Wednesday, April 4, 2018

California Commits Massive Medicaid Fraud

American Spectator
David Catron
April 2, 2018, 12:05 am

California is indeed the Golden State where Medicaid is concerned. The HHS Office of Inspector General (OIG) has found that, by exploiting Obamacare’s expansion of the program, California has enrolled hundreds of thousands of ineligible adults in Medicaid. Consequently, the state has bilked the federal government out of more than $1 billion in funding to which the state was not entitled. Indeed, these figures probably understate the amount of money that California officials have fraudulently extracted from the taxpayers. The OIG sampled a mere six-month period, from October 1, 2014 through March 31, 2015, to arrive at its damning assessment.

If the word “fraud” seems over the top, consider what happens to doctors who filch Medicaid funds to which they aren’t entitled. This case, reported by the Boston Globe, is typical: “A Brookline doctor has been sentenced to 11 months in jail and ordered to pay $9.3 million for running a Medicaid fraud scheme.” Likewise, Michigan CBS affiliate WNEM reports that a Saginaw doctor “was charged with three felony counts of Medicaid fraud.… Each charge is punishable by up to four years in prison and a $50,000 fine.” Such cases are prosecuted every day and the charge pursued by the authorities is “fraud.” So, isn’t the skullduggery described below also fraud?

On the basis of our sample results, we estimated that the State agency made Medicaid payments of $628,838,417 (Federal share) on behalf of 366,078 ineligible beneficiaries and $402,358,529 (Federal share) on behalf of 79,055 potentially ineligible beneficiaries.

Don’t be confused by the vague bureaucratic vernacular used in the above passage. When the OIG says, “the State agency made Medicaid payments (Federal Share),” it means all of the money used to cover these ineligible enrollees was provided by the federal government. For the period of time covered by the OIG audit, the federal Share of the costs for newly eligible, adult enrollees is 100 percent (which isn’t true in the case of low-income beneficiaries for whom the program was originally created). In other words, every dime California ostensibly “paid” for the people described above came straight out of your federal tax bill. As the OIG explains:

Thank You Mr Catron and American Spectator

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