and Professional Regulation put the Wexford doctor on probation following another lawsuit against them and the next year put their medical license on “permanent inactive status” after they failed to take a required exam.
He said a nurse examined him but didn’t write him a permit for the equipment because only a doctor had that authority. Sevier submitted a grievance to the prison and asked to be seen by a doctor. A counselor at the facility responded in writing, saying that Sevier’s complaint was warranted. “Lawrence [Correctional Center heath-care unit] + Wexford Health Sources does not have a full time physician on site to treat and see patients.
Sevier wrote to me that he needs those medical devices to manage a chronic injury, but Wexford employees at the facility wouldn’t give them to him.
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