State Moves Against TennCare Company with Ties to Ford - | Nashville News, Weather & Sports

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State Moves Against TennCare Company with Ties to Ford

(Story created: 4/20/05)

FIRST ON 5: The fallout from the John Ford investigation has led regulators to take dramatic action against one of TennCare's biggest contractors.

The order -- first obtained by NewsChannel 5 -- was issued Wednesday against United American Healthcare Corp., which is known by most TennCare patients as OmniCare.

In it, the state's insurance commissioner expresses her concern that the Ford scandal could end up sinking the TennCare provider if action is not taken quickly.

That's why she has now appointed someone to supervise the company's operations.

It all stems from the controversy surrounding the powerful Senate chairman, John Ford, and his high-dollar consulting fees.

Just last week, the company admitted for the first time that it, too, had paid Ford -- despite its earlier denials.

In her order, Commissioner Paula Flowers cites the company's submission of false information about Ford, along with a lawsuit from a former executive claiming she was fired for not covering up certain "illegal acts."

Plus, it says another former executive is about to file a lawsuit claiming Ford was paid $10,000 a month by this one company.

The order concludes that:

"The submission of false information to the Department concerning potential conflicts of interest on the part of executive management, coupled with the facts alleged by former senior management concerning practices of intentional and knowing concealment from state and federal regulators of potential violations of law, and the current lack of any internal audit function to review and evaluate management's compliance with applicable laws, policies, procedures and regulations supports the conclusion that the current management of the Respondent poses a risk to the TennCare enrollees which rely on the Respondent for the delivery of health care services in this State."

Under the order, the commissioner's supervisor will not be running the company.

He'll just be there to keep control of the books and the money until the state figures out exactly what's been happening.

Meanwhile, the state will not renew its contract with the company that provides dental services TennCare patients.

Doral Dental has held the TennCare contract for more than two years.

Then, it was discovered that Doral had hired a company linked to the powerful Senate chairman to help it win that contract.

That deal is currently under investigation.

In a statement released today, TennCare director J.D. Hickey said, "Doral Dental has performed well.... However, there is not sufficient information available in the public record at this time to answer the questions that surround the company's contractual arrangements to justify the continuation of this contract.

The contract will be put out for bids, and Doral plans to submit a new proposal.

Meanwhile, officials say they will demand that the company reimburse the state if it's determined that TennCare funds were used to pay Ford

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