Tag: Medical

Obama’s HHS Gave Sweetheart Deal To Firm Linked To Medical Data Fraud

Feds Gave Sweetheart Deal To Firm Linked To Medical Data Fraud – Daily Caller

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Health and Human Services (HHS) Secretary Sylvia Burwell awarded a rarely used open-ended sole-source contract to a firm whose corporate owners were embroiled in a $400 million fraudulent medical data scheme that cheated doctors and consumers, according to a Daily Caller News Foundation investigation.

The company Burwell selected is Optum Labs, which is part of UnitedHealth Group’s Optum subsidiary. Andrew Slavitt, President Barack Obama’s nominee to head HHS’s Centers for Medicare and Medicaid Services (CMS), was formerly a top Optum executive at the time of the fraudulent database involved in the scheme. The database enabled insurers to pay dramatically lower reimbursements to doctors and patients for out-of-network care.

Optum and UnitedHealth Group settled the landmark fraud case with then-New York Attorney General Andrew Cuomo in 2009 and paid out a record $400 million. Optum Labs – which is one of nation’s largest medical data analytics companies – was not a party to the settlement.

Under the contract, Optum Labs will provide HHS with 160 million administrative claim records it accumulated over 20 years and 40 to 50 million electronic medical records it collected over the last seven years, according to Optum Lab spokesman Jeffrey Smith. Some of the records to be given to HHS are part of the database involved in the 2009 settlement, Smith says.

Cuomo – now New York’s Democratic governor – said at the time of the settlement that Optum and UnitedHealth Group had “ripped off patients” by rigging out-of-network reimbursements to providers and consumers. “Too many people have been hurt,” he said.

UnitedHealth Group’s insurance division, United Healthcare, is the nation’s biggest health insurance company and warned last month it may stop participating in Obamacare in 2017 due to unexpectedly large financial losses.

Slavitt left Optum to join CMS as deputy administrator and became acting administrator when Marilyn Tavenner stepped down after the troubled launch of Obamacare. Obama nominated Slavitt as the permanent administrator July 10, 2015, but a confirmation vote has yet to be taken in the Senate.

Slavitt was granted a rare “ethics waiver” by the Obama administration that permits him to rule on issues involving past employers. American Commitment, a conservative non-profit advocacy group, recently delivered to the Senate more than 20,000 letters it generated demanding rejection of Slavitt’s nomination.

It was clear from the beginning of the award process Burwell’s choice for the contract was Optum Labs. In a May 29 public notice, she declared the contract would be awarded without any competition, declaring, “this is a notice of intent, not a request for a quote. A solicitation will not be issued and quotes will not be requested.”

Optum Labs has hundreds of rivals. There are 971 health IT companies registered with the federal government under the same service code in which Optum Lab was awarded the account.

Burwell added in the May 29 notice that the sole-source contract also was a “blanket purchase agreement,” (BPA) which means the contract will provide continuous government orders without competing bidders. No dollar amount is specified for the contract.

Federal officials aren’t required by BPA procurement rules to issue any public notice or solicitation when the contract is up for renewal. The contract is for one year, with options to renew over the following four years. It started in September of this year.

“This seems like another example of the revolving door paying off for a contractor, and more proof that who you know might be more lucrative than what you know,” Scott Amey, general counsel for the Project on Government Oversight, tells TheDCNF.

Sen. Chuck Grassley, an Iowa Republican, tells TheDCNF that “sole-source contracts by their nature raise questions about whether the taxpayers are getting the best deal.”

Grassley, chairman of the Senate Committee on the Judiciary and a senior member of the Senate Committee on Finance that oversees Obamacare, demands the administration justify its decision to offer Optum Labs a sole-source contract.

“The administration should be explicitly transparent about the reasons for any sole source contracts, and especially here where the firm getting the contract has been controversial,” Grassley tells TheDCNF.

“Companies would love to get that contract because it means that there won’t be any on follow-on competition and the agency will place their orders only with them,” says a 30-year senior procurement officer in an interview with TheDCNF.

The procurement officer who requested anonymity tells TheDCNF that “when they say ‘sole- source,’ that means they’re not going to look to other people. They’re not going to consider anyone else. They’re going to go straight to who they’re going to pick.” He requested anonymity because he is barred from speaking on the record due to his governmental post.

“A sole source BPA is an instrument that any company would be probably would be happy to have. Let’s not kid ourselves,” the procurement officer tells TheDCNF.

American Commitment president Phil Kerpen says “it’s rather remarkable that a division of Andy Slavitt’s UnitedHealth Group, Optum Labs, has now gotten an open-ended contract from HHS.”

Kerpen points to the ethics waiver that allows Slavitt to make decisions involving his former employers as an especially important factor in questioning the Optum Labs sole-source award.

“I think that certainly the perception of corruption is one reason why the unusual ethics waiver from the administration is so inappropriate. You now have a top executive of a company that does business every day, both as a regulated entity and as a vendor, with a top executive right there in the building,” Kerpen says.

CMS officials insist Slavitt is not involved in the Optum Lab contract. But an HHS spokeswoman refused to make public the memorandum of understanding between the department and Optum Labs.

The Optum Lab contract is with an obscure HHS operation called the Agency for Healthcare Research and Quality (AHRQ). The House Appropriations Committee zeroed-out the agency in June. The bill is in the Senate awaiting action.

Republicans charge AHRQ duplicates many other agencies, including the National Institutes of Health for which congressional Republicans have increased funding.

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Veterans Still Struggling To Get Medical Treatment As Obama Regime Continues To Lie To Congress

Veterans Still Can’t Get Medical Help On Time – WorldNetDaily

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Months after the Veterans Administration scandal exploded in the headlines, top officials are still lying and hiding information from Congress, and President Obama is actively trying to roll back the freedom of veterans to seek health care outside of the government system.

That’s the conclusion of Rep. Tim Huelskamp, R-Kan., a member of the House Veterans Affairs Committee.

Last May, the VA was rocked by reports that veterans were forced to wait months for routine medical appointments and that some officials were doctoring hospital and medical records to cover up the failure to provide care. In response, Veterans Affairs Secretary Gen. Eric Shinseki resigned and Congress approved legislation giving future secretaries more freedom to remove ineffective personnel. Former Procter & Gamble Chairman Robert McDonald was eventually confirmed to succeed Shinseki and lead major reform efforts.

Are there signs of improvement?

On Monday evening, the House Veterans Affairs Committee grilled VA General Counsel Leigh Bradley over why more than 100 separate requests for information from the committee have gone unanswered for months and why the information that is given is often found to be false.

“The news only gets worse and worse,” Huelskamp said.

According to Associated Press reports on the hearing, committee chairman Jeff Miller, R-Fla., expressed deep frustration with the VA’s lack of cooperation on key facts, including wait times for veterans at the Phoenix hospital where the scandal began.

“Let there be no mistake or misunderstanding: When this committee requests documents, I expect production to be timely, complete and accurate,” Miller said.

Huelskamp is particularly incensed at the falsehoods coming out of the VA, including one stated by Secretary McDonald on NBC’s “Meet the Press.”

“They have falsified information, and it is not just lying to members of Congress; it’s lying to the American people,” he said. “We even had the secretary about a month ago lie on national television and claim that he had fired 60 employees that made up, falsified, cooked the books on wait times for our vulnerable veterans.”

The real number was nowhere near that high.

“He only fired four,” Huelskamp said. “There’s a big difference between four and 60, so there’s a lack of trust there. But this is, more importantly, a lack of trust between veterans who deserve their care and whether they’re getting in on time and whether they’re getting the proper care.”

And the congressman said the lies don’t stop there.

“The VA claimed that at the (Los Angeles) veterans facility, the wait was only four days,” he said. “We found out later, according to a CNN report, that it’s more than 30 days. Who do you believe? Who I believe is the veteran. If the veteran says they’ve been waiting, that’s what happens.”

Huelskamp said when Congress tries to separate fact from fiction, the massive VA bureaucracy grinds investigations to a halt.

“We’ve had, I think, three secretaries of the VA in my four years here,” he said. “For secretary after secretary and undersecretary after undersecretary, I didn’t know that had that many undersecretaries. They always send a new one over, and the answer is always, ‘We’ll get back to you. We’ll get that answer to you.’

“We have documented where they have lied to the committee, where they have falsified information,” he said.

If anything good came out of the VA scandal, Huelskamp believes it is the provision within last year’s reform bill that allows veterans to access care outside of the government system to shorten how long they wait for care. The congressman said expanded choice is working well for veterans and no longer forces many of them to travel hundreds of miles to approved doctors and facilities. He said that change is further proof the less government is involved in our health care, the better that care will be.

“That’s the best government health care you can get, and what we saw in Phoenix and around the country is that it’s been an abysmal failure,” Huelskamp said.

While the expanded health-care choices may be popular with veterans, Huelskamp said the Obama administration is actively trying to eliminate it.

“When the administration came in and asked to end the Veterans Choice Program, that sent shock waves through Congress because most Democrats and Republicans agree we need to improve the system and give veterans more choice in their health care,” he said.

“There’s a pushback from the administration, but the secretary has agreed – maybe not the president but the secretary has agreed – veterans deserve to keep their choice,” he said. “We’re trying to push the VA in a different direction than Obamacare is taking the rest of the health-care system. I think, at the end of the day, the better model is putting Americans in charge of their health care, not Washington, D.C.”

When will Congress get timely answers and the VA operate more efficiently? Huelskamp said a big part of the problem is a massive government bureaucracy that takes a long time to straighten out.

“There’s a culture of non-accountability, a culture of attacks on whistleblowers. That’s been going on for decades. It’s difficult to change that. That takes years,” said Huelskamp, who estimates some 330,000 bureaucrats are involved in VA operations.

“I think many of them do a terrific job, but it’s a system that’s set up based on the 1950s and ’60s, not 2015,” he said. “So it is a cultural shift at the VA, but the president has to provide leadership. I fear in the next two years, he will continue to drift away from any commitments to veterans in terms of reforming the system.”

What about Secretary McDonald? Is he the right man to lead this change?

“We’ll see if the secretary can answer those questions we asked a couple of nights ago,” Huelskamp said. “Some of these questions have been outstanding for months, which will give us insight (into) whether they’re really making the changes that were promised.”

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Leftist Nightmare Update: 33,000 Jobs Lost Due To Obamacare’s Medical Device Tax

Study: 33,000 Jobs Impacted Due To Obamacare’s Medical Device Tax – WNEW

A new study reveals that nearly 33,000 jobs have been impacted due to the Affordable Care Act’s medical device excise tax.

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The report comes from the Advanced Medical Technology Association following an online survey of member companies last year.

“According to the report, the tax has led to employment reductions of approximately 14,000 industry workers and foregone hiring of 19,000 workers,” the study stated. “The total job impact of the tax on industry employment was approximately 33,000.”

Stephen J. Ubl, CEO of AdvaMed, said this tax needs to be repealed.

“During a time when there is bipartisan support for growing high-technology manufacturing jobs, these results should serve as a wake-up call. As a result of the medical device tax, we have seen an unprecedented impact on jobs and key investments in R&D (research and development),” Ubl said. “The findings of the report underscore the need to repeal this tax.”

Unified in their opposition to Obamacare, Republicans have been relentless in focusing on its problems, from complaints of canceled policies to higher insurance premiums and President Barack Obama’s unilateral decision to delay for two years the requirement that small businesses cover employees.

The GOP effort has intensified this election year as Republicans look to capitalize on dissatisfaction with the law, turning voter dismay into November victories. The ill effect of Obamacare is the GOP’s constant refrain.

Nearly 3.3 million Americans have enrolled through the federal and state marketplaces as the federal online site worked out the problems of its disastrous rollout, a recent sign of promise for the 4-year-old law.

A silver lining for Democrats in the recent enrollment numbers is the actual sign-ups exceeding projected totals in New Hampshire, North Carolina, Michigan and Colorado, according to the January figures. Three of those states have Senate Democrats who voted for the law and now face re-election – Kay Hagan in North Carolina, Jeanne Shaheen in New Hampshire and Mark Udall in Colorado.

In the next eight months before the election, Republicans who call the shots in the House will cast a harsh spotlight on the law through hearings and narrowly focused legislation designed to divide Democrats. The GOP has done it this year with bills requiring the Obama administration to report weekly on how many Americans have signed up for health care coverage and a measure bolting new security requirements on the law.

One bill drew the support of 33 Democrats; the other attracted 67 Democrats who bucked the administration.

Last year, House Republicans voted more than 40 times to repeal, replace or gut the law, and strong GOP opposition to Obamacare precipitated the 16-day partial government shutdown last fall that was a political blow to Republicans.

Since recovered, Republicans say privately they are unlikely to push for full repeal in light of the law’s popular elements, such as insurance for individuals even with an existing condition and allowing children to remain on their parents’ plans until age 26. Also, Republicans have been unable to unify around an alternative to health care plan.

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VA Employees Destroyed Veterans’ Medical Records To Cancel Backlogged Exam Requests (Audio)

Department Of Veterans Affairs Employees Destroyed Veterans’ Medical Records To Cancel Backlogged Exam Requests – Daily Caller

Employees of the Department of Veterans Affairs (VA) destroyed veterans’ medical files in a systematic attempt to eliminate backlogged veteran medical exam requests, a former VA employee told The Daily Caller.

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Audio of an internal VA meeting obtained by TheDC confirms that VA officials in Los Angeles intentionally canceled backlogged patient exam requests.

“The committee was called System Redesign and the purpose of the meeting was to figure out ways to correct the department’s efficiency. And one of the issues at the time was the backlog,” Oliver Mitchell, a Marine veteran and former patient services assistant in the VA Greater Los Angeles Medical Center, told TheDC.

“We just didn’t have the resources to conduct all of those exams. Basically we would get about 3,000 requests a month for [medical] exams, but in a 30-day period we only had the resources to do about 800. That rolls over to the next month and creates a backlog,” Mitchell said. ”It’s a numbers thing. The waiting list counts against the hospitals efficiency. The longer the veteran waits for an exam that counts against the hospital as far as productivity is concerned.”

By 2008, some patients were “waiting six to nine months for an exam” and VA “didn’t know how to address the issue,” Mitchell said.

VA Greater Los Angeles Radiology department chief Dr. Suzie El-Saden initiated an “ongoing discussion in the department” to cancel exam requests and destroy veterans’ medical files so that no record of the exam requests would exist, thus reducing the backlog, Mitchell said.

Audio from a November 2008 meeting obtained by TheDC depicts VA Greater Los Angeles officials plotting to cancel backlogged exam requests.

“I’m still canceling orders from 2001,” said a male official in the meeting.

“Anything over a year old should be canceled,” replied a female official.

“Canceled or scheduled?” asked the male official.

“Canceled… Your backlog should start at April ’07,” the female official replied, later adding, ”a lot of those patients either had their studies somewhere else, had their surgery… died, don’t live in the state… It’s ridiculous.”

Listen:

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El-Saden, according to Mitchell, was “the person who said destroy the records.” And her plan was actually carried out during the Obama administration’s management of VA.

“That actually happened,” Mitchell said. “We had that discussion in November 2008 and then in March 2009 they started to delete the exams. Once you cancel or delete an order it automatically cancels out that record” so that no record of the exam requests remained.

Mitchell tried to blow the whistle on the scheme and ended up being transferred out of his department and eventually losing his job.

“I actually filed a complaint with the VA [Inspector General] IG and the office of special counsel. The IG requested if I had any documentation. They wanted names. I gave them [about] a thousand names,” Mitchell said. ”The list I turned into the IG went all the way back to 1997.”

“I filed the initial complaint with the IG… The IG instead of doing their own investigation just gave it to the facility and made them aware of my complaint.”

Mitchell eventually wrote to Congress about the issue in January 2011. Two months later, in March 2011, he was fired.

Mitchell received an April 30, 2013 letter from the U.S. Office of Special Counsel stating that OIG found in November 2009 that “all imaging services across the country were instructed to mass purge all outstanding imaging orders for studies older than six months, where the procedure was no longer needed” and that “patient imaging requests found to still be valid were scheduled… Approval was granted for this process by the MEC [Medical Executive Committee], and in collaboration with the Service Chiefs and/or Careline Directors within the health-care system.”

But Mitchell said that in Los Angeles, exam requests that were found to still be needed were “definitely” destroyed.

“The IG’s report said this was a nationwide issue, but I know when we were having our meeting we weren’t talking nationwide – we were talking about our department,” Mitchell said.

“It is the general policy of OSC not to transmit an allegation of wrongdoing to the head of the agency involved, where the agency’s OIG or its delegate, is currently investigating or has investigated, the same allegations. Consequently, this office will take no further action concerning this allegation,” according to the U.S. Office of Special Counsel letter.

“That was an excuse” and part of a “cover-up,” Mitchell said.

“I’ve actually filed a lawsuit against them” for wrongful termination and another complaint, Mitchell said. “I filed it in district court in August of last year. It was accepted in September. The court dismissed it and wants me to amend the complaint with additional facts. I’m turning that in this week.”

VA did not return repeated requests for comment. The VA Greater Los Angeles Healthcare System did not return a request for comment and for an interview with Dr. El-Saden.

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