Quick Look: Federal Investigators Subpoena Zoom Health Plan

State officials have confirmed they are assisting a federal investigation into Zoom Health, which is in receivership, even as they proceed with a lawsuit against Zoom Management.

The exact nature of a federal investigation into Zoom Health Plan is not clear, but officials with the company, as well as state insurance regulators and a several current and former employees, all have confirmed that investigators delivered a subpoena to CEO Dave Sanders on Thursday morning.

A former employee says they believe the subpoena is related to a whistle-blower report given to the FBI, in which that employee alleged that Zoom Health submitted incorrect financial reports in order to improve its bottom line.

“We are still trying to figure out what the investigators are trying to get at and we don’t have anything to say on the record,” said Len Bergstein, a Zoom Health spokesman. “We are not going to comment on what any former employees might have to say.”

Zoom is also being investigated by state insurance regulators, who have placed the health plan in receivership, and who have sued Zoom Management in state court for $3 million over its handling of its finances.

“We can confirm that our receivership offices for Zoom Health Plan were visited by federal investigators and that they interviewed select staff,” said Jake Sunderland, spokesman for the Oregon Department of Consumer and Business Services, which houses the state Insurance Division.

Lisa Morawski, a spokewoman also with DCBS, said the Insurance Division is still working to get a full picture of the financial operations of Zoom Health Plan, and could not provide specific details about allegations shared by former employees.

But according to The Lund Report’s primary inside source, Zoom Health Plan CEO Dave Sanders directed workers to hide reimbursement information from government officials, patients, and even many employees of the health plan and its sister company Zoom Management Inc. The goal of this secrecy was allegedly to avoid large payments required of health plans sold on Affordable Care Act exchanges that spend less than 80 percent of premium dollars on medical care.

Click here to read the full in-depth Lund Report examination of Zoom Health.

--

Reach Courtney Sherwood at sherwood@thelundreport.org.

News source: