Posted on 04/27/2002 4:36:55 PM PDT by ATOMIC_PUNK
Both reports are PDF files that require the Adobe Acrobat Reader. We have extracted the 8 most important pages so you don't have to wade through all 464 pages.
If you ever doubted that TennCare is a blackhole for your hard earned tax dollars, here it is from the state auditors. Please take your blood pressure medicine before reading.
TennCare Fraud and Mismanagement
TennCare Fraud and Abuse:The Ultimate Taxpayer RIP-OFF
As noted in the six prior audits of the Bureau of TennCare, internal control over TennCare eligibility is not adequate. Management concurred in part with the prior audit finding, as discussed throughout this finding. However, problems still exist.
Recipiants found onTennCare Twice
Using computer-assisted audit techniques to search the TennCare recipient eligibility history file located on the TennCare Management Information System (TCMIS), a listing of 1,018 recipient records with duplicate social security numbers was compiled. A sample of 60 sets of recipient records with duplicate social security numbers representing 120 of the 1,018 recipient records was tested to determine if overlapping capitation or fee-for-service payments were made during the fiscal year ended June 30, 2001. Testwork revealed that for 9 of 60 sets of recipient records with duplicate social security numbers tested (15%), overlapping capitation payments were made. Follow-up with management regarding these nine pairs of recipient records revealed that these nine individuals were on TennCare twice for all or part of the dates of services that were paid for during the audit period. TennCare’s capitation payment amounts for recipients are based upon the recipients’
managed care organization (MCO), age, eligibility classification, and the region of the state. In some cases, when overlapping payments were found, different capitation rates were paid for each recipient in a set. It could not be determined which recipient record contained the appropriate payment and which recipient record contained the inappropriate payment. As a result, we had two different amounts in each set of recipient records that could be unallowable.
No Verification of Applications Management stated in response to the prior audit finding, “We believe that the accuracy of eligibility determinations will be improved with our new Member Services Unit and proposed rules and policies.” However, the Bureau still does not verify information contained on applications for individuals losing Medicaid eligibility. According to 1200-13-12-.02(5)(a) of the Rules of the Tennessee Department of Finance and Administration, Bureau of TennCare, Persons losing Medicaid eligibility for TennCare who have no access to insurance may remain in TennCare if they are determined to meet the non-Medicaid TennCare eligibility criteria.
These applications are entered on TCMIS and processed without verification of information contained on the application. Without verifying the information on the applications, the Bureau of TennCare cannot ensure that the applicant meets non-Medicaid TennCare eligibility criteria. In addition, not verifying the information on the applications can result in inaccurate premium amounts based upon the unverified and possibly inaccurate income amounts reported by the recipient.
TENNESSEEANS ARE FIGHTING THE GOOD FIGHT AND FIGHTING HARD
GO TENNESSEE GO
GREAT post!
Only private enterprise does that...
That is why government is a failure at everything it touches...
Government forcibly sacrifices the innocent value producer and the values that he creates in order to continue it's own existence and growth... Taking more and more values...
Government destroys where individuals create...
Government causes problems where none previously existed...
Government is antithesis of value production and happiness...
When will the sheeple start to question the essence of external authority government and what role it should play in controlling conscious life on this planet???
This is just the tip of the ice berg. You have to add in DayCare, Family's First DHS, the DOT, and the schools, especially higher ED. THere is $58M in this budget for NEEDLESS sports related items at colleges whining about budget cuts. A half a million for a golf cart crossing and a golf practice area, $19.3M for a new swimming pool for one of the colleges. $1M for a tennis court, $1M for a sports museum. $25M for a parking garage for the grizzlies. The U of Memphis is whining about cuts to research programs...they have $38M in this budget for two buildings. $16M for a performing arts center and $22M for renovations to another building. There is $1M for the country music hall of fame, over $2M for the State musuem. Over $3M for PBS who wants an additional $6.5M to go digital. (which it would take that amount to do Memphis alone (hubby did a stint as a public tv broadcast engineer an that is his opinion, especially since he deals in radio transimitter sites)
Tennessee has a SPENDING PROBLEM.
NO STATE GOVERNMENT CAN KEEP UP WITH AN ADDITIONAL $1BILLION IN NEW SPENDING A YEAR.
And....just last week a big news article about a 50c a pack increase in the cigarette tax to help fund ....God knows what new spending. And there was the lottery. And there have been tax increases and fees and ....
You know the story. The POLITICIANS will continue to spend and continue to create crises designed to get more cash. There is no end to their appetite for more money.
Schools are spending $650 per school each month on a T1 line because they have internet access through a third party company. If the school systems went through Bellsouth the same line would only cost approximately $250 each month.
As a student at Pellissippi State Tech. Community College, I have seen more wasted taxpayer money than most people can imagine. As a freshman, I witnessed free meals at the college nearly once per two weeks for nearly 3,000 students. As a sophomore, I witnessed every computer in every classroom upgraded from a Dell w/Pentium II 300 mhz. computer to a Dell w/Pentium IV 500 mhz processor. As a computer science student, I can say firsthand that this purchase is unnecessary and wasteful. Although the number of these purchased computers is unknown, I estimate nearly 500 for the entire college. Also, laser discs, computer projectors w/remotes, new mulch, trees, flowers, sidewalks, fountains for the pond, decorative flags, a new basketball court, new indoor gymnasium and "bubble", and many other purchases have been made during my two year education which were unnecessary.
TDEC is paying $30,000 a month for a CRS Center for Tennessee Resort State Parks. This is a $360,000.00 per year expense that provides zero benefit to Tennessee taxpayers.
This entry from the Office for Information Resources (OIR) establishes an overall goal of replacing all desktop computer hardware after 3 years of use. Does the State really need to replace every computer, printer, scanner, etc. just 3 years after they were purchased? Here is the section from the OIR guidelines from their online site: Information Systems Plan Guidelines - February 2002 Appendix F: Desktop Hardware Replacement Desktop Hardware Replacement strategy and projects: Each agency should develop a strategy for desktop hardware replacement. The overall goal of the strategy is to establish and maintain a 3-year replacement cycle for all desktop hardware. Projects to implement the strategy should be submitted in Chapter 5 for the replacement of the current base of equipment, regardless of the funding source(s) used to replace the equipment.
Some state buildings have been lit up all night with all of the inside lights burning. Can someone be given the responsibility for shutting these down during non-working hours?
On November 1, 2001 Gov. Don Sunquist announced he is directing $8 million in state funds toward immediate security needs. One expenditure that was sinply reinstated is for a new class of 50 state troopers. This is to cost $5.3 million which comes to $106,000 per trainee. Why so much? Why is it so expensive to train new state troopers? Private university tuition is $25,000 a year and this training program only takes six months.
This department has contracted with private businesses for the housing and care of mentally and physically impaired individuals. These individuals were formerly the responsibility of the state asnd housed in state facilities. These contracted group homes were established for the housing of up to 3 individuals. These homes were allowed to set up in residential neighborhoods and ignore local zoning laws and covenants. In fact the law prevented the notification to the residential owners of the planned group home. The reported daily payment by the state, as given to me by a resident involved in a similiar situation in another location, is $800 PER DAY per person. This means the contractor receives $300,000.00 annually. With a maximum of 3 persons per group home, that comes to almost a million dollars a year to house THREE people. Also there was not been a corresponding state employee reduction in the department for the workers who should have been displaced by this action.
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