Our KELOLAND News investigation followed a 2017 police chase through Moody County that ended in a crash. Three young people suffered from broken necks and brain injuries.
While their families are questioning the legality and necessity of that police pursuit, they are still left to deal with the aftermath.
In the case of 20-year-old Morgan Ten Eyck, a brain injury has left her unable to talk or walk.
After more than 30 years in the military, Morgan’s father counted on his insurance, to cover his daughter’s mounting medical expenses. But the Ten Eycks say they’ve been let down by an insurance company with a new multi-billion dollar government contract: Health Net.
KELOLAND News Investigates uncovered a host of problems with Health Net when it came to veterans’ care in 2016.
In our latest KELOLAND News investigation, Angela Kennecke looks into how it’s hurting Morgan’s chances of gaining back at least some of the function she’s lost.
“She reacts to everything we talk about. She knows when we talk about her, the accident, her friends,” Michelle Ten Eyck said.
Morgan Ten Eyck’s parents say the daughter they knew and loved before June 17, 2017, is trapped inside a body with a badly damaged brain from this horrific crash, when she was thrown from the vehicle.
“There was a bleed throughout her entire brain,” Michelle said.
“She has a disconnect between her brain and her body. That disconnect is slowly coming back. She’s able to lift her arm and reach for things when we ask her to. In the beginning she couldn’t do anything, Michelle said.
After spending two months in a Sioux Falls hospital, Morgan was sent to a brain rehabilitation center in Nebraska.
“You can’t find brain injury specific therapy in South Dakota,” Michelle said.
Her mother says Morgan needs hours of intense therapy every day to create new pathways in the brain. The rehab center provided that.
“She’s getting great therapy; therapists were amazing. Then all of a sudden we were told her therapy is getting cut off and we were getting discharged. And the only response we got was; because of insurance,” Michelle said.
So the Ten Eycks brought Morgan home and spent $30,000 of their own money remodeling their house to accommodate her needs and create their own therapy room.
The medical bills at the Nebraska brain injury rehab center went unpaid for months until the Ten Eycks filed a congressional complaint. Senator Rounds’ office worked on the case, and with the Ten Eyck’s permission spoke to us about it.
“In the middle of this is one step after the other of miscommunication by Health Net and no follow up. And so what we’ve tried to do is direct from the top down, get case manager in place,” Sen. Mike Rounds said.
The Ten Eycks say they are still waiting for Health Net to cover a wheelchair ramp, a ceiling lift to get her in and out of bed and a lift for their van.
“It’s a mess; it’s a hot mess. We have this insurance that offers us coverage. But we can’t get what we need,” Michelle said.
“Instead of taking care of me with an insurance I paid into for over 30 years of military service, they are boiling it down to how much money; how much profit does our corporation make. How much did we pay our shareholders at the end of the day, versus how many people did we help today?” Tom Ten Eyck said.
In January, Health Net got a multi-billion dollar federal government contract to run the military insurance program TRICARE for the western region, which includes South Dakota. Patients began experiencing long call center wait times, backlogged enrollments and referrals and delayed payments to providers.
“When Health Net came in, there was dysfunction, things weren’t working right. They’ve come a long way, but when they first started we had a mess on our hands here,” Sen. Mike Rounds said.
KELOLAND Investigates obtained an email between an Health Net executive and company managers.
James Lariviere Vice President, Government Relations for Health Net Federal Services sent it after an inquiry from Senator Rounds office into Morgan Ten Eyck’s case. Lairivier wrote: “Looks like a beneficiary that had issues that started with United mid-last year and were exacerbated by the switch over the HNFS–or Health Net Federal Services”
If these holdups sound familiar, it’s because KELOLAND Investigates uncovered a similar problem with Health Net involving a different military insurance program called “Veterans Choice.” Local veterans were being denied medical coverage of services by the company. But despite Health Net being behind on nearly $900 million in payments for medical services for vets in 2016, the federal government rewarded the company with the TRICARE contract anyway.
Kennecke: After having seen the things that happened with Veterans Choice, would you have awarded HealthNet another government contract?
Rounds: Not without significant penalties for failure to do the job right.
“We’re not breaking through the bureaucracy of the health care system, even with the congressional support,” Tom Ten Eyck said.
While the Ten Eycks wait for insurance to cover medical equipment for their daughter, they are looking into a new brain injury facility that Health Net will cover.
“The only person that everyone here is hurting is our daughter. We need to get her to a facility where she can get true rehab for a traumatic brain injury,” Michelle said.
“My hope and my desire is that we get the therapy and things she needs to make her new normal more functional. That we get her out of the wheelchair and get her walking on her own two feet,” Tom said.
No matter the challenges, the Ten Eycks say they’re grateful for every day they have with Morgan.
“When we get her out of bed and into her wheel chair she will nuzzle her head and neck right in; right into my shoulder and she’ll just close her eyes, like little kid do. you know. And then I’ll ask her, ‘baby did you need some love today and she will give me a big smile.’ It’s just a different relationship right now, but we always make sure she knows she’s loved and she’s safe,” Michelle Ten Eyck said.
We asked Health Net about the delay in paying Morgan Ten Eyck’s medical bills and her family’s inability to get equipment covered. We received a statement which said, “operations at HNFS are healthy and stable, and there are no systemic issues impeding care to beneficiaries.” Health Net also also told us due to HIPPA, they cannot comment specifically on Morgan’s case.
Morgan’s injuries were the result of a high-speed police pursuit in Moody County in 2017. She was a passenger in a vehicle that ended up crashing at a dead end. You can watch our investigation into that chase by clicking the links next to this story.
Health Net gave KELOLAND News this statement:
HNFS Statement – October 22, 2018
Thank you for your email inquiry. Health Net Federal Services (HNFS) is honored to serve the men and women who serve and their families as a partner with the Department of Defense and the Defense Health Agency (DHA). We are pleased to report that operations at HNFS are healthy and stable, and there are no systemic issues impeding care to beneficiaries.
Due to HIPAA laws and company policy, we cannot comment beyond that we work closely with the DHA on behalf of all beneficiaries to ensure access to quality care outlined in the TRICARE program.