“. . . a passive approach to identifying and preventing fraud.”
Well, that Patently Pathethic, Asininly Puerile Abomination law called the Patient Protection and Affordable Care Act, or PPACA – AKA “ObamaCare” – is in the news again. And as usual, it’s not in the news in any good way.
Essentially, it’s a huge fraud magnet. We already knew that, and I’ve written about that before. In fact, I’ve written about that as an ObamaCare issue more than once.
Turns out the government knows all that. And you know what? The clown krewe running DC today current Administration doesn’t seem to give a sh!t that people are using ObamaCare to rob the American taxpayer blind.
The GAO recently conducted a study of ObamaCare. The “money quote”? Here ya go:
“CMS has assumed a passive approach to identifying and preventing fraud.”
For those who might not recognize the acronym, CMS is the Federal entity that oversees Medicare, Medicaid . . . and the abomination known as ObamaCare.
Fox News has an article today that gives a good overview of the situation. The full GAO report can be found here.
Sheesh. We really need to kill off this abomination of a law. Now. Then burn the remains, mix them with quicklime – and bury them in an abandoned mine shaft at least 1000′ deep.
Category: "The Floggings Will Continue Until Morale Improves", "Your Tax Dollars At Work", Health Care debate
Sounds like the people who have read it found ways to make a boatload of cash via the cavern sized loopholes.
Nah, that wouldn’t happen, would it? Dodd-Frank, Oxley-Sarbannes, list your shitty legal reforms here that have helped the average Joe.
It’s okay. I’ll wait.
The they don’t care about fraud or misuse because that doesn’t effect them or even their kids. The they also don’t care because they don’t use obamacare and their kids won’t have to use it either.
I’m sure they don’t care because they themselves are making money from insider info they got while writing that living abortion of a law, there were accounts of John “Lurch” Kerry making huge investments in healthcare companies as soon as it got passed and I’m sure many others did as well. WHEN was the last time anyone saw a push to find and prosecute welfare or SSI fraud? Since when haven’t there been loads of con gamers lining up as soon as these programs are set up?
Seriously, this is news? Go to the GAO and search “Medicare fraud” or “medicaid fraud” and it’s like an annual report that HHS and CMS need to do a better job. The states fraud detection units are too small and can’t get help from the feds and in certain situations actively hinder investigation because it’s part of a larger investigation by the feds or the medical provider has what amounts to Most Favored Doctor status. The reports go back to at least the Carter Administration, but the typical answer is “MOAR MONEY TO THE GOVERNMENT AND THIS WILL END” at which more is budgeted and guess what? It’s still not enough.
No, it’s not news in general. Pretty much the only things the US government seems to do these days that can’t be described as “effing up by the numbers” is defend the nation and build roads. And I’m not really sure about the “build roads” part any more after some of the crap I’ve seen from highway designers and builders over the last couple of decades.
This is, however, the first time that the same thing has been proven about ObamaCare. No, it isn’t a surprise, really. But it does qualify as news, albeit bad news.
See that was a sticking point on the issue for me. All the discussion there was a constant drum beats about how fraud ridden Medicaid and Medicare. Yet, the prog-leftists hand wave that away with the usual “never happens in noticeable levels” but the fact that it happens and these are the same Mike Foxtrot that kvetching about DoD hammers and toilet seats.
It is also no surprise that the executive branch is looking the other way about the fraud. They have been looking the other way for as long as I mentioned (if not since the opening of the war on poverty).
Yep. As I’ve said elsewhere:
“Whenever someone can get free stuff simply by asking, sooner or later someone who doesn’t qualify will ask for – and get – it. And it’s usually sooner rather than later.”
And the hits just keep on coming….
Fraud in the VA/DoD is just as bad if not worse. I’m a healthcare fraud examiner/forensic auditor. I could make a great living if the VA’s OIG, the DoD and the Federal District Attorney’s would act on fraud complaints under the False Claim Act of 1865. The VA used to respond to my letters with bullshit excuses how they were focused on providing high quality care to vets and couldn’t be bothered to investigate fraud. Now they don’t even respond.
You can’t see it, but this is my shocked face…
D, are you a contractor or with a private insurer? I’m an HCF Audit Investigator with a Mid-sized plan. None of this is surprising and only confirms what we saw coming from miles away before ACA started. We got hammered on some fraud with mandated coverage and fraudulent ACA enrollment related to inpatient drug treatment…that wasn’t inpatient, and wasn’t drug treatment.
The answer is the repeal of oBaMa-don’t care in its entirety. It doesn’t need tweaking. It doesn’t need this. It doesn’t need that. It needs only one thing: gone.
Passive approach…isn’t that the same approach they started out with to deal with the JV squad in the middle east?
How’d that passive approach turn out?
What’s happening throughout the nation that’s not as widely reported is the impact on community non-profit hospitals in smaller cities and towns. Most are having to close or work to be acquired by a larger for profit or non-profit system.
Here in the PRoM, widely touted as a model for the ACA, had anyone bothered to check before forcing this horseshit on the rest of the nation they might have noticed that even non-profit operations employing 11,000 people were hemorrhaging cash and struggling to find a way to maintain profitability that didn’t involve reducing staff.
No matter what anyone claims to the contrary, simply reducing payments for services while still mandating that community non-profits treat all comers doesn’t actually reduce the cost of the care, just the amount of reimbursement. Some hospitals are resolving the issue by closing their ERs or stopping their childbirth facilities from operating. I remain unclear on exactly how that improves access to care for anyone in the nation.
I am also unclear on the concept of how someone who was unable to afford insurance previously will be able to pay the fine for not having something they couldn’t afford in the first place.
It’s that leading from behind thing.
Don’t forget, according to King Barry, his is the “Most Transparent Administration in history” too.
VOV….you are headed in the correct direction of thinkers, and you may not even realize it. This SHOULD not be news, but throughout the country, the bigger hospitals are buying up the small ones as fast as they can. Than includes buying privately owned facilities and hiring the doctors who were former owners. In the not-too-distant future, all areas will be broken down into regional medical areas. The gub. will send one VERY LARGE check to the entity overseeing all those hospitals within each region. That entity will then distribute funds accordingly to each hospital. How that will be determined who gets what is yet to be made public. No surprise that this is only typical gub. creating just another bureaucracy. It’s just that CONTROLLING doctors and hospitals will be much easier this way. Control them and then the minions will be MUCH easier to control.
I feel for folks who never wanted anything to do with Obumbles-care but are negatively affected by it anyway. Just the same, I wonder what the attitude is of those who thought it was a great idea and are now getting fucked over for it.
Karma and all that.
This just gives me more reason to hate politicians.
It is not just fraud that is a problem. It is also doctors/health organizations/providers who are – in D&D terms – exploiting broken rules.
One of the things the Health Insurance has to pay for (at no direct cost to you) is your doctor giving you a lecture on how to live and eat better. They can get up to $75 directly from your insurer as long as they are not providing treatment and do not take more than an hour a year.
You can see the intent is for the doctor to give you ideas and to spend time with you to help you get healthy and by extension use less health care.
The rule is “broken” in that it says nothing about your doctor visiting a work place at lunch time and giving the lecture to everyone at the office. Or showing up at an inservice training session and giving their talk to a group mandated to show up.
We had a local doctor group figure this out and conned at least five companies (Ford was one) and half of the County Government to require employees to show up to their lectures and fill out a “authorization to bill” form.
In the Ambulance Company alone, we have 260 people who were forced to attend one of four sessions. So the Doc had to spend four or five hours talking at us so he could bill insurance companies $75 each – about $117,000…for five hours of work.
I don’t feel the guy was evil, he was following the rules, I blame the rules. (Apparently starting in 1 April 2016, HHS has changed that rule to require it be done in the office)
Same for mandated annual alcohol screening coverage. Fill out a survey prior to your OV, they get paid $35 for the piece of paper.
“Sheesh. We really need to kill off this abomination of a law. Now. Then burn the remains, mix them with quicklime – and bury them in an abandoned mine shaft at least 1000′ deep.”
Don’t hold back Hondo. It’ll just raise your blood pressure. Tell us what you really think.
(smile)
January 2017 can’t come soon enough.
Soooo. .. . Can I take the same “passive approach” in paying my FedGov income taxes this year?
I suppose you can. But I wouldn’t recommend it.
As I remember, the amount of fraud in Medicare / Medicaid is enough to have paid for the private health care insurance of the millions of people that were claimed to not have health insurance which was the driving force behind the “compassionate” ObamaCare.
The government – both parties – were never interested and don’t ever seem interested in reducing waste in anything.
In my neck of the woods there is a huge debate on raising the tax on gas to pay for roads.
The County Manager proclaimed that since the economic downturn, the County had eliminated over 500 jobs without a reduction in services. He was immediately confronted with a citizen saying “so we paid all those years for people we did not need instead of paying for roads?
The people in government don’t care about waste.
Feds estimate 3-10% of the total dollars spent annually are lost to FWA in a $2T system. That’s a conservative estimate IMO. That equates to anywhere between $60-200 BILLION lost annually, and it’s either tax payer money in the case of Medi/Medi or your premiums for private pay.
Obama Care, AKA Hillary Care, might be Bernath’s fault, as this cluster foxtrot of an individual might have given Hillary and Barrack this bovine excrement idea in the first place.