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Despite public scrutiny and complaints from inmates and their attorneys, the Indiana Department of Correction has renewed its contract with its third-party health services provider for up to another year.
But records show that the state is making moves this summer to consider other options.
Many state inmates and federal immigration detainees have raised service concerns in recent months, claiming that the staff of contractor Centurion Health of Indiana have delayed medical treatments and provided improper medication. They are accusations federal and state officials deny.
And in mid-March, shortly before the state’s contract with the Virginia-based private medical provider was set to end, the Department of Correction moved to extend the contract for up to one year, agreeing to pay the company an additional $213 million to provide health care services to state detainees, according to a copy of the latest contract amendment that the department’s spokesperson, Noelle Russell, provided The Indiana Lawyer last month.
The contract, which was first signed in 2021, will extend through March 31, 2027. By then, the state will have spent more than $1 billion on health care services with the company.
The latest extension gives the Department of Correction the ability to terminate the agreement sooner, and an internal email indicates that the agency will be exploring other options — again.
The Indiana Department of Correction issued a solicitation for correctional health care services in September, but it ultimately canceled the process on May 20, according to an email Indiana Department of Administration spokesperson Molly Timperman sent to The Lawyer last month. A copy of the cancellation letter is also now available on IDOA’s website.
It’s unclear why the state canceled its previous RFP, or request for proposal. Department of Administration procurement consultant Angie Alexander said in the cancellation letter that the state “determined it is in its best interest.”
Russell declined to comment. The Lawyer called and emailed Centurion Health for an interview for this story, but those messages were not returned.
“Actual interest in providing services to inmates has to be the core” of a new contract, said Michael Harris, president of Indiana CURE, a nonprofit criminal justice reform organization.
State’s plans
In a written statement to The Lawyer, Russell said the Centurion Health contract was extended simply to ensure continuity of medical services during what the department anticipates will be a “competitive” procurement process.
The Lawyer requested a copy of the canceled RFP. But Alexander said because it was canceled, the state would not be able to provide proposals it had already received. The Lawyer has since filed an open records request seeking documents related to the since-terminated RFP.
According to the May 20 cancellation letter, the state intended to issue a new request for information, or RFI, on or about June 1.
Russell told The Lawyer last week that the department has issued an RFI for pharmacy services, with vendor responses due July 1.
An RFI is a tool state agencies use to gather feedback from potential vendors to gain a better understanding of solutions, risks and cost estimates, Timperman said. RFIs are not procurement methods resulting in a contract award. Rather, the interested agency might use a vendor’s RFI response to develop a future, formal solicitation: an RFP.
An RFP is a publicly posted request that outlines the agency’s specific needs, scope of work, evaluation criteria, contractual requirements and submission instructions.
According to the Department of Administration letter, the state anticipates publishing a new correctional health care RFP around the beginning of July.
After the agency issues its RFP, interested vendors submit proposals, which are then evaluated by a review team using criteria established in the RFP. Some of the evaluated areas include the vendor’s qualifications and experience, ability to meet the state’s requirements and cost.
After evaluating the submitted RFPs, the state can enter negotiations with the respondent that scores the highest on the criteria before finalizing a contract, Timperman said.
Only once a contract is awarded and executed does a vendor’s proposal become public.
State Rep. Ed DeLaney, D-Indianapolis, said the planned procurement process is evidence the state wants options, especially as it continues to provide services for U.S. Immigration and Customs Enforcement detainees.
“They want a choice at a time when they’ve added this large new responsibility, so it’s a difficult set of facts,” DeLaney told The Lawyer.
“I have some sympathy with trying to find or retain a supplier for such important services at the same time you’re rapidly expanding your population,” he added.
The state agreed in October to house ICE detainees. The Miami Correctional Facility in Bunker Hill now holds about 600 immigration detainees daily, said DeLaney, who has toured the facility numerous times.
No matter what the next contract entails, Indiana CURE’s Harris emphasized the need for government oversight, particularly from the Governor’s Office.
“There has to be some accountability for not only how we’re spending money but also for what services we’re providing,” Harris said.
Indianapolis civil rights attorney Stephen Wagner, who has handled numerous inmate death cases over the past 20 years, supports the idea of the state moving away from privatized medical care and toward state-run services. But even if the state maintains a private contractor, he encouraged a different approach to the one already in use.
“I think it’s about looking at the incentives to patient care and not capitating all of those costs in a contract, but leaving open the option of the state retaining responsibility for outside costs, so that you don’t have a nurse practitioner sitting there worried about sending a patient out to the emergency room because they might get called out by a supervisor for eating into, what might be, a razor-thin profit to begin with,” Wagner said. “I think it puts medical decision-making in a difficult place to put all of that financial responsibility on the contractor.”
The contract
The corrections department entered into a four-year, $673 million contract with Centurion Health on July 1, 2021. It was the most expensive proposal from four vendors at the time, news outlets reported.
According to DeLaney, six companies bid for the health services contract but only two competitors qualified, among them Centurion Health. DeLaney, who is an alternate member of the State Budget Committee, said he does not know who the other qualified applicant was.
Under the original contract, Virginia-based Centurion Health oversaw health care needs, including medical, dental, mental health, pharmacy and addiction recovery services, at all of the state’s prisons.
The all-inclusive contract essentially leaves Centurion Health to handle all the costs associated with inmate medical care, which Wagner considers “problematic” because it also means Centurion makes important medical decisions, such as when to send an inmate for surgery or emergency care.
“There’s definitely a financial cost to Centurion to send a patient out of the prison, and so that raises questions about the timeliness of those referrals,” Wagner said.
Centurion provides health care services in more than 10 states and to nearly 275,000 incarcerated individuals, according to the company’s website.
But Centurion has faced scrutiny across the country in recent years for what some call subpar medical service and staffing shortages.
A quick search of federal court dockets shows that Centurion Health of Indiana faces more than 150 active lawsuits in the Northern and Southern Districts of Indiana, all of which relate to conditions of confinement or prisoners’ civil rights issues.
Centurion Health has also been Missouri’s prison health contractor since 2021, according to the Missouri Independent newspaper. During a Missouri House Corrections Committee hearing earlier this year, Missouri Department of Corrections Director Travis Foley said that the state fined Centurion Health for failing to meet standards in each quarters since its contract was renewed in 2024.
Under the original contract with Indiana, Centurion Health was required to reimburse the state when it failed to meet the minimum staffing schedule, known as a staffing payback.
From Jan. 1, 2022, to June 30, 2022, Centurion Health agreed to pay the state for any month it did not meet 85% of the required full-time equivalent hours, or FTE, which is essentially the measure of total labor hours rather than headcount.
The total allotted FTE for all of IDOC’s facilities was 825.38 in 2021, which explicitly included a Centurion Health regional office. For 2026, the number is 791.84. (It’s unclear whether the updated 2026 staffing levels also include the regional office.)
Some of the positions outlined in the staffing matrix that Centurion Health was to fill included licensed practical nurses, registered nurses, behavioral specialists and dentists, among many others.
State records show that at Miami Correctional Facility, the number of Centurion-staffed FTE dropped from 67.25 per week in 2021 to 62.25 in 2026. Among the positions that lost FTE hours were licensed practical nurses, which saw a drop of 2 hours (from 11.6 in 2021 to 9.6 in 2026). Registered nurses also decreased by one FTE, from 12.6 to 11.6.
The staffing payback requirements fluctuated over the years, but in June 2025, when the state extended the contract to March 31, 2026, the parties completely removed the section of the contract that provided for staffing paybacks.
It is currently unclear whether or how often Centurion Health has failed to reach staffing benchmarks. The Department of Correction did not address questions about the staffing paybacks.
According to an August 2023 contract amendment, Centurion Health must provide quarterly reports to show whether its staffing levels remained below 85% of the required hours for any position and any action plans describing the efforts to address a shortage.
The Lawyer filed a records request with IDOC earlier this month, asking for copies of any such reports, but it has not received any documents as of publication.
Other recent revelations
Many political leaders, prison-advocacy organizations and immigration attorneys have sounded alarms in recent months about inadequate health care coverage at Indiana’s prisons, specifically Miami Correctional Facility.
The Indiana Lawyer recently reported that U.S. Immigration and Customs Enforcement detainees and their attorneys say they have been subject to delayed medical treatment at the large Bunker Hill prison, nicknamed the “Speedway Slammer” by former Department of Homeland Security Secretary Kristi Noem.
Wagner said he hopes the state looks at available data when evaluating new provider options and places patient care over costs.
“When someone’s incarcerated, they can’t just pick their doctor; they can’t go to the emergency room if they know something’s wrong,” Wagner said. “They’re completely dependent upon the prison and then the prison medical contractor to provide that care and get them the needed care.”
But health care is just a piece of the concerns.
“The whole system needs to be revamped,” said Harris, the president of Indiana CURE.
Official grievance reports that The Lawyer obtained earlier this year — documents that could include complaints from state and federal inmates — showed a pattern of poor nutrition and unsanitary living conditions. Many inmates described being forced to remain in cells flooded with feces and urine-laced water for days on end.
Under its contract with the federal government, which ends in September 2027, the state is to be reimbursed for housing ICE’s detainees. But so far, those payments have been delayed by at least a few months.
According to an email the Department of Correction sent to the State Budget Committee in March, the state had spent more than $10 million to house ICE detainees since last fall. According to the email, which The Lawyer obtained last month, the federal government had only reimbursed $5 million for Indiana’s October and November expenses.
The state has since received a $4.7 million payment for December, according to the Indiana Capital Chronicle, and a $5.2 million payment for January, Russell told The Lawyer.
During the State Budget Committee’s June 18 meeting, Department of Correction Commissioner Lloyd Arnold told the committee that the department recently received an additional payment from the federal government for housing its detainees in February.
Although Arnold did not specify the amount at the meeting, Russell later told The Lawyer that it was $4.5 million.
This brings the total to about $20 million.•
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