IDOC replaces prison health care provider

The Idaho State Correctional Institution is  a 1,446-bed, medium-security men’s prison south of Boise. (Photo courtesy of IDOC)

By Ruth Brown, Idaho Reports

As coronavirus continues to rage across Idaho’s unvaccinated population, the Idaho Department of Correction has changed health care providers.

IDOC is responsible for the health care of roughly 8,000 people in the department’s custody. For more than 10 years, the department contracted with Corizon Health. Corizon was established in 2011, after merging with two other medical services companies that IDOC also used for resident care.

But on Oct. 1, Centurion Health took over that contract to provide IDOC residents with medical and mental health care. The state will pay Centurion $299,418,000 across five years through its contract, according to copies of the agreement.

The contract will last from Oct. 1- Sept. 30, 2026, costing roughly $59.833 million a year for the care of people in custody.

Idaho Reports obtained copies of the contracts through a record request. 

Centurion’s five-year contract includes up to 10 years of renewal options.

“Centurion is honored to be awarded the contract to provide care for the residents of the IDOC,” said Centurion CEO Steven H. Wheeler in an August press release. “Centurion strives to infuse innovation with high-quality care and we look forward to building a strong relationship with the IDOC based on their passion to do the same.”

As the health care provider, Centurion takes on sole responsibility for the provision of healthcare services and all associated costs of that care during the term of its contract. 

Per the agreement, Centurion must designate an infection control coordinator, among other issues. A physician licensed in Idaho must be available 24-hour a day, every day for emergencies. Emergency response times via telephone cannot exceed 15 minutes.

The contract covers everything from pharmaceutical treatment, to chronic illness, to oral health and diagnostics.

The proposals from other health care companies that submitted proposals to the Board of Correction were not subject to public record, per Idaho code 74-107 1(a). The Board received several proposals which were weighed based on services offered and cost. 

Corizon Health’s contract for 2019-2020 with IDOC paid the provider per diem $17.56 per inmate per day for all medical and some mental health services, according to Board of Correction minutes from March of 2019. At the time, the contract allowed for a second-year renewal. 

In the last Idaho legislative session, IDOC was allocated $55.8 million to pay for medical services in fiscal year 2022. That means medical services were little more than one-fifth of IDOC’s total $309 million budget.

In IDOC’s fiscal year 2023 budget request, which has not yet been approved, IDOC asked for $68 million for medical services.

Corizon also recently lost a $1.4 billion contract to Centurion Health that Corizon held with the Missouri Department of Corrections. That issue is heading to the court in November, according to the Missouri Independent

Corizon Health has contracts with correctional facilities across the country, but has been the subject of several lawsuits in Idaho in recent years.

Corizon has faced lawsuits from Idaho inmates filing claims ranging from untreated infection to untreated hepatitis C, or delays in timely care that resulted in adverse outcomes for incarcerated patients.

Historically, IDOC used medical care from companies called Correctional Medical Services (CMS), and Prison Health Services (PHS), from at least the late 1990s until 2011, when the companies merged and became known as Corizon, according to IDOC. Corizon is now based in Tennessee.


Hospital lawsuits

St. Luke’s Health System and Saint Alphonsus Health System both sued Corizon Health around 2018 due to what they claimed was millions of dollars in unpaid medical bills. 

Corizon was paying the health systems at the Medicaid rate, which is lower than what the health systems agreed to accept for patient care. The health systems treat people who are in IDOC custody but need specialized care or hospitalization. 

The Idaho Supreme Court in 2018 weighed in on a lawsuit between Corizon Health and Portneuf Medical Center in Pocatello. Portneuf was providing care to some inmates at the Pocatello prison and expected reimbursement at a higher rate than the Medicaid rate. 

The Supreme Court found that “the statute is clear in that it prohibits the ‘state board of correction’ from paying more than the Idaho Medicaid reimbursement rate to a ‘provider of a medical service’ whose services are ‘billed directly to the department of correction.’”

But, the hospital’s bills were being sent to Corizon Health, which is only a contractor with IDOC, and is a for-profit private company. The court ruled that Corizon does not fall under the exception of being prohibited from paying more than the Medicaid rate. 

The Balla case 

Medical care for in-custody people has been an ongoing, evolving system at prisons across the nation, including Idaho. 

In 2012, a special master report was released regarding Idaho State Correctional Institution that said health care was so poor at the facility it amounted to neglect and cruel and unusual punishment. Corizon disputed the claim, saying the report was misleading and erroneous

In 2015, IDOC was sanctioned after a federal judge determined that it intentionally misled the court about medical and mental health care provided to inmates, according to the Associated Press. 

The report followed the prominent case of Balla v. Idaho, stemming from Walter “Bud” Balla, an inmate at ISCI who in May 1981 sued the Idaho Board of Correction over conditions within the prison, including medical care. The litigation in that class-action suit would last for nearly 40 years, until a federal judge closed it in 2020. 

Today, the Balla case is regularly referenced in lawsuits between IDOC and inmates taking issue with conditions or care.

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