Debate: Are Proprietary Correctional Healthcare Providers Reliable Partners To Corrections?

Highlighted Stories

Editor's Note

When it rains, it pours. This week brings a downpour of stories about proprietary correctional healthcare vendors: Wellpath, NaphCare, Wexford, and VitalCore. One reason states and local jurisdictions contract with these companies is the belief that they are stable and reliable partners. Let us take a look at that assumption.

We begin with Wellpath. Subscribers may recall that last week we highlighted a story from Charleston County, South Carolina, in which an attorney representing a detainee in a malpractice suit against Wellpath was seeking the financial records of county officials connected to an earlier contract with the company. The attorney stopped short of alleging impropriety. Earlier this year, on February 3, we also covered a story from Arkansas in which a state legislator accused officials of “fraud and corruption” in the handling of a renewed contract with Wellpath. The state had sought a cheaper alternative, but after the RFP process it stayed with Wellpath at a price $350 million higher than Wellpath’s original proposal.

Against that backdrop, the first highlighted article, from Kentucky, brings further accusations of fraud. In Kentucky, correctional healthcare vendors are required to maintain third-party insurance to cover medical negligence and wrongful-death claims. We previously covered the story of Britney Jones, whose brother, Chad Lake Raymond, died in a Kentucky prison. She sued the state attorney general and the corrections commissioner for allowing Wellpath to operate with what Wellpath’s own insurance director acknowledged was merely a “fronting policy” — an arrangement offering no real protection against lawsuits. That insurance was also supposed to protect against the consequences of Wellpath’s bankruptcy, which it plainly failed to do. Now the state itself has joined the lawsuit, questioning not only the insurance arrangement but the bankruptcy itself as a means of avoiding liability while continuing to profit from public contracts.

These accusations do not arise in a vacuum. As we noted also last week, when Wellpath operated as Correct Care Solutions, its CEO, Gerald Boyle, and the sheriff of Norfolk County, Virginia were convicted on felony bribery charges tied to jail medical services. Still, perhaps things are changing at Wellpath. This week’s news also includes the announcement that Wellpath has changed its name — drumroll please — it is now New Wellpath.

But we are far from done.

Now to NaphCare. The New York attorney general has barred NaphCare from operating in New York State for five years. (The last time this happened was in 2016, when Armor Correctional Health Medical Services was barred for failing to meet contractual obligations in the Nassau County Correctional Center). NaphCare was found to have violated New York’s prohibition on the corporate practice of medicine by setting up a shell company in New York while medical decisions were actually being made in Alabama. What is particularly striking is that NaphCare had reportedly been violating the law since 2020. This has a familiar feel: as with Wellpath’s insurance, the problem appears to have gone largely unaddressed until deaths and lawsuits forced the issue. In NaphCare’s case, multiple deaths occurred in Onondaga County jails before investigations uncovered the unlawful corporate structure. It is worth noting that California, like New York, also prohibits the corporate practice of medicine. One wonders where NaphCare may have similar arrangements there. As our readers know, the San Diego sheriff currently has a contract with NaphCare.

Turning to New Orleans and Wexford, we find another form of instability. Wexford, the jail’s healthcare provider, abruptly fired Dr. Andrea Blake, the jail’s medical director for many years. The dismissal prompted Judge Kimya Holmes to ask whether detained people were receiving their medications at all, given that the jail suddenly had no medical director. Another judge, Lance Africk, ordered Wexford to appoint one. Wexford says it gave proper notice of Dr. Blake’s departure. It also quickly found an interim replacement: Dr. Charles Cucchiara, who received his medical license 60 years ago in 1966. He is now 86 years old.

Finally, we turn to Massachusetts and VitalCore. As we all know, suicide is a major risk in correctional settings. The last highlighted story, from the Boston Globe, examines suicides in the Behavioral Assessment Unit — essentially solitary confinement. A psychologist, Sharen Barboza, faulted VitalCore, the healthcare provider in the Massachusetts prison system. Documentation showed that the vast majority of contacts with medical staff lasted less than five minutes, and in some cases less than a minute.

So let us return to the assumption that proprietary correctional healthcare vendors are hired because they are stable and reliable partners. Is that really true? When we see accusations of fraud, hollow insurance, violations of state law, hurried appointments of octogenarians to critical medical roles, and what appear to be cursory assessments of high-risk patients, are these companies bringing stability and reliability? Or are they introducing yet more instability into an already fragile system—at a very high cost? On the other side of the equation, these proprietary contracts are typically for a fixed price which are perceived to provide consistency to state and county budgets.

Wellpath

Kentucky state agencies, including the Department of Corrections, have joined a lawsuit challenging Wellpath’s insurance coverage, arguing it may have been fraudulent or legally unenforceable. The case grew out of a suit filed by Britney Jones after her brother died in Wellpath’s care at Eastern Kentucky Correctional Complex. When Wellpath declared bankruptcy, her attorney began questioning whether the company had the required insurance to cover settlements at all. Kentucky now wants additional defendants added, including insurers and brokers, and is asking the court to determine whether the coverage Wellpath presented was essentially sham coverage. The state is also raising the possibility that Wellpath used bankruptcy to avoid responsibility while continuing to profit from public contracts. Wellpath continues providing healthcare in Kentucky prisons and has received $72 million from the state this fiscal year. The article also notes that this issue is not confined to Kentucky: Wellpath faced hundreds of lawsuits nationwide as of October 2025, and similar allegations about inadequate or misleading insurance have surfaced in Georgia. For the current fiscal year, the state paid $72 million to “New Wellpath LLC,” the version of Wellpath that emerged from bankruptcy proceedings to continue providing health care services to Kentucky prisoners.

NaphCare

NaphCare provided medical services at Onondaga County jail facilities from 2020–2022. Following multiple in-custody deaths, the New York Office of the Attorney General (OAG) launched an investigation and uncovered a scheme in which NaphCare created a shell New York corporation called Proactive to appear legally compliant, while actually running medical operations illegally from Alabama. In practice, NaphCare employees in Alabama were issuing treatment orders, prescribing medications, and directing patient care remotely — often without ever seeing or speaking to patients — in violation of New York's corporate practice of medicine laws, which prohibit non-medical corporations from owning medical practices. NaphCare must pay $875,000 in penalties and is prohibited from bidding on or entering into any contracts with New York state or any New York municipality to provide correctional health services for five years. For an additional five years after that, NaphCare must provide advance notice to OAG and receive written approval before entering into any such contract.

Wexford

Orleans Parish Criminal District Court Judge Kimya Holmes wanted to know: Were inmates from the Orleans Justice Center who require medication were receiving it? The judged raised this question two days after Wexford Health notified the Oreleans Parish Sheriff's Office (OPSO) that it had fired Dr Andrea Blake, the longtime medical director at the jail. Blakes resignation caused growing concerns about inmate care at the city’s jail during the time when no one was in that role. U.S. District Judge Lance Africk ordered Wexford to “retain a medical doctor with the qualifications and experience necessary to assume the Medical Director’s responsibilities and administer constitutionally adequate care to the inmates and staff of a correctional facility”. Next Sheriff’s Office announced that Wexford had named Dr. Charles Cucchiara as interim medical director for the Orleans Justice Center. State records show Cucchiara, who specializes in family medicine, has been licensed in Louisiana since 1966.

VitaCore

Drugs, isolation, and drive-by clinician visits at state prisons. Is it any wonder six inmates died by suicide in two Massachusetts prisons last year? A newly released report on those suicides, authored by a clinical psychologist with expertise in corrections, is shockingly candid not simply about how those deaths took place, but about the everyday horrors of a system where drug intoxication is not uncommon and isolation in a so-called behavioral assessment unit (BAU) has often been the prison system’s response. A psychologist, Sharen Barboza, has stated that the frequency with which deaths by suicide in 2025 included substance use and BAU placement cannot be overlooked.” She also faulted the clinical response from the system’s relatively new, for-profit health care provider, VitalCore, noting, “the vast majority of [clinical] contacts documented with individuals in the BAU last for under five minutes, with some being documented as lasting less than one minute.”

Follow Ups

Oversight

Editor's Comment: This article from Harris County, Texas, raises a basic but important question: how can a jail remain in compliance with the Texas Commission on Jail Standards while people continue to die there from a range of causes, including homicide and overdose? But this problem is hardly unique to Texas. Since 2024, COCHS has repeatedly expressed skepticism about the effectiveness of correctional oversight, noting in one Editor’s Note that “oversight embedded within correctional systems are often ineffective.” Which brings us, once again, to COCHS’s consistent refrain: improving healthcare outcomes behind the walls requires a system that stands outside these internal conflicts—namely, Medicaid.

Texas jails have to meet 26 standards that include health services, supervision, commissary, and the admission and release process to be compliant with the state regulatory authority, the Texas Commission on Jail Standards. In Harris County, twenty in-custody deaths were reported by the jail last year, including one homicide. So far in 2026, two deaths have occurred. The cause of death in both 2026 cases is pending autopsy. Both men, ages 55 and 56, were sent to hospitals with medical emergencies. That could mean anything from a drug overdose to a pre-existing condition to being beaten up by another prisoner. A series of failed inspections dates back to 2022, citing staff shortages, missed medical appointments, delayed ER visits and faulty fire alarms. Sheriff’s department personnel say all those issues have been addressed, so does that mean there’s hope for fewer inmate deaths this year? Not necessarily.

Arizona

Editor's Comment: As our subscribers know well, healthcare in Arizona’s prison system was recently placed into receivership by Judge Roslyn Silver. In response, multiple elected state officials—including Governor Katie Hobbs and Arizona Senate President Warren Petersen—have protested the decision. So it comes as little surprise that the Arizona Department of Corrections, Rehabilitation and Reentry (ADCRR) has now filed a Notice of Appeal. Nor is it surprising that another incarcerated person is suing ADCRR’s healthcare vendor, NaphCare, for malpractice. Yes, that NaphCare—the same company recently barred from practicing in New York State (see this week’s Editor’s Note).

Arizona prison officials appealed a federal judge’s order placing prison health care under outside control, escalating the legal fight over medical and mental health services in the state’s prison system. The Arizona Department of Corrections, Rehabilitation and Reentry (ADCRR) filed a Notice of Appeal with the U.S. Court of Appeals for the Ninth Circuit. The appeal challenges the U.S. District Court’s order that appointed a “receiver” to oversee all health care services in the nine state prisons run by the department last month. This wouldn’t cover the nearly 10,000 people incarcerated in private prisons for state convictions.

An inmate is suing the Arizona Department of Corrections, Rehabilitation & Reentry, its health care vendor NaphCare and a long list of carceral health care providers for medical malpractice, alleging failing to provide care for a severely infected wound.

Medicaid

The Wisconsin State Senate passed a bill last week that will request funding for health care coverage for incarcerated people from the federal government. State Assembly lawmakers had already passed the bill last month. Under the bill, the state’s Department of Health Services would submit a request to conduct a demonstration project to provide 90 days of prerelease coverage to incarcerated people for case management services, medication-assisted treatment for all types of substance use disorders and a 30-day supply of prescription medications. Incarcerated people would have to be otherwise eligible for coverage under the Medical Assistance program, which provides health services to people with limited financial resources.

Mental Health

The Bureau of Justice reports that 15% of persons in prison and 24% of persons in jail reported having thought disturbances. Psychotic patients have lost touch with reality and have unusual thought disturbances such as hallucinations and delusions. Thus, correctional nurses are likely to provide nursing care to psychotic patients during their career. The most common psychotic disorder is schizophrenia, but patients can manifest any variety of psychotic symptoms without having this diagnosis.

ICE

The number of immigrants in ICE custody has nearly doubled in the last 14 months, and the detention centers have been strained by the surge. A spokesman for CoreCivic, which operates the Arizona detention center where Emmanuel. Damas fell ill and died of a tooth infection, said only that the company takes “very seriously” the death of anyone in its care. Many ICE detention facilities are run by large private companies, such as CoreCivic and the GEO Group, that also operate many prisons. The companies say that they provide round-the-clock medical care and proper diets and that they are subject to government oversight. But a federal lawsuit and more than two dozen interviews with lawyers, detainees and their family members and elected officials depict acute deficiencies that they believe contributed to the deaths.

At a protest outside the Adelanto ICE Processing Center earlier this month, hundreds of Angelenos expressed opposition to conditions faced by immigrant detainees — and many said the facility would be more aptly described as a “concentration camp.” Current and former detainees say immigrants at the Adelanto ICE Processing Center face substandard conditions, including rotten food, denial of medical care and solitary confinement. At least 23 people have died in ICE detention this fiscal year. Across the country, about 70,000 people are currently detained.

The ACLU of Louisiana today sent formal demand letters to ICE detention facilities across the state, citing widespread failures to provide detained immigrants with adequate access to legal counsel, a fundamental constitutional right and a requirement under ICE’s own Performance-Based National Detention Standards. The letters detail systemic barriers at facilities where detained immigrants face months long delays in receiving legal documents, unreliable phone appointment systems, and confidentiality violations that make meaningful attorney-client communication nearly impossible.

The Otero County Commission voted Wednesday night to once again extend its federal immigrant detention contract, setting up a growing legal battle with the State of New Mexico as a new law banning such agreements is set to take effect in May. The unanimous vote extends the county’s agreement with ICE and private prison operator Management and Training Corporation (MTC), allowing the Otero County Processing Center in Chaparral to continue housing federal immigration detainees. The move comes after the far-left Democrat-led New Mexico Department of Justice under Attorney General Raúl Torrez claimed that the county’s previous attempt earlier this month to extend the contract violated the state’s Open Meetings Act.

The Adams County Correctional Center, located near Natchez in southwestern Mississippi, is one of more than 200 ICE detention facilities nationwide. Operated by CoreCivic Inc., the facility holds more than 2,000 detainees and is a major employer in the area, with roughly 400 staff members. In 2021, a Department of Homeland Security inspection found deficiencies in medical care and facility operations, including delayed responses to grievances and inadequate COVID-19 protocols. The American Civil Liberties Union has called for the shutdown of the facility. The facility operates under a contract with ICE, paying approximately $3.9 million monthly, with costs expected to rise.

Aging

A growing share of the state’s incarcerated population is older and sicker — a demographic shift that’s driving rising costs. Research shows that incarceration has adverse effects on health and accelerates aging, and people develop chronic and life-threatening illnesses earlier than those outside prison. A 2018 report by the Program Evaluation Division at the N.C. General Assembly found that average health care spending for an incarcerated person age 50 and older is typically four to five times higher than for younger prisoners — costing the prison system an estimated $27,748 more per person each year.

A new report shows a number of inmates eligible for parole have died in prison instead — in part because they have nowhere else to go. The report from Nebraska’s Inspector General of Corrections focuses on people eligible for either medical or geriatric parole. The Inspector General of Corrections found several cases where inmates were eligible for these types of parole but died behind bars because the state could not find anywhere for them to go.

Lawmakers are considering whether to streamline the process to release people with serious health problems from Oklahoma prisons. Senate Bill 1255 would the allow the chief medical officer of the Oklahoma Department of Corrections to submit cases for medical parole directly to the Pardon and Parole Board, which makes the ultimate decision on who is granted release. The bill lands as Oklahoma faces a problem that states across the nation are trying to handle: An aging prison population that needs more advanced care.

Transgender

The Department of Justice told the governors of Maine and California on Thursday that it was investigating their housing of transgender women in women’s prisons, to assess whether the constitutional rights of other prisoners at the facilities had been violated. Federal officials said they would investigate “allegations of sexual assaults, rape, voyeurism and a pervasive climate of sexual intimidation due to the presence of males” in women’s prisons in California. In Maine, they said, they were responding to allegations that “a biological male” remained housed with women despite complaints that the inmate had assaulted or harassed female inmates.

State Roundup

Connecticut

The state Department of Correction needs to do a better job providing nutrition, medication and treatment for the state's 11,000 incarcerated people, a legislative committee said. The bill, which won bipartisan support in the Judiciary Committee and next goes to the House, would order an audit of nutrition and food services, and require medical histories of offenders in pre-sentencing reports. Nine inmates have died in Connecticut prisons this year, according to data from the state Office of the Chief Medical Examiner and state officials.

Texas

The trial over insufficient air conditioning in Texas prisons is slated to start in Austin. The proceeding comes over a year after U.S. District Judge Robert Pitman said in a groundbreaking, 91-page ruling that housing Texas prison inmates in sweltering facilities that lack air conditioning is “plainly unconstitutional.” Pitman declined last March to order the Texas Department of Justice to immediately install temporary or permanent air conditioning, instead forcing the plaintiffs to move towards a trial.

Smith County in East Texas has agreed to pay a $1.5 million settlement to more than 100 people kept in that county jail after completing their sentences. An attorney now with Southern Methodist University's Deason Criminal Justice Reform Center filed the federal lawsuit for three people who were kept detained after they were eligible for release.

Technology

California transformed the way its prison population connects to the outside world by handing every incarcerated person an electronic tablet to make free calls, receive messages and access other services. But today, the entire system with almost 90,000 prisoners is in the midst of a disruptive switch to new tablets from a new vendor. The project is months behind schedule, which temporarily resulted in increased text messaging charges for consumers at the first prison facility where it became fully implemented. This comes after a bidding war between the two national companies that provide these services, Securus and Viapath/Global Tel Link. Securus came out ahead, claiming the four-year $189 million contract and replacing Viapath. Incarcerated tablet users worry most about two aspects of the switch from Viapath to Securus: disruptions in service as their facility transitions and losing access to the personal photos, videos and messages they’ve received over the last three years.

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