Medicaid Money Laundering

Wall Street Journal ^ | 19 May 2008 | Editorial Staff

[shrinkermd]

...Now it turns out that states have been goosing their financing arrangements to maximize their federal payouts and dump more of their costs onto taxpayers nationwide.

The swindle works like this: A state overpays state-run health-care providers, such as county hospitals or nursing homes, for Medicaid benefits far in excess of its typical rates. Then the federal government reimburses the state for "half" of the inflated bills. Once the state bags the extra matching funds, the hospital is required to rebate the extra money it received at the scam's outset. Cash thus makes a round trip from states to providers and back to the states – all to dupe Washington.

The Government Accountability Office and other federal inspectors have copiously documented these "creative financing schemes" going back to the Clinton Administration. New York deposited its proceeds in a Medicaid account, recycling federal dollars to decrease its overall contribution. So did Michigan. States like Wisconsin and Pennsylvania fattened their political priorities. Oregon funded K-12 education during a budget shortfall.

The right word for this is fraud. A corporation caught in this kind of self-dealing – faking payments to extract billions, then laundering the money – would be indicted. In fact, a new industry of contingency-fee consultants has sprung up to help states find and exploit the "ambiguities" in Medicaid's regulatory wasteland. All the feds can do is notice loopholes when they get too expensive and close them, whereupon the cycle starts over.

[shrinkermd]

"...The Bush Administration did just that. In 2003, it began audits that resulted in 29 states dialing back the practice. In 2007, officials tried to make the reforms permanent through formal rules changes, saying federal Medicaid dollars would only pay for Medicaid services received by Medicaid beneficiaries.

Naturally, the states were furious. All 50 Governors were (and are) opposed, while pressure groups like AARP and their media collaborators chime in with horror stories about "cuts" to the social safety net. Congress promptly forbade enforcement of the new regulations. That moratorium, which was slipped into last year's Iraq war funding bill, expires at the end of this month

[SierraWasp]

The office right next to mine is a service to help Seniors qualify for Medicare financing of their nursing home expenses since they didn't secure any Long-Term Care insurance while they were still able to qualify for it.

There are others with radio and T.V. informercials for seminars and workshops leading to a service like this guaranteeing that mom and/or dad can qualify for this and screaming about the state's "estate recovery system" to pay the state back for all that uninsured nursing home expense!!!

They push the idea that if you ever paid any kind of taxes and didn't recover them through some kind of services, then you are absolutely entitled to having your nursing home or residential care facility bills be paid even though you never even bothered to look into insurance before you became too feeble to get anyone to insure you!!!

Now this isn't some minority group feeling like vitims that are "owed" or "entitled" to government largess... These are your middleclass neighbors moms and/or dads who just didn't want to plan or prepare for almost inevitable chronic care or severe cognitive impairment in any way, rather than make you pay for it through confiscatory taxation of everybody else!!!

[groanup]

If we pre qualify you and you are turned down by Medicare we'll give you a scooter free:

The Scooter Store.

Grrrrr.

[Grampa Dave]

The over educated liberals, who work in these places are called Senior Advocates.

This is just another example of the entitlement BS that will destroy the economy of our country, and we were discussing the “entitled” ones this past week.

The liberal boomers are aging and have no real personal financial safety nets they have provided for their old age care.

A couple of decades ago their parents, aunts and uncles disposed of their assets and then qualified for MediCal nursing home benefits after they disposed of their assets.

Now they are doing the same thing. Take a cruise and see how many seniors are taking their families on cruises to dispose of their assets. Then they go to “The office right next to yours for a service to help Seniors qualify for Medicare financing of their nursing home expenses since they didn’t secure any Long-Term Care insurance while they were still able to qualify for it.”

[swmobuffalo]

“Now they are doing the same thing. Take a cruise and see how many seniors are taking their families on cruises to dispose of their assets. Then they go to “The office right next to yours for a service to help Seniors qualify for Medicare financing of their nursing home expenses since they didn’t secure any Long-Term Care insurance while they were still able to qualify for it.”

And it really makes what difference? At some point the money is going to run out and they’re going to qualify for Medicaid. Notice I said Medicaid, not Medicare. Getting old and being sick and old is an expensive business. Assets run out, insurance has maximums and nursing homes aren’t free.

[socialismisinsidious]

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