Tag: Medicaid

I really should not mock Maxine Waters…………….

……but I am going to nonetheless H/T Moonbattery

Of course she did not mean 700,000,000,00 people in Kentucky will be kicked off Medicaid. She knows that is not true. She just misspoke. However, Maxine Waters has said dozens of other things that are so sincerely stupid that I am cutting her no slack! In fact, the only people more clueless than Mad Maxine are the knuckle dragging paste eaters that vote for her

Arkansas Governor Hutchinson Ends Taxpayer-Funded Medicaid Payments To Planned Parenthood

Arkansas Ends Taxpayer-Funded Medicaid Payments To Planned Parenthood – Christian News Network

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The governor of Arkansas has directed the state Department of Human Services to terminate its Medicaid contract with the abortion giant Planned Parenthood.

In compliance with the request, the department sent a letter to Planned Parenthood of the Heartland on Friday as notice that the contract was being terminated.

“[T]he Arkansas Department of Human Services is hereby exercising its authority to terminate its existing agreements with Planned Parenthood of Arkansas & Eastern Oklahoma,” the correspondence reads. “The termination… will be effective 30 days from the date of this letter.”

Gov. Asa Hutchinson has also released a statement about the move, remarking that the decision was influenced by the recent video exposes’ outlining Planned Parenthood’s apparent harvesting and sale of aborted baby organs.

“It is apparent that after the recent revelations on the actions of Planned Parenthood, that this organization does not represent the values of the people of our state and Arkansas is better served by terminating any and all existing contracts with them,” he said. “This includes their affiliated organization, Planned Parenthood of Arkansas and Eastern Oklahoma.”

Planned Parenthood likewise released a statement, stating that by revoking the agreement, states like Arkansas are aligning themselves with “extremists.”

“The politicians behind these reckless policies have allied themselves with extremists who will stop at nothing to end access to abortion – breaking laws, pushing misinformation, and violence and harassment of women and doctors,” it read in part.

Arkansas is the fourth state to pull funding to Planned Parenthood, following Alabama, Louisiana and New Hampshire. As previously reported, the New Hampshire State Executive Council voted earlier this month despite objections from Gov. Mary Hassan to cancel its $650,000 contract with the abortion giant. The funds will be reallocated to other women’s health facilities.

The day prior, Louisiana Gov. Bobby Jindal announced that the state would terminate Planned Parenthood’s Medicaid contract.

“Planned Parenthood does not represent the values of the people of Louisiana and shows a fundamental disrespect for human life,” he said. “It has become clear that this is not an organization that is worthy of receiving public assistance from the state.”

The Obama administration has contended that it is illegal for states to terminate Medicaid contracts with Planned Parenthood because of its abortion services. Medicaid payments do not include abortions, but still provide support to the organization.

“Even though we anticipate a federal review, standing up for Arkansas values is most important to the governor,” spokesman J.R. Davis told the Arkansas Times.

“American tax dollars should not be used to subsidize billion-dollar corporations that inhumanely and illegally sell baby body parts,” Alliance Defending Freedom (ADF) Senior Counsel Casey Mattox said in a statement. “Tax dollars that went to two Planned Parenthood clinics in Arkansas will be better used by the 179 community health centers and other clinics that actually provide comprehensive health care. We commend the governor and hope other states will follow his example.”

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Michigan Healthcare Providers Defraud Medicaid To The Tune Of $29M

Medicaid Scam In Michigan Takes $29 Million From Taxpayers – Daily Caller

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Health care providers defrauded Medicaid to the tune of $29 million by coordinating with a day care center for mentally ill adults to steal patient information, the Washington Examiner reports.

Abdul Malik Al-Jumail and his daughter Jamella Al-Jumail created a series of fake health companies, and then collaborated closely with Felicar Williams, 51, who ran the day care center. Felicar would steal patient information, the Jumails would file false claims, and then provide kickbacks to Felicar. Many complex procedures for mental health were billed that were simply never provided.

Sometimes the Jumails would even fabricate entire medical records if necessary to gain reimbursement, showing how patients desperately needed treatment, and how their companies provided care. All three individuals involved are now in prison. The actual sentencing, however, hasn’t yet been scheduled. Two others, Mohammed Sadiq and Philandis Thomas, are charged in the indictment and scheduled for trial later this month. Another individual remains on the loose.

A 61-year-old psychiatrist, Carey Vigor, was also named in the indictment, but was later acquitted by the jury.

As the investigation by the Department of Health and Human Services inspector general (HHS-OIG) deepened and Malik Al-Jumail was promptly arrested, his daughter panicked and instructed an employee to burn the falsified medical records. In total, they siphoned off $29 million dollars in the scam.

However, since its inception in 2007, the HHS-OIG has worked closely with the Department of Justice and the FBI, among others. These agencies together work in the Medicare Fraud Task Force, and together, they have recuperated approximately $14.9 billion dollars. The task force has charged almost 2,000 individuals and operates in 9 cities across the United States.

With this recent case in mind, the HHS Centers for Medicare and Medicaid Services are joining with the HHS-OIG to further crackdown on fraud.

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Corruption Update: Medicare/Medicaid Administrator Instructed Subordinate To Delete Obamacare-Related Email

Top Obamacare Official: ‘Please Delete This Email’ – The Blaze

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Congressional investigators are demanding answers from Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner after she reportedly instructed a subordinate to “delete” an Obamacare-related email conversation involving key White House officials.

In a August 15 letter to Tavenner, leaders of the House Committee on Energy and Commerce bring to light an October 5, 2013, email discussion involving White House representatives. The email was then forwarded to the CMS communications director with the following message: “Please delete this email-but please see if we can work on call script.”

According to veteran journalist Sharyl Attiksson, this revelation is “significant” for a number of reasons:

First, the email to be deleted included an exchange between key White House officials and CMS officials. Second, the email was dated October 5, 2013, five days into the disastrous launch of HealthCare.gov. Third, federal law requires federal officials to retain copies of –not delete– email exchanges. And fourth, the document to be deleted is covered under Congressional subpoena as well as longstanding Freedom of Information requests made by members of the media (including me).

Members of Congress are now requesting answers from Tavenner, including why she instructed a subordinate, CMS Director of Communications Julie Bataille, to delete the email exchange rather than telling her to retain it as she claimed was the official policy.

As Attkisson notes, those copied on the email exchange included Jeanne Lambrew, director of the White House Office of Health Reform, White House Chief Technology Officer Todd Park, White House health care advisor Christopher Jennings, as well as other HHS and CMS officials.

In the 2013 email exchange, Tavenner reportedly explained how CMS staff were dealing with the high volume of Obamacare applications as Healthcare.gov failed. She noted officials were accepting PDF files that “look and act like a paper application” while also trying to accept some information online. Eventually, another official asked for more details on the process.

The Department of Health and Human Services recently informed Congress that they would not be able to produce some of Tavenner’s emails requested under a subpoena as they were deleted. Lawmakers, who are investigating the “processes and procedures” that led to the disastrous rollout of Healthcare.gov, were told “most but not all” of the emails would likely be provided.

Tavenner blamed the email loss on the “extremely high volume of emails” that she receives on a daily basis.

The Friday letter from lawmakers asks Tavenner if any other emails were purposefully deleted and how CMS intends on attempting to recover them. Lawmakers also requested an explanation regarding several redactions made in some documents already provided to Congress.

“[N]ow we know that when HealthCare.gov was crashing, those in charge were hitting the delete button behind the scenes,” Rep. Fred Upton (R-Mich.), chairman of the House Committee on Energy and Commerce, said in a statement.

Despite the “delete” request, CMS spokesman Aaron Albright told FoxNews.com that the email exchange was saved anyway.

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Medicaid Made $14.4B In Improper Payments In 2013

Medicaid Made $14.4 Billion Improper Payments Last Year – Washington Free Beacon

The federal government paid out $14.4 billion in fraudulent reimbursements through Medicaid last year, according to the Government Accountability Office (GAO).

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………………………………….Medicare and Medicaid chief Marilyn Tavenner

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Sen. Orrin Hatch (R., Utah) highlighted a recent GAO report on the lack of oversight within Medicaid’s managed care organizations (MCOs) delivery system, which accounts for roughly $4 billion in waste each year.

“Today’s report is particularly troubling given Obamacare expands this broken program without substantial reforms to protect patients and taxpayers,” Hatch said in a statement Wednesday. “CMS is responsible for safeguarding the billions of dollars it receives from hard-working American taxpayers, and I strongly urge [CMS] Administrator [Marilyn] Tavenner to implement the changes recommended by GAO to improve CMS oversight of MCO payments.”

“This report underscores the need for Medicaid reform in order to ensure that scarce tax dollars are used properly,” he said.

Managed care organizations, in which Medicaid beneficiaries get the majority of their care through an organization under contract with their state, are especially vulnerable to fraud since neither federal nor state governments are “well positioned to identify improper payments,” the GAO said.

“The size and diversity of the Medicaid program make it particularly vulnerable to improper payments – including payments made for treatments or services that were not covered by program rules, that were not medically necessary, or that were billed for but never provided,” the report said.

Nearly 50 million people currently receive benefits through MCOs. While MCO payments are still overshadowed by fee-for-service payments (FFS) – the traditional method where health care providers are paid for each service – individuals receiving their care through MCOs are “growing at a faster rate.”

State officials told the GAO that they have “not begun to closely examine program integrity in Medicaid managed care.” While the Centers for Medicaid and Medicare Services (CMS) requires states to audit their payments according to their MCO contracts, states are not required to audit the “appropriateness of these payments.”

The GAO warned that the problem would worsen under Obamacare, which has expanded Medicaid programs in many states.

“Improving federal and state efforts to strengthen Medicaid managed care program integrity takes on greater urgency as states that choose to expand their Medicaid programs under the Patient Protection and Affordable Care Act are likely to do so with managed care arrangements, and will receive a 100 percent federal match for newly eligible individuals from 2014 through 2016,” the report said.

“Unless CMS takes a larger role in holding states accountable, and provides guidance and support to states to ensure adequate program integrity efforts in Medicaid managed care, the gap between state and federal efforts to monitor managed care program integrity will leave a growing portion of federal Medicaid dollars vulnerable to improper payments,” it said.

Overall, Medicaid covered 71.7 million Americans in fiscal year 2013, totaling $431.1 billion, an estimated $14.4 billion of which were improper payments.

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25 People Charged In Largest Medicaid Fraud Bust In History Of Washington D.C.

25 Charged In Largest Medicaid Fraud Bust In D.C. History – WNEW

Federal authorities say 25 people have been charged in a wide-ranging scheme to obtain millions of dollars in fraudulent Medicaid payments from the District of Columbia government.

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U.S. Attorney Ronald Machen calls it the largest health-care fraud case in the city’s history. It involved bogus claims for home care services, a category of Medicaid claim that has grown dramatically in the city over the past eight years. Machen says fraud is largely responsible for the increase in those claims. The uptick in billings for home care – from $40 million in 2006 to $280 million last year – was part of what tipped off authorities to illegal activity, U.S. Attorney Ronald Machen said.

“We concluded that much of the growth was due to aggressive networks of fraudsters paying kickbacks to beneficiaries to manufacture false claims for nonexistent services,” Machen said, later adding: “Medicaid fraud in the District of Columbia is at epidemic levels.”

Among those charged Thursday was Florence Bikundi, 51, of Bowie, Md., the owner of a home care agency in suburban Maryland who had lost her nursing license and was ineligible to receive Medicaid payments. Authorities say that by using different names, she was able to bill the city for $75 million in Medicaid payments.

Prosecutors say many of the defendants persuaded patients to fake illness or injury so they could bill Medicaid for home care they didn’t receive. Some of those patients received kickbacks, authorities said, although no patients have been charged.

Machen said it wasn’t clear whether any of those payments went to legitimate home care services, but Bikundi was able to amass significant personal wealth, authorities said. Among the property seized from her were millions of dollars from 46 bank accounts, a 7,300-square-foot home valued at $927,000 and five luxury vehicles.

No attorney was listed in court records for Bikundi, who is in custody, and no one answered a call to her home Thursday afternoon.

Machen said there wasn’t any particular weakness in the district’s Medicaid program that made it vulnerable to bogus claims, and he noted that similar schemes have been perpetrated in other cities, including Detroit and Miami. The investigation is ongoing, and authorities said it was impossible to put a dollar amount on the fraudulent billings, although the indictments not involving Bikundi outlined schemes valued at less than $500,000.

“These numbers could likely grow. This is what we know so far,” Machen said.

A dozen people were charged in five federal indictments that were unsealed Thursday. Thirteen others were charged with fraud in D.C. Superior Court. All but three were in custody Thursday afternoon, authorities said.

Many of those charged are immigrants from Cameroon in west Africa, but authorities did not go into detail about their nationalities.

Click HERE For Rest Of Story

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The Left uses issues to push their twisted agendas

The Left has a long history of latching on to worthy issues, ending slavery, ending segregation, raising awareness to stop sexual harassment, unfair labor practices, etc. to push for radical changes in our nation.The issues I listed above are a few examples. The Left used those issues to destroy state sovereignty, create a perpetual racial divide in America, which the Left exploits for electoral victories. they used them to create unions that have morphed into Left wing anti-Capitalist thugs. And they have created work environments where so many rules exist employees walk on virtual minefields of political correctness where any joke that offends, no matter how innocent could cost you your job.

I could also talk about how the Left has bastardized “zero-tolerance” policies in schools to create the insanity of kids being punished for have aspirin, or drawing a picture of a soldier. The Left has done similar damage to freedom of speech and worship. Where their unquenchable thirst for “tolerance” and “inclusion” have created things like a war on Christmas, and all public displays of religion, and speech codes on college campuses.

The Left cried for an income tax, that was, initially one percent. Yes, one percent! Social Security, Medicare, Medicaid are also great examples of how the Left uses issues to instill more Socialism into our nation. No matter how noble, or worthwhile an issue is, once the Left latches onto it, it begins to, as Dennis Prager says, to  metastasize, and the results can be seen in every issue the Left has championed.

Why is this? Many reasons could be listed. The inherent greed and thirst for power that afflicts the Left are two reasons. The Left’s disregard for Individualism, and natural rights is another reason. I bring these up because there is another issue now, the issue of Gay marriage. Whether or not you agree with allowing Gay’s to marry, you must admit that the Gay activists, who are Leftists. are using this issue to further change our country.

Allowing Gay’s to marry bothers me not. But, this issue will be used, and in fact IS being used to both radically change how we define marriage. It is being used to force not just tolerance for Homosexuals, but to force businesses like wedding photographers, and bakeries to do their business with Gay couples wanting to marry. That is not about liberty, that is about the Left forcing their will onto everyone. Again, the Left’s appetite for power knows no bounds. Evidence of this can be found at American Power, where Donald Douglas links to a piece at Front Page magazine by Daniel Greenfield

From Daniel Greenfield, at FrontPage Magazine:

And yes. Turning gay marriage into a thing paves the way for legalizing polygamy. As everyone with a brain predicted. Polygamy, unlike gay marriage, was actually a thing. It has thousands of years of history behind it. So this was bound to happen.

If we’re not going to have any standards for marriage except “People in a relationship of some kind” then there’s no reason not to recognize polygamy. Or any of the crazier stuff coming down the pike. And that was why the left pushed the gay marriage scam to begin with.

Can’t say we didn’t warn you.

Continue reading

This is the problem with the Left, they can never be trusted to not use every issue to “reform” America “reeducate” our children, or to “redefine” American traditions and culture

And the push for full blown Socialized Medicine commences

Donald Douglas links an article in which a Communist lays out their oh, so enlightened solution to health care. I figured I would take a few minutes to parse, their arguments, and destroy them

Website delays – the most unwelcome news for computer acolytes since the tech boom crashed – are not the biggest problem with the ACA, as will become increasingly apparent long after the signup headaches are a distant memory.

So, we are to believe that a government that cannot even get a website to work, after spending $600,000,000 on said website, can somehow implement full blown national health care?

What prompted the ACA was a rapidly escalating healthcare nightmare, seen in 50 million uninsured, medical bills plunging millions into un-payable debt or bankruptcy, long delays in access to care, and record numbers skipping needed treatment due to cost.

50 million uninsured? I thought it was 30 million. Or was it 44 million? The Communist uses propaganda to sway opinion, and overly inflated numbers that are often simply made up serve that purpose. The strategy of a Communist is to create panic, and frighten people into empowering government to fix whatever the crisis is.

The main culprit was our profit-focused system, with rising profiteering by a massive health care industry, and an increasing number of employers dropping coverage or just dumping more costs onto workers.

But of course, profit, which is evil, is the culprit here, it always is with Communists isn’t it? Never mind that government programs always fail because there is no accountability, no bottom line. If an evil, profit-seeking insurance company does not perform, it will go belly up. Competition has always increased quality, and costumer service, and helped to make things more affordable. The answer in part, to our health care problems is to increase competition by allowing health insurance to be more easily sold across state lines. With a state run system, there is no option, no competition. And if you need to see where that leads, look at Medicare, Medicaid, or Social Security, which are all broke!

The ACA tackles some of the most egregious inequities: lack of access for many of the working poor who will now be eligible for Medicaid or subsidies to offset some of their costs for buying private insurance through the exchanges, a crackdown on several especially notorious insurance abuses, and encouragement of preventive care.

But the law actually further entrenches the insurance-based system through the requirement that uncovered individuals buy private insurance. It’s also chock full of loopholes.

Well, here we go, another self-defeating Communist argument. Obamacare, a government mandate has loopholes, it will fail. Given that, why would anyone support even more government run legislation?

Some consumers who have made it through the website labyrinth have found confusing choices among plans which vary widely in both premium and out of pocket costs even with the subsidies, a pass through of public funds to the private insurers.

Translation? You are just too stupid to handle having choices, you need a government agent handle all those icky details there comrade!

The minimum benefits are also somewhat illusory. Insurance companies have decades of experience at gaming the system and warehouses full of experts to design ways to limit coverage options.

The ACA allows insurers to cherry pick healthier enrollees by the way benefit packages are designed, and as a Washington Post article noted on 21 November, consumers are discovering insurers are restricting their choice of doctors and excluding many top ranked hospitals from their approved “network”. 

Again, insurance companies are EVIL! See they are limiting your choices, taking away you doctor, and restricting the hospitals you can use. Well, actually, it is the government, through Obama Care that is doing that, so, of course, the answer is to give that same government even greater control. Good Grief, how stupid are these folks?

Far less reported is what registered nurses increasingly see – financial incentives within the ACA for hospitals to prematurely push patients out of hospitals to cheaper, less regulated settings or back to their homes. It also encourages shifting more care delivery from nurses and doctors to robots and other technology that undermines individual patient care, and that may work no better than the dysfunctional ACA websites.

And we are to somehow delude ourselves into believing that an elimination of private insurance will ameliorate these problems?

Is there an alternative? Most other developed nations have discovered it, a single-payer or national healthcare system.

Of course it is, sure! Forget that the issues we are seeing with Obama Care clearly illustrate the consistent failures of central planners and their Statist schemes. Forget that every concern those opposed to national health care have expressed are proven by Obama Care. Forget history, forget all of it. Just push forward to total government control of our health care. Bring on the death panels, and the elimination of personal choice and autonomy. Just leave it all to people so incompetent they cannot even get a vastly over priced website to work. A website, by the way, they had  more than three years to get right. THREE YEARS!

A closing thought. Isn’t it odd that Leftists foam at the mouth if insurance companies deny a prescription, or treatment, but if the government does it, it is wonderful? It is not odd, it is simply that the Left see government as their god. Just as Christians see God, yes THE REAL GOD, as perfect, Leftists see their god, in this case Washington D.C. as perfect. Now you might say that is just a different view of the world until you consider that God created the universe, and all life in it. The Leftists’ god on the other hand cannot even get a website to work.

Stacy McCain, AKA Gramps: You do not have to be a buffoon to write for the NY Times, but it helps

Do Liberals ever tire of bashing the South? Of course not, after all, the South IS the most Conservative part of the country, and the most patriotic. And the Left will never forgive the South for taking a stand against a power hungry federal government. McCain has the scoop

This is just downright bizarre:

[T]he South is once again committed to taking a backward path. By refusing to expand health care for the working poor through Medicaid, which is paid for by the federal government under Obamacare, most of the old Confederacy is committed to keeping millions of its own fellow citizens in poverty and poor health. They are dooming themselves, further, as the Left-Behind States.

Just another historical illiterate who thinks Washington has a grove of money trees or something. McCain eviscerates this tool

Do you believe this? “Free” money from the federal government? Medicaid as a job-creation dynamo? While I have not bothered to dig down on the data here, the basic economics of it is like saying that if you take $5 out of your pants pocket and put it in your coat pocket, you will then have $10. Government has no money of its own to spend. Every cent expended by government must come either from tax revenue or from borrowing, and borrowing — i.e., deficit spending — is ultimately a drag on economic growth, because capital invested in government bonds (which is how deficit spending is financed) is capital not invested in private-sector businesses.

The liberal belief in “free government money” is like one of those quasi-religious magical thinking exercises that Ace discusses here.

To cite X-number of people signing up for “expanded Medicaid” as “success” is simply to say that if you’re giving away the taxpayers’ money, moochers will gladly take their share of the loot.

Is the South doomed to be the “Left-Behind States”? Next time you hear of someone moving from Texas to Detroit, let me know.

 

Stunning Incompetence: Obamacare Flaw Allows Anyone On Earth To Fraudulently Enroll In Medicaid

Medicaid For Al-Qaeda? Obamacare Flaw Allows Anyone on Earth To Fraudulently Enroll Through Healthcare.gov – Pajamas Media

Though a sideshow throughout Obamacare’s passage and litigation, Medicaid’s pivotal role in President Obama’s health care reform effort has become apparent following the law’s October 1 implementation. In many states, Medicaid enrollment through the Healthcare.gov portal is dwarfing the number of “private” insurance plan purchases.

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While this development represents a major financial threat to the survival of Obamacare, new regulations established by Obamacare to cover Medicaid enrollment have created a major threat to the United States’ ability to administrate that far larger benefit program.

Following is a summary of the problem:

* Non-citizens are eligible for Medicaid and CHIP (Children’s Health Insurance Program). This is not a new development. However, the documentation and verification process for such enrollments was significantly eased by regulations in the Affordable Care Act.
* Getting fraudulent applications for Medicaid or CHIP approved is now easier, and thus more likely.
* The risk is increased by the security concerns inherent in the Navigator/Assister program. (For background on these concerns, read: “DRAINING THE SWAMP: Top 40 Troubling Listings from the Obamacare Navigator/Assister Security Nightmare”, and “Identity Theft Russian Roulette: Healthcare.gov Refers Users to Uncertified Navigators and Assisters”.) Also watch James O’Keefe’s undercover sting, which reveals the inevitable results of creating such an unaccountable program.)

While troubling, final approval of fraudulent applications represents a lesser element of the problem regarding non-citizen enrollment. The greater concern is initial approval:

* Applicants attempting to register for Medicaid as non-citizens by using Healthcare.gov will have their identification checked in real-time by the SAVE (Systematic Alien Verification for Entitlements) database. But if SAVE verification fails, the applicant is not prevented from enrolling in Medicaid/CHIP.
* In fact, the opposite occurs: the applicant is likely enrolled in Medicaid immediately.
* The applicant is then given a 90-day period to clear up the identification problem.
* This “enroll first, confirm later” regulation, combined with the ACA’s easing of verification requirements, allows anyone, from a computer anywhere in the world, to successfully auto-enroll for 90 days of Medicaid by entering fraudulent information about being a certain category of legal alien living in the United States.
* There is no guarantee that state governments will take action to cancel these enrollments at the end of each application’s 90-day period if identification is never provided. The cancellation of unverified enrollments is left to each state’s available manpower and political will.
* At the end of the 90-day period, if states do indeed ask the applicant to produce identification or to have the enrollment canceled, the applicant is allowed to ask for an extension of the 90-day period. The applicant can get the period extended for significantly longer.
* Obamacare does not allow any information entered into Healthcare.gov to be used for legal action against illegal immigrants. Like “catch and release,” an applicant could attempt to fraudulently enroll repeatedly.
* Foreign entities looking to flood the Medicaid rolls with fraudulent auto-enrollments are, of course, beyond U.S. prosecution and able to cause such chaos.
* An organized effort by domestic or foreign entities to create countless numbers of these fraudulent enrollments could challenge Medicaid with an unsolvable administrative situation.

In February of this year, James Edwards of the Center for Immigration Studies published a report titled “Immigration and Obamacare: Proposed Medicaid Rules for Verifying Status”. His report summarized the federal government’s January publication of such rules being proposed by the Health and Human Services Department and the Centers for Medicare and Medicaid Services. These proposed rules were later finalized on July 15 (click here for the 164-page “Final Rule” document).

Edwards’ report documented the security flaws developing as a result of the Obama administration’s political goal of enrolling as many people as possible in some sort of health care coverage.

Following are highlights from Edwards’ report, focusing on the easing of the non-citizen application process and the removal of safeguards:

* Two, down from three, documents are to be required to establish one’s status. Attestation made about someone’s citizenship status in a single affidavit counts as one of the accepted forms of identity.

This means that a signed document from a second individual which simply states that the applicant is who he says is will be an accepted form of identification.

* Electronic documentation begins to overtake presentation of authentic identification documents. Similarly, a record of identity or status verification is regarded as more important than having authenticated copies of valid, legitimate documents on record.

States do not need to file copies of the documents. They are only required to keep track of whether or not the documents were accepted. No paper trail.

* If electronic verification of citizenship or immigration status fails or is delayed, applicants for health benefits must have a “reasonable opportunity period” in which to confirm their status. If otherwise eligible for Medicaid, states must grant Medicaid enrollment to unverified persons during this period… “Reasonable opportunity” even applies, under this rule, to persons “unable to provide a SSN [Social Security number]“ – a rather glaring loophole for frauds to exploit.

Edwards’ use of the phrase “otherwise eligible” raises the issue of the expansion and easing of the verification process for Medicaid and CHIP under President Obama. For example, eligibility for CHIP was expanded during President Obama’s first term, and the necessary documentation was decreased.

So: how simple is it to fraudulently enroll for Medicaid under the rules governing Obamacare?

Submit electronic copies of a false affidavit and a false work document while claiming to be a member of the “presumed eligible” populations, and you are required to get at least 90 days.

Most troubling, the establishment of Healthcare.gov and the other state-run exchanges allows this fraud to be perpetrated from anywhere on the planet. I asked Edwards:

PJM: “Based on the HHS/CMMS rules, couldn’t, say, al-Zawahiri get himself auto-enrolled with a “reasonable opportunity period” from a laptop in Pakistan?”

Edwards: “I hadn’t thought of that. Yes.”

In addition to the economic risk of millions arriving at domestic health care providers with fraudulent approvals and Medicaid ID numbers, Medicaid databases could be so overwhelmed with fraudulent information so as to be rendered administratively unmanageable and unreliable.

Effectively, the databases would be useless and pointless. An organized entity could, rather simply, employ this tactic to economically damage and humiliate the United States.

Ironically, the massive failure of the exchange websites has postponed the risk until the websites are functioning properly.

If the Obama administration is able to get the electronic exchanges working, they will immediately face a fresh nightmare. Flaws in the ACA law itself may create much larger problems than slow enrollment, dropped coverage, and more expensive plans.

Click HERE For Rest Of Story

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Jindal calls Obama like he sees him

BULLY!

Obama first delivered a pitch for the creation of jobs by fixing roads, dredging ports and modernizing the U.S. air traffic control system.

Then he took a veiled jab at Jindal for failing to support a key plank of the healthcare law.

Louisiana is one of 24 states that has refused federal funds to expand Medicaid to more low-income people, money that Obama said would help 265,000 people in the state gain access to health insurance.

“Even if you don’t support the overall plan, let’s at least go ahead and make sure that the folks who don’t have health insurance right now and can get it through an expanded Medicaid, let’s make sure we do that,” Obama said.

That opened the door for Jindal to accuse Obama of trying to “bully” the state.

“We will not allow President Obama to bully Louisiana into accepting an expansion of Obamacare,” Jindal said in a statement, saying the expansion would cost the state too much.

“The dysfunction of the website and the president’s broken promises on being able to keep your health plan are just the tip of the iceberg in regards to the problems with this law,” Jindal said.

Good for Jindal

 

Maryland: 96% Of Enrollments At Health Exchange For Medicaid Not ObamaCare

In Friday News Dump, Maryland Announces Its ACA Enrollment Totals… 96% Medicaid – Conservative Intelligence Briefing

I can’t tell exactly when Maryland’s health benefit exchange posted its new numbers, but it appears to be no earlier than late this afternoon – perfect timing. WBAL posted the news at 8:23 p.m. tonight:

More than 3,100 Maryland households have chosen to enroll through the state’s online marketplace for health insurance… The state also says 82,473 residents are signed up to be automatically enrolled in Medicaid coverage on Jan. 1.

So Medicaid accounts for more than 96 percent of enrollments so far. This might be the highest ratio we’ve seen yet. But to say it again, people will come out of the hills to sign up for something that’s free, they haven’t yet shown a determination to sign up for things that are overpriced.

Meanwhile, the exchange has paid a substantial sum to advertise on tonight’s Ravens pre-game show.

Click HERE For Rest Of Story

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Planned Parenthood Nailed On Medicaid Fraud, Gets Off Light With $1.4 Million Settlement

Planned Parenthood To Pay $1.4 Million In Medicaid Fraud Settlement – The Foundry

Planned Parenthood Gulf Coast, which serves southeast Texas and Louisiana, agreed this week to pay $1.4 million to the state of Texas, settling claims that one of the largest abortion providers in the Southeast had fraudulently overbilled the state’s Medicaid program.

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Texas Attorney General Greg Abbott’s office stated that its investigation into the fraud allegations “revealed that Planned Parenthood Gulf Coast improperly billed the Texas Medicaid program for products and services that were never actually rendered, not medically necessary, and were not covered by the Medicaid program.”

The Texas Planned Parenthood allegedly “falsified material information in patients’ medical records” to bolster fraudulent claims for reimbursement.

Alliance Defending Freedom’s recent analysis of state and federal audits of family planning programs suggests that in 12 states, Planned Parenthood affiliates overbilled Medicaid for more than $8 million. One federal audit of New York’s Medicaid family planning program reported that certain providers, “especially Planned Parenthoods,” had engaged in improper practices resulting in overpayment.

Despite mounting accusations of fraud, the organization that performs roughly one out of every four abortions in the U.S. has continued to ride the waves of taxpayer funding to annual surpluses. During its last reporting year alone, Planned Parenthood received over half a billion dollars in taxpayer government funding, all the while performing a record 333,964 abortions. To solidify its place as the top abortion provider in the country, Planned Parenthood announced that all local affiliates would have to begin providing abortion services starting in 2013.

If allegations of fraud and its single-minded provision of abortion services isn’t enough to question a continual stream of taxpayer dollars, Planned Parenthood’s opposition to legal protections for infants born after botched abortions and the group’s apparent willingness to abet the sex trafficking of minor girls should at least raise scrutiny of the organization’s federal funding.

The organization also allegedly turned a blind eye to unsafe and unsanitary conditions in Pennsylvania and Virginia. State officials began investigating a Planned Parenthood in Delaware this spring after two of the clinic’s nurses quit, claiming that the clinic kept unsafe, unsanitary conditions while performing what one report called “meat-market style of assembly-line abortions.”

“Planned Parenthood is far less concerned with providing competent healthcare to women than it is with padding its bottom line with taxpayer dollars,” says Alliance Defending Freedom in its report.

Yet this is the group that President Obama vowed to support, “fighting every step of the way.” And this is the industry that stands to benefit from an influx of abortion funding under Obamacare.

Policymakers looking for organizations that are capable of self-funding more of their activities would do well to view Planned Parenthood’s subsidies with a critical eye.

Click HERE For Rest Of Story

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It Figures… 17.5 Million More Americans On Medicaid Today Than HHS Predicted

Over 17.5 Million More Americans On Medicaid Today Than HHS Predicted In 2010 – Gateway Pundit

In 2010 the Obama Department of Health and Human Services predicted in their Actuarial Report that 55.1 million Americans would be enrolled in Medicaid in 2013.

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Here’s how that prediction worked out…

A record 72,600,000 were enrolled in Medicaid for at least one month in fiscal 2012. This is more people than the population of France or the United Kingdom.

That means HHS was off by 17.5 million.

Only in government can you be so off in your predictions and still keep your jobs.

More… HHS did not do much better in their 2011 report.

Click HERE For Rest Of Story

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How many Sophie’s will Obamacare cost us?

My friend Chris Wysocki at Wyblog gives us a frightening preview of what will happen under Obamacare

Barack Obama would have condemned my daughter to death. No, that’s not an exaggeration. If he’d railroaded Obamacare through before she was born, it’s quite likely she’d have died when she contracted a virus called RSV.

New guidelines issued by one of his Medicaid advisory boards eliminate payment for RSV treatment, calling the vaccine “unnecessary,” because it costs too much. And when Medicaid speaks, insurance companies and doctors listen.

While there is no vaccine for RSV, there is an FDA-approved treatment available. When it became available in 1997, the American Academy of Pediatrics issued evidence-based guidelines for its use, recommending that the treatment be administered once per month during outbreak season (an average of five months total).

But in 2009, with no clear medical evidence for doing so, the AAP both shrunk the pool of eligible infants and reduced the number of RSV treatments that would be made available — for some babies down to 3 doses, while for others as low as 1 dose. The only clear reason given was cost.

Unfortunately, the AAP s guidelines are widely implemented by Medicaid and insurance providers, who in turn followed suit and greatly reduced coverage. 

Sophie got RSV (Respiratory Syncytial Virus) soon after she was born. It was touch-and-go for a few days but she pulled through. Sleeping on the floor next to her hospital bed we did a lot of praying and a lot of worrying.

Left untreated, RSV causes pneumonia and weakens the heart and lungs. It hit Sophie hard, at first she could barely breathe, and the hospital had her on pure oxygen for days. Her doctors immediately prescribed a series of shots, along with inhaled steroids, for as long as she was susceptible to RSV.

Those shots saved her life.

Think about that the next time some Democrat uses their Republicans want children to die rhetoric. Remember not one single Republican voted for Obamacare. It was the Democrats that gave us the curse. So, how many Sophie’s will there be under Obamcare?

 

A Country Run by Idiots

A Nod to A Nod to the Gods for this My favorite ones are these three, but go read them all

3. If you have to show identification to board an airplane, cash a check, buy liquor, or check out a library book, but not to vote, … you might live in a country founded by geniuses but run by idiots.

4. If the government wants to ban stable, law-abiding citizens from owning gun magazines with more than ten rounds, but gives 20 F-16 fighter jets to the crazy new leaders in Egypt, you might live in a country founded by geniuses but run by idiots.

12. If being stripped of the ability to defend yourself makes you more safe according to the government,… you might live in a country founded by geniuses but run by idiots.

 

Pundit and Pundette: Mr. Electable hones his message: “I’m not concerned about the very poor”

Mitt is now writing campaign ads for Obama. What a stupid thing to say. I am glad we are in the process of choosing the “great, polished, smooth, and OH YES ELECTABLE” candidate! Jill rips him a new one!

But the problems with this interview go beyond a tone-deaf 1%-er delivering another juicy ad into the Democrats’ hands. If you keep listening, you’ll hear Romney reveal a vision of a permanent welfare state that is as bleak as any liberal’s:

We will hear from the Democrat party, “the plight of the poor,” and there’s no question, it’s not good being poor. . . . We have a very ample safety net and we can talk about whether it needs to be strengthened or whether there are holes in it, but we have food stamps, we have Medicaid, we have housing vouchers, we have programs to help the poor.

And don’t forget the prisons and workhouses. I know Romney gives generously to charity but what a cold fish he is. Can’t he hire someone to teach him to show empathy?

But my real point is that a conservative candidate would talk about increasing opportunity for the very poor, about lessening the need for food stamps and housing vouchers by reducing government and invigorating the economy, rather than touting the awesomeness of our massive, dependency-inducing welfare state and suggesting it might need some beefing up.

But Romney’s no conservative. So this is to be expected.

Vodpod videos no longer available.

The worst kind of damned fools indeed!

President Lyndon Johnson foresaw the end of th...
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Milton Wolfe has a great piece up at The Washington Times that deals with Medicare, and the looming disaster that Obamacare will be. Read the whole thing, but I found this snippet the most telling

America somehow managed to survive for 189 years without Medicare or Medicaid and, in fact, became the greatest nation in the history of humankind. Established in 1965 – a mere 46 years ago – too many politicians today lack the perspective to understand this health care altar at which they worship. Instead of reforming the system to align it with American values, they abuse it as an eternal source of giveaways to buy votes. As for the politicians of the 1960s, except for the mop tops and go-go boots, they were very much like the politicians of today: They made a lot of empty promises.

President Lyndon B. Johnson promised that Medicare would cost about $500 million a year – yes, million. He even said that if costs went higher, then he was going to look like the “worst kind of damn fool.” Just a year later, in 1966, the House Ways and Means Committee estimated that Medicare would cost about $12 billion a year by 1990. The actual 1990 cost was $107 billion – off by an order of magnitude but close enough for government work. And that’s when costs really took off. By 2008, annual costs hit $599 billion and the program for the first time went into deficit-spending mode.

For all the Democrats’ dishonesty and reckless spending, Republicans weren’t exactly blameless either. In 2003, President George W. Bush and a Republican Congress doubled down and ushered in the largest expansion in Medicare history with their senior citizen prescription drug entitlement program. They claimed the price tag would be $400 billion for the first decade but quietly adjusted that estimate upward to $534 billion just one month after passage.

Simply unbelievable isn’t it? The depth of incompetence is staggering o the mind. And again, this is Medicare that is such a disaster, how bad will the much larger Obamacare be? God help us

Now THAT is cutting the budget!

I have to say, this Paul Ryan chap is looking like a winner! I mean when he talks about budget cuts, he means business!

The Republicans have recently come under fire by conservative voters–myself included–for what is perceived as their mishandling of the current budget negotiations after having failed to live up to their proposal to cut $100 billion in spending from the current budget, but are the Republicans finally beginning to get serious about this issue? While the current budget negotiations are underway Paul Ryan is working on a budget for the next fiscal year which he is set to unveil on Tuesday. This budget would include a cut in federal spending of $4 trillion over the next decade. The details are still not available, but here is what we know so far:

A “premium support system” for Medicare. In the future, older people would choose plans in the marketplace and the government would subsidize those plans. Ryan said that would differ from the voucher system he has proposed in the past. Those 55 and older would remain under the present Medicare system. Ryan acknowledged that the “premium support system” would shift more costs to Medicare recipients, especially what he called “wealthy seniors.” He did not define at what level someone would be considered wealthy.

-Block grants to states for Medicaid, the health program for the poor. Ryan disputed reports that the plan would seek savings of $1 trillion over 10 years from Medicaid, but would say only that the details would be in the plan.”Medicare and Medicaid spending will go up every single year under our budget. They don’t just go up as much as they’re going right now,” he said. Ryan said governors have told members of Congress they want “the freedom to customize our Medicaid programs. … We want to get governors freedom to do that.”

-A statutory cap on actual discretionary spending as a percentage of the economy. While Ryan did not specify the amount during the interview, he said it would be at a lower level than proposed by Obama and would return the government to its “historic size.”

-Pro-growth tax changes, including lower tax rates and broadening the tax base. Ryan said overhauling taxes would boost the economy. The plan will not propose tax increases.

Well, I will need to see the proposal, but, I like the sound of that number! Sounds like someone IS dead serious about getting a handle on America’s fiscal insanity. The Mind Numbed Robot is liking this too

Fortitude.

…as in testicular fortitude.

As used by R.S. McCain to accurately describe Rep. Paul Ryan, who announced the first real plan to cut government’s wasteful spending.

Stacy McCain likes Ryan’s, er, he admires Ryan’s, ummm guts, yeah, that’s it!

The gentleman from Wisconsin steps up:

The Republican chairman of the House Budget Committee said his party’s budget proposal for 2012 would cut deficits by more than $4 trillion over the next decade, vowing to tackle costly entitlements like Medicare and Medicaid.
The proposal, set to be unveiled Tuesday, would serve as the Republicans’ official response to President Obama’s proposed $3.7 trillion budget for 2012. The White House claims its plan would cut deficits by $1.1 trillion over a decade.
But Ryan, R-Wis., in an interview with “Fox News Sunday,” accused Obama of “punting” and said Republicans’ plan would exceed the fiscal goals set by the president’s fiscal commission — which issued a report calling for $4 trillion in cuts. That report never made it out of committee.
“We can’t keep kicking this can down the road,” Ryan said. “The president has punted. We’re not going to follow suit.”

The Beltway spin on this: By proposing large cuts for the fiscal 2012 budget, Ryan’s plan gives House Republicans political “cover” if negotiations over the remainder of the fiscal 2011 budget require them to accept smaller levels of cuts for the current year.

I could care less about buying the GOP “cover” that is fine, but the meat here is that finally, a Republican leader is ACTING like a leader in a major way! No BS, no nibbling at the debt, no dancing, no prancing, or playing games. Paul Ryan has come out swinging for the fences, he has come out, let me say it again, LEADING! You want to get the GOP base fired up? Propose budget cuts that actually cut something.

Representative Paul Ryan, a mastermind on economics and budgetary issues, was on Fox News Sunday declaring that Republicans will lead when it comes to the 2012 budget.

Unlike President Obama and the Democrats who are missing in action, Ryan will release a 2012 budget proposal that will greatly reduce federal spending by tackling Medicare and Medicaid.

Ryan said it’s ironic that President Obama will relaunch his reelection campaign on the week that Republicans are trying to get Democrats to debate budgetary issues and get us out of the debt crisis looming in the horizon.

This Tuesday, Ryan will lay out his budget which will include more than $4 trillion in spending cuts over the next decade. Leading where Obama and the Democrats won’t.

Transcript via The Hill:

“Where the president has failed to lead, we’re going to lead and we’re going to put out ideas to fix this problem,” Ryan said.

“Democrats could use the plan as a “political weapon,” Ryan said.

“We are giving them a political weapon to go out against us, but they will have to lie and demagogue to make that a political weapon. They are going to demagogue us, and it’s that demagoguery that has always prevented political leaders in the past from actually trying to fix the problem. We can’t keep kicking this can down the road.”

He added, “Shame on them if they do that.”

They will demagogue, he knows it, I know it, you know it. But, consider that they have been doing the Democratic Dance of Demagogue and Doom like the Devil over the paltry cuts proposed so far. Harry Reid and his cohorts would bitch if Ryan suggested we cut five bucks of spending. Let them take that bag of BS to the American people if they choose to