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May 31, 2011

Bravo! The State Takes Ken Block Up On His Offer to Look for Waste and Fraud

Monique Chartier

... in our Medicaid dollars. (Hey, Ken, will you be looking in any other areas?)

By the way, apparently he'll be doing it for free. This is very nice of him but personally, I'd have no problem with the state paying for such a service - a fee based on a percentage of dollars recovered would make sense.

The Barrington resident and business owner says he recently met with DLT Director Charles Fogarty and has met more than once with Health and Human Services Secretary Steven M. Costantino.

Block said he is offering his services free of charge. The challenge, he said, is to come up with a legal framework — perhaps a contract in which the state pays him a token $1 — that allows him access to state data so he can look for cases of fraud.

Block said he still believes Rhode Island could save $100 million to $250 million in its Medicaid programs, based on similar efforts in other states that have uncovered anywhere from 10- to 20-percent waste and fraud.

Comments

This is excellent news. I hope he has is given the clout to really get his hands dirty and make a change. He did it in Texas. This is what I want to see RI do get itself out of this hole, not screw every worker and every tax payer while sparing everyone on the dole who doesnt get up for work everyday.

Posted by: Rich at May 31, 2011 9:27 PM

I can hear the special interests and public sector unions howling now about the unfairness of whatever Mr. Block recommends.

Posted by: Mark at May 31, 2011 10:25 PM

Actually, we could save billions by eliminating welfare and its associated subsidies including Medicaid, entirely for able-bodied people. If they don't like being poor then they can work.

That's always been the American way until the Marxist/Progressives took over.

Posted by: BobN at June 1, 2011 6:49 AM

I've personally never understood the "people dying in the streets" scenario progressives describe without all these government wealth redistribution programs. I'm fairly certain that I could find a steady stream of menial/manual labor to perform if my life literally depended upon it, and there are so many people and charities who would be willing to help out if you approached them. They could certainly do a better job determining whether people deserve their money than government, which often just writes a check.

There is a homeless guy who just sits on a park bench all day everyday on my way to work and he's still alive. I doubt he's on government assistance and he doesn't panhandle, so people go out of their way to feed him I guess.

Posted by: Dan at June 1, 2011 9:50 AM

Not that the Know Nothing chorus here cares, but the vast majority of Medicaid fraud is conducted by pharmaceutical companies, medical device manufacturers, and providers. But, hey, it's much more fun to blame the poor, immigrants, whatever.

Posted by: Russ at June 1, 2011 11:24 AM

" I doubt he's on government assistance and he doesn't panhandle"

He might do both. Maybe he goes to a soup kitchen somewhere for meals. Those are often government-subsidized along with private money. Maybe he does panhandle, but at places you don't see him. It depends on what his priorities are. If he gets meals for free at the soup kitchen and can get $10 a day out of people for whatever else he thinks he needs/wants, that's not too hard to do.

Posted by: Patrick at June 1, 2011 11:47 AM

Just another unsupported blanket assertion by Russ, which is probably totally counterfactual.

Medicaid shouldn't exist in the first place. And without it, there would be no Medicaid fraud at all.

Posted by: BobN at June 1, 2011 12:06 PM
Just another unsupported blanket assertion by Russ, which is probably totally counterfactual.

And yet another area where unfamiliarity with the subject doesn't stop the uninformed from chiming in anyway.

If you know me, you know I'm speaking from experience. If you don't, a quick search on Google will confirm I'm right.

Posted by: Russ at June 1, 2011 12:37 PM

No, we're not playing that game today. No evidence, no standing.

And you can keep your gratuitous insults to yourself.

Posted by: BobN at June 1, 2011 12:54 PM

I wasn't trying to insult you. It's just the truth in this case. I know quite a bit about this one, which shouldn't be hard to confirm.

Play the game. Don't play the game. Suit yourself.

Posted by: Russ at June 1, 2011 1:06 PM
"Not that the Know Nothing chorus here cares, but the vast majority of Medicaid fraud is conducted by pharmaceutical companies, medical device manufacturers, and providers."

Russ, what evidence to you have to support this claim? Please omit any references with the word "progress" in the title in your response.

Please also be sure to explicitly name any specific companies in your charge. It would bring me great pleasure to see you get sued by said companies for libel, and I assure you, they WILL sue you for libel if you accuse them of Medicaid fraud on an online forum.

Posted by: Dan at June 1, 2011 1:11 PM

So "the Know Nothing chorus" is a standard phrase in civil conversation?

Talk about defining deviancy down.

Russ, your games aren't worth playing.

Posted by: BobN at June 1, 2011 1:21 PM

Sheesh, if you insist. Last year alone... Pfizer, AstraZeneca, Novartis.

www.justice.gov/opa/pr/2010/November/10-civ-1335.html

Fiscal year 2010 also saw records for several types of health care fraud. A $2.3 billion settlement with Pfizer Inc. marked the largest health care fraud settlement in history. The $2.3 billion includes $669 million recovered under the federal False Claims Act, $1.3 billion in criminal fines and forfeitures, and $331 million in recoveries for state Medicaid programs and the District of Columbia. (These latter two amounts are not included in the total health care fraud recoveries announced today, which are limited to the federal government’s civil recoveries.) In addition, a $108 million settlement with The Health Alliance of Greater Cincinnati and one of its former member hospitals, The Christ Hospital, was the largest ever under the health care Anti-Kickback Statute for the conduct of a single hospital.

The largest fiscal year 2010 False Claims Act recoveries came from the pharmaceutical and medical device industries, which accounted for $1.6 billion in settlements, including the $669 million from Pfizer Inc., $302 million from AstraZeneca, and $192.7 from Novartis Pharmaceutical Corporation.

Posted by: Russ at June 1, 2011 1:26 PM

I was careful to capitalize "Know Nothing." You telling me that there isn't a strong nativist sentiment here?

en.wikipedia.org/wiki/Know_Nothing

Posted by: Russ at June 1, 2011 1:33 PM
Actually, we could save billions by eliminating welfare and its associated subsidies including Medicaid, entirely for able-bodied people. If they don't like being poor then they can work.

Just another unsupported blanket assertion by BobN, which is probably totally counterfactual.

I assume you have sources for such a whopper. I say all that does is push costs to unreimbursed care, especially in high cost venues like ERs (and guess who pays for that?).

Posted by: Russ at June 1, 2011 2:38 PM

That's easy. Over $2 billion in the state budget is for "human services". Cut that by 3/4 and we save $1.5 billion.

Enforce immigration laws and the illegal parasites will decamp for home or other states.

As to the supposed "evidence", the headlines quoted by Russ are hardly evidence of actual fraud by those companies. Unfortunately, with today's (ironically named) Justice Dept. using the byzantine statutory maze to conduce political assaults, it is entirely possible that any violations by these companies were merely technical and on a minuscule scale relative to the punitive fines imposed by the tyrannical government. And the companies settle because they know that it's less expensive for the shareholders than fighting it out in court. This kind of shakedown operation used to be the Mafia's specialty, but now our national government has become the expert in using this tactic.

So Russ, your "evidence" fails to support your statement.

Further, your incorrect application of the term "Know-Nothing", in an attempt to equate today's conservatives with that short-lived movement from the 1840s is indeed an insult. Next you'll be calling us the KKK.

Posted by: BobN at June 1, 2011 3:09 PM
That's easy. Over $2 billion in the state budget is for "human services". Cut that by 3/4 and we save $1.5 billion.

Not so fast, first off you said "able-bodied people." The vast majority of Medicaid expense is from a small percentage of high cost members with complex medical problems. If I remember correctly a full 25% of the program goes to 1% of those covered.

Well people cost next to nothing to cover. Well that is unless you kick them off the program. What could have been fixed with preventative care, then becomes a massive expense when they show up with untreated diabetes and a foot that needs amputation. All you've done is propose fairy dust and unicorn horns to solve the problem.

Oh, and we're still waiting on the source for your "savings." Thought we weren't playing that game?

Posted by: Russ at June 1, 2011 3:18 PM

Well, first of all, Russ, a settlement is not a admission of wrongdoing, and even if there was wrongdoing, it was not necessarily "fraud."

Besides, $1 billion here and there is chump change compared to the Medicare/Medicaid fraud that occurs across the nation on a massive scale:

Medicare Fraud: A $60 Billion Crime
www.cbsnews.com/stories/2009/10/23/60minutes/main5414390.shtml

Just another example of how progressive intentions inevitably turn into the most egregious abuse, fraud, and systemic breakdown imaginable.

Posted by: Dan at June 1, 2011 3:28 PM

I think its safe to assume that there are massive amounts of fraud perpertrated by both recipients who are able bodied and companies. As to which group costs more, pissing matches dont matter to me, investigate both.

Posted by: Rich at June 2, 2011 10:44 PM