Latest news with #SuperiorHealthPlan
Yahoo
10-04-2025
- Business
- Yahoo
Lawmakers and advocates call for accountability after insurance company hired investigators to look into patients
AUSTIN (Nexstar) – Lawmakers and patient advocates are calling for accountability after a legislative hearing revealed emails indicating an insurance company's use of private investigators to gather information on customers and state lawmakers. Superior HealthPlan receives funding from the state to manage the care of sick and disabled children through programs like STAR Kids. Texas Attorney General Ken Paxton launched an investigation into Superior HealthPlan, one day after a heated public hearing at the Capitol. In the March 26 hearing, lawmakers on the House Committee on Delivery of Government Efficiency, or DOGE, grilled the company's CEO over surveillance practices, they say, that crossed a line. During the hearing, committee chairman Rep. Giovanni Capriglione, R-Southlake, revealed emails indicating Superior hired private investigators to get information on lawmakers and customers. 'Why would you go and and run a background check, hire a private investigator to follow, to dig into the records of people who are your customers?' Capriglione asked CEO Mark Sanders. 'First of all, I will say we no longer use that practice, and haven't for several years,' Sanders answered. 'At the time, we really just wanted to have information on those individuals, and really nothing beyond that of what was publicly available to us.' One day after the hearing, Centene, the parent company to Superior HealthPlan, announced that Sanders was no longer with the company. Rep. Capriglione spoke with the State of Texas host the week after the hearing. Capriglione was joined by Hannah Mehta, founder of the advocacy group Protect TX Fragile Kids. Rep. Giovanni Capriglione: 'Let's start with the fact that Superior was funded almost entirely with taxpayer dollars, right? They used those taxpayer dollars to hire private investigators to surreptitiously follow journalists, customers, and lawmakers. I was made aware of these emails, which led to the discovery of additional information about who they were following and the intent behind them. And so in our committee hearing just a week ago, we revealed that to the public and made them answer.' Josh Hinkle: 'Hannah, what are some of the concerns you've heard from the families with medically fragile children who rely on the state's STAR Kids program?'Hannah Mehta: 'You know this is horrifying and alarming for families who literally are fighting for life, sustaining care for their children, trying to keep their kids alive. In this case, Linda Badawo was one of those who was fighting for her foster child who was actually awarded the state to be able to breathe and maintain his trach care that was ordered by his doctor, and so we have seen this pattern of behavior from Superior and it is alarming and horrifying that patients who are literally just trying to stay alive and follow their doctor's orders are being targeted for trying to access that care.'Josh Hinkle: 'So in last week's hearing, Sanders admitted he authorized hiring private investigators to get information on patients. Hannah, you knew about these emails for a while. What was it like for you to hear the admission in the hearing itself?'Hannah Mehta: 'Sunlight is the best disinfectant. There is, I think again, a pattern of behavior here that is really disturbing. Texans deserve better, and taxpayers deserve better. Patients deserve better. No family, no patient, should be targeted for trying to keep their child alive, for trying to access care for their loved one. And this could be anyone. This could be you. This could be any text, and we should all be horrified and concerned about what we're hearing here.' Josh Hinkle: 'One question I have is about the transparency surrounding this type of program. You know, it was even difficult for the media to get confirmation of rumors we've been hearing for months, and finally, it came out in this hearing, is there more transparency to be had in the future when it comes to this type of funding and these type of programs?'Rep. Giovanni Capriglione: We have several bills going right now in the legislature, several on contracting, of course, a few on transparency. HB 111 and a few other bills that we're working on that will require Absolutely, much more transparency, making sure that whether it's the press or patients or lawmakers get more access to what is going on with our dollars. I mean, we created the Speaker of the House, created the delivery of government efficiency [committee], and I think behind efficiency is transparency. The way that we need to make sure that we do this is that everyone has access. These are taxpayer dollars. I mean, and not just a few. This is the second biggest expense for the state. Okay, there's tens of billions of dollars of contracts that are going out to provide medical care to constituents of Texas. We deserve answers. We deserve responses as soon as possible.'Josh Hinkle: 'So I have a question for both of you. Sanders is obviously out. The company is under investigation from the AG, what do you hope changes after this?'Hannah Mehta: 'You know, I think the truth of the matter is, Josh, there are some massive changes that need to be made in this system, but let's take one step at a time, and let's start by addressing these issues and also ensuring that patients can access, incredibly vulnerable patients can access the life sustaining care that they need on a daily basis. And that starts with, as Gio said, some oversight, responsibility and some transparency for where those tax dollars are going. Are they being utilized in the way that the Legislature has allocated them, and are the patients, these vulnerable patients, who are often in life and death situations, able to access the care that they need to remain stable? That, that is really the intended purpose of these programs.'Josh Hinkle: 'You've touched on the transparency. What other changes are you hoping for?'Rep. Giovanni Capriglione: 'Well, first of all, I'm thankful that Attorney General Ken Paxton is investigating Superior. I'm expecting him, and I'm sure that he will do everything he can to make sure that he digs into what they're doing. Because I'll tell you, a company that has a culture of doing this probably has a culture of doing other things as well, whether it's double billing to the state unethical behavior, I think the state should consider dropping the contracts that it has with Superior and requiring all other providers to follow ethical guidelines. And that's what I'm hopeful will happen, not just here in Texas, because I think other states across the country now are going to start looking and asking these same tough questions to their providers.' After the hearing on March 26, Centene issued a statement in response: Centene recognizes that rebuilding trust requires more than words. Following the hearing, Centene immediately launched an internal investigation to examine the conduct in question and to ensure our current practices are fully aligned with our core values and ethical standards. In addition, Mark Sanders is no longer with the company. Our investigation to date indicates that all research in question was conducted through publicly or commercially available resources and limited to desk-based research. Background research has many business uses, including meeting preparation as well as helping to identify conflicts of interest and potential fraud, waste, and abuse, which is part of our duty as a government-sponsored healthcare organization. The research in question included irrelevant and unnecessary personal information. That was inappropriate and never should have happened. This occurred prior to 2019 and does not reflect the values or standards of our current leadership. For that, we offer our sincere and unequivocal apology. We have found no evidence of any legal violations, and no individual was ever followed or photographed. Suggestions that these materials were used for leverage or blackmail are completely false. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
31-03-2025
- Business
- Yahoo
Health insurance CEO admits to hiring private investigators to dig up dirt on patients, doctors and politicians
The CEO of a Texas health insurance company was fired after admitting before a DOGE panel of state lawmakers that he hired private investigators to spy on customers and obtain sensitive details about their lives. Mark Sanders was dismissed from his duties as chief executive of Austin-based Superior HealthPlan after he testified before the Texas House Delivery of Government Efficiency Committee in a hearing on Medicaid procurement last week. Sanders acknowledged Wednesday that private investigators were hired to surveil and glean background information on state lawmakers, journalists, healthcare providers, and patients. Texas Attorney General Ken Paxton announced Thursday that his office was launching an investigation into the company after Sanders' remarks. 'The allegations concerning Superior's actions, such as actions that were characterized as potentially blackmailing lawmakers to secure state contracts and surveilling private citizens to avoid paying legitimate claims, are deeply troubling,' he said in a statement. 'I will get to the bottom of this, uncover any illegal activity, and hold bad actors responsible.' Sanders was subsequently dismissed on Thursday, Superior Healthplan's parent company told The Dallas Morning News. 'The conduct highlighted yesterday during the course of the Texas House Committee hearing is not reflective of our values nor is it a practice Centene's current leadership condones,' the company said in a statement. While the embattled health insurance firm was already facing lawsuits for declining coverage, a series of private investigations allegedly started in 2017 when Sanders took over as CEO. Sanders told committee members that the company had since abandoned the practice of so-called 'routine' background checks on customers. 'We've done what I would call general research,' he said. 'Anything that's publicly available.' According to documents obtained by the Morning News, State Representative Giovani Capriglione, state Senator Charles Schwerner, and former state Senator Dawn Buckingham—all Republicans—are among the victims. 'Why would you go and run a background check, hire a private investigator to follow, to dig into the records of people who are your customers?' Capriglione asked. 'I don't think what any of us expected was for a health insurance company, funded mostly by Texas taxpayer dollars, to use some of those funds to hire private investigators,' he added. The state representative accused the company of 'likely' having known about Sanders' actions before Wednesday's hearing. Capriglione said that legislation has been filed to prevent similar incidents in the future, adding: 'If any company does something like this again, they will never get a government contract again.' State Representative Tony Tinderholt said he was 'appalled' after reviewing a folder of alleged email correspondences between Sanders and firms hired to conduct the investigations – stating he initially thought they were a joke. When asked if he was embarrassed about what was in the folder, Sanders replied: 'Yeah, I am.' 'It could be illegal. I don't know,' Tinderholt said before asking Paxton to investigate the matter and hold Superior Healthplan accountable. The Independent has contacted Superior Healthplan for more information.
The Independent
31-03-2025
- Business
- The Independent
Health insurance CEO admits to hiring private investigators to dig up dirt on patients, doctors and politicians
The CEO of a Texas health insurance company was fired after admitting before a DOGE panel of state lawmakers that he hired private investigators to spy on customers and obtain sensitive details about their lives. Mark Sanders was dismissed from his duties as chief executive of Austin-based Superior HealthPlan after he testified before the Texas House Delivery of Government Efficiency Committee in a hearing on Medicaid procurement last week. Sanders acknowledged Wednesday that private investigators were hired to surveil and glean background information on state lawmakers, journalists, healthcare providers, and patients. Texas Attorney General Ken Paxton announced Thursday that his office was launching an investigation into the company after Sanders' remarks. 'The allegations concerning Superior's actions, such as actions that were characterized as potentially blackmailing lawmakers to secure state contracts and surveilling private citizens to avoid paying legitimate claims, are deeply troubling,' he said in a statement. 'I will get to the bottom of this, uncover any illegal activity, and hold bad actors responsible.' Sanders was subsequently dismissed on Thursday, Superior Healthplan's parent company told The Dallas Morning News. 'The conduct highlighted yesterday during the course of the Texas House Committee hearing is not reflective of our values nor is it a practice Centene's current leadership condones,' the company said in a statement. While the embattled health insurance firm was already facing lawsuits for declining coverage, a series of private investigations allegedly started in 2017 when Sanders took over as CEO. Sanders told committee members that the company had since abandoned the practice of so-called 'routine' background checks on customers. 'We've done what I would call general research,' he said. 'Anything that's publicly available.' According to documents obtained by the Morning News, State Representative Giovani Capriglione, state Senator Charles Schwerner, and former state Senator Dawn Buckingham—all Republicans—are among the victims. 'Why would you go and run a background check, hire a private investigator to follow, to dig into the records of people who are your customers?' Capriglione asked. 'I don't think what any of us expected was for a health insurance company, funded mostly by Texas taxpayer dollars, to use some of those funds to hire private investigators,' he added. The state representative accused the company of 'likely' having known about Sanders' actions before Wednesday's hearing. Capriglione said that legislation has been filed to prevent similar incidents in the future, adding: 'If any company does something like this again, they will never get a government contract again.' State Representative Tony Tinderholt said he was 'appalled' after reviewing a folder of alleged email correspondences between Sanders and firms hired to conduct the investigations – stating he initially thought they were a joke. When asked if he was embarrassed about what was in the folder, Sanders replied: 'Yeah, I am.' 'It could be illegal. I don't know,' Tinderholt said before asking Paxton to investigate the matter and hold Superior Healthplan accountable.
Associated Press
28-03-2025
- Business
- Associated Press
Texas AG investigating insurance company accused of spying on lawmakers, journalists, other Texans
Texas Attorney General Ken Paxton announced Thursday that he has launched an investigation into one of the state's Medicaid insurance providers after allegations that the company illegally spied on Texans. The state is investigating Superior HealthPlan, an insurance company that provides Medicaid coverage to adults and children and coverage for the Children's Health Insurance Program in Texas, for allegedly using private investigators to perform surveillance and gather potentially confidential information on lawmakers, journalists and other Texans. 'The allegations concerning Superior's actions, such as actions that were characterized as potentially blackmailing lawmakers to secure state contracts and surveilling private citizens to avoid paying legitimate claims, are deeply troubling,' Paxton said in a statement. Superior HealthPlan CEO Mark Sanders was questioned Wednesday by members of the Texas House Committee on the Delivery of Government Efficiency about his company's use of private investigators. The topic surfaced as lawmakers questioned company representatives about potential fraud and waste of taxpayer funds connected to its Medicaid contracts, and Sanders told the committee members that the company used private investigators in the past, but hasn't done so for the past few years. On Thursday, Superior fired Sanders, the Dallas Morning News reported. At Wednesday's hearing, Sanders defended his company's actions at the hearing by saying that the information gathered was nothing beyond what was publicly available. 'It was just understanding (what interests people), so we could have been knowledgeable of when we're meeting with different individuals. That's really it,' Sanders replied. Lawmakers expressed concern that the actions aimed to secure leverage to help the company win future state contracts, discredit legitimate insurance claims by individuals, and track journalists reporting on allegations against Superior HealthPlan. 'I disagree. You wanted leverage, and you felt that you were going to use it. Just disgusting,' said state Rep. Tony Tinderholt, R-Arlington. State Rep. David Cook, R-Mansfield, asked Sanders that if there was no intent to gain leverage over people, why did private investigators working for Superior HealthPlan look into legislators' divorce records? 'I don't recall at the time,' Sanders told lawmakers. House Bill 5061, filed by state Rep. Jeff Leach earlier this month, addresses some of the lawmaker's concerns by prohibiting any contractor that works with the state from engaging in surveillance. 'We're up here talking to a company who has received millions, billions of dollars in taxpayer funds through Medicaid contracts, who has used that money to hire private investigators to follow around patients and legislators that are (now) asking questions about what the heck is going on,' said state Rep. Ellen Troxclair, R-Lakeway. 'It's ridiculous.' Tiffany Young, spokesperson for Texas Health and Human Services, referred questions on how the investigation could affect Texans' Medicaid coverage to Paxton's office. The attorney general's office didn't immediately respond to a request for comment Thursday afternoon. ___
Yahoo
27-03-2025
- Business
- Yahoo
Texas AG investigating insurance company accused of spying on lawmakers, journalists, other Texans
Texas Attorney General Ken Paxton announced Thursday that he has launched an investigation into one of the state's Medicaid insurance providers after allegations that the company illegally spied on Texans. The state is investigating Superior HealthPlan, an insurance company that provides Medicaid coverage to adults and children and coverage for the Children's Health Insurance Program in Texas, for allegedly using private investigators to perform surveillance and gather potentially confidential information on lawmakers, journalists and other Texans. 'The allegations concerning Superior's actions, such as actions that were characterized as potentially blackmailing lawmakers to secure state contracts and surveilling private citizens to avoid paying legitimate claims, are deeply troubling,' Paxton said in a statement. Superior HealthPlan CEO Mark Sanders was questioned Wednesday by members of the Texas House Committee on the Delivery of Government Efficiency about his company's use of private investigators. The topic surfaced as lawmakers questioned company representatives about potential fraud and waste of taxpayer funds connected to its Medicaid contracts, and Sanders told the committee members that the company used private investigators in the past, but hasn't done so for the past few years. Sanders defended his company's actions by saying that the information gathered was nothing beyond what was publicly available. 'It was just understanding (what interests people), so we could have been knowledgeable of when we're meeting with different individuals. That's really it,' Sanders replied. Lawmakers expressed concern that the actions aimed to secure leverage to help the company win future state contracts, discredit legitimate insurance claims by individuals, and track journalists reporting on allegations against Superior HealthPlan. 'I disagree. You wanted leverage, and you felt that you were going to use it. Just disgusting,' said state Rep. Tony Tinderholt, R-Arlington. State Rep. David Cook, R-Mansfield, asked Sanders that if there was no intent to gain leverage over people, why did private investigators working for Superior HealthPlan look into legislators' divorce records? 'I don't recall at the time,' Sanders told lawmakers. House Bill 5061, filed by state Rep. Jeff Leach earlier this month, addresses some of the lawmaker's concerns by prohibiting any contractor that works with the state from engaging in surveillance. 'We're up here talking to a company who has received millions, billions of dollars in taxpayer funds through Medicaid contracts, who has used that money to hire private investigators to follow around patients and legislators that are [now] asking questions about what the heck is going on,' said state Rep. Ellen Troxclair, R-Lakeway. 'It's ridiculous.' Tiffany Young, spokesperson for Texas Health and Human Services, referred questions on how the investigation could affect Texans' Medicaid coverage to Paxton's office. The attorney general's office didn't immediately respond to a request for comment Thursday afternoon. We can't wait to welcome you to the 15th annual Texas Tribune Festival, Texas' breakout ideas and politics event happening Nov. 13–15 in downtown Austin. Step inside the conversations shaping the future of education, the economy, health care, energy, technology, public safety, culture, the arts and so much more. Hear from our CEO, Sonal Shah, on TribFest 2025. TribFest 2025 is presented by JPMorganChase.
