Taxpayers Left Holding the Bag Again on Massive Cost Overruns and Bureaucrats Sitting at Home on Paid Leave

moneyWith the Government Accounting Office estimating that in 2014 some $124 billion was siphoned off the Medicaid and Medicare system nationally, we are again witnessing the truly schizophrenic nature of Medicaid enforcement actions in this country.

In New York, this past week the Attorney General there sent out a press release that his office had successfully investigated a single nurse for Medicaid fraud.  She had pleaded guilty to ripping off the system for $5,000.


This is something to crow about?  Apparently so.  We’ve brought this sort of thing up before.

The release promoted the number of high-level staff in state agencies that had been involved in the investigation and prosecution.

“The case was investigated by Special Investigator Debra Clementi and Principal Auditor/ Investigator Thomas Clarke with assistance from MFCU Deputy Chief Investigator William Falk and OMIG Investigator Colleen Balkin.  The case is being prosecuted by Special Assistant Attorney General Timothy McFarland.  Catherine Wagner is Director of the Rochester Regional MFCU Office and the Upstate Chief of Criminal Investigations.  The Medicaid Fraud Control Unit is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. The Division of Criminal Justice is led by Executive Deputy Attorney General Kelly Donovan.”

We can only joke that 24.8 million more Medicaid providers need to be convicted at $5,000 a head, that’s 5,000 divided into 124,000,000,0000, to cover Medicaid fraud in the country.  Pretty funny.

Don’t get us wrong.  The nurse should be prosecuted and good of the NY AG to do so.  We just don’t think it is anything that merits a self-congratulatory press release.

Schizophrenic system goes after pennies when millions lost

The crazy thing is that while New York is apparently willing to devote unlimited resources to get back $5,000 from a Medicaid provider and convict them,  Texas apparently isn’t interested in hundreds of thousands or millions of dollars in waste or abuse much less find someone to be responsible for it.

Ah, but the Texas situations have nothing to do with Medicaid providers.  That they would tackle with alacrity.

It involves the apparent executive bureaucratic and corporate entitlement programs surrounding Medicaid and state coffers in Texas.  Those are sacred.

Former state executive sitting at home collecting $100,000

The vigilant Austin media found a few weeks ago that one of the executive staff of the Texas Health and Human Services Commission who had been put on administrative leave LAST December in the wake of the 21CT scandal over Medicaid fraud detection software was still sitting at home getting her $100,000 per year salary.   $100,000 spent with no value to the taxpayers, no value to the government and no one apparently cares.

Why should they?  There is no law against that.  Shucks, it is only the wife of former Inspector General Doug Wilson.

It’s executive bureaucratic entitlement Texas-style.  Just like those cushy $2,800 chairs Jack Stick bought for himself and Wilson when they both worked at HHSC-OIG.  Or that $100,000 Kyle Janek, in violation of state regulations, gave to his assistant for his MBA when Janek was HHSC Executive Commissioner. It only becomes an issue when the media finds out.

Hey, these people aren’t some nurse doctoring a time sheet!

New Medicaid claims administrator needs $50 million more on over-cost project, but that’s okay

In the Austin media this morning, corporate data giant Accenture was pointed out as the main player in an unfolding drama over massive cost increases for a data system for the Office of Attorney General’s child support division, named “T2.″

As the Statesman reported, “the project’s price tag has increased by about 40 percent — or $86.4 million — over the past six years, to $310 million. There’s talk that it will take at least another $50 million to rescue the project.”

Yeah, after six years and millions spent, it still isn’t going.

Accenture?  They are the guys that took over the job of Medicaid claims administrator for the state after HHSC fired the former administrator Xerox. The state is suing Xerox over its Medicaid orthodontic prior authorization mess.

Of course, that only happened after Medicaid dentists sued Xerox because the state was going after – of course – them, Medicaid providers.

This is corporate entitlement at its best or worst, depending on your point of view.  The Attorney General, rather than investigating Accenture on the cost overruns, wants to pay them $50 million more.  Cha-ching!

It is too bad that Accenture is not a Medicaid nurse with time sheet anomalies.   Then you’d probably see some action along with a self-congratulatory press release.

Just like they did in New York.

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