Skip to comments.State Medicaid may have to pay back $75 million unauthorized use of money for immigrants
Posted on 04/28/2006 6:51:48 AM PDT by XR7
OLYMPIA -- A state audit has questioned nearly $1 billion that Washington's Medicaid program spent last year -- including $75 million that may have to be repaid to the federal government because it was used for unauthorized medical services for undocumented aliens.
Undocumented aliens received prenatal care, chemotherapy, kidney transplants and other procedures the federal government prohibits its money from being spent on, the audit released Thursday found.
The report examined Medicaid payments in the fiscal year that ended in 2005.
Medicaid, a joint state and federal program, spent $6.2 billion last year on health services for the state's poor and disabled.
"We found no improvements in the ... controls from previous years," the audit said. "Washington state is providing service to thousands of ineligible clients using federal Medicaid money. The majority of these clients were admitted into the program due to unaddressed significant weaknesses in the department's controls. This is causing the nation's taxpayers to subsidize Washington state's non-compliance."
The U.S. Health and Human Services Department began reviewing Washington's Medicaid spending on undocumented aliens in March, but it has yet to determine how much, if any, federal money should be repaid.
State Medicaid Director Doug Porter said the federal report most likely will recommend policy changes and tighter controls on how the federal money is spent.
"We might owe them money back -- we might not," Porter said. "Largely, the federal government will determine: Did we make a mistake that was an honest mistake that can be corrected? Or were we trying to game the system and rip off more federal money than we were entitled to and we knew it? That largely drives the corrective action."
Porter said he hopes investigators' findings will concur with what he believes are the facts: "We were looking at the regulations and making the best sense out of them as we could."
In that case, Porter said he expects the federal government to clarify its rules instead of issuing sanctions and a demand to repay the money.
Porter said he's skeptical that the government will demand the full $75 million to be repaid.
"We think what's really at risk is something on the order of maybe $8 million or $10 million," Porter said.
State Auditor Brian Sonntag said it's not up to his office to decide how much of the total liability would have to be repaid.
"What we're going to do is identify improper payments. We're going to identify problems in the audit report," Sonntag said. "In the follow-up, the federal government will determine what or how much has to be repaid. ... Ideally, you wouldn't want to be misspending any of these dollars."
Sonntag said he's concerned that most of the 28 findings in this year's audit were flagged before.
"A lot of these issues are repeat issues," Sonntag said. "You've read these in previous audit reports, and here they are again."
But on the upside, Sonntag said the response from the new head of the Department of Social and Health Services was encouraging.
DSHS Secretary Robin Arnold-Williams said she takes the latest audit findings seriously.
"We share a common goal of ensuring the proper use of public funds," she said.
Sonntag said Arnold-Williams' attitude and commitment to resolving audit issues was "very refreshing."
Animosity and a lack of cooperation between agency officials and the auditors marked Sonntag's previous Medicaid audit.
The 2005 audit found that DSHS and Medicaid:
Lack a reliable system to identify treatments and services that are not covered by the Medicaid plan.
Spent federal money on services for undocumented aliens. They did not adequately review pharmaceutical claims for fraud and abuse.
Lack adequate internal controls to prevent Medicaid payments to dead people or people using a dead person's Social Security number.
Porter said the findings could be broken down into three main categories: One, the federal government is giving mixed signals in interpreting its own rules; two, DSHS and auditors are interpreting the rules differently; and three, DSHS and the federal government have agreed on an interpretation of the rules and the Auditor's Office is just wrong.
"We just plain disagree on some issues -- and will likely continue to disagree," he said.
Porter and Sonntag agree that the federal investigation will prove useful in at least clearing up conflicting interpretations.
"What we're looking for is the federal government to come in and provide some clarification to DSHS and to our office," Sonntag said. "This was supposed to happen a couple years ago, and we are very encouraged that it will happen now."
Porter said the department is trying to move quickly to address the problems they do agree on.
"If we haven't already started a correction, we will," he said. "We would like to have that done and in place before his next audit commences"
Hate to think what the figure might be here in California.
Yes, and my Mother, who is an 80 year old American citizen, and worked hard and paid taxes all her life, is having to pay for her own medical insurance.
Washington's faux-governor hasn't fixed its faux-accounting system, and Democrats are stealing money. What a surprise.
Please tell your mother that we are doing all that we can to put an end to this crime.
You just know Gov. Fraudoire will blame the Bush for the fact that her controlling party can't handle finances.
If duly elected officials, under oath, are aiding anf abetting ILLEGALS to break the law, to obtain unauthorized government benefits using fraudulent documentation, and if elected and appointed officials did, in fact, allow illegals to break the law and allowed illegal access to government agencies, this might be a violation of the Hobbs Act. If elected officials took campaign contributions from illegal aliens, this could be characterized as extortion, and/or bribery, and a violation of the Hobbs Act.
The Hobbs Act was used recently to nail four TENN state legislators and their aides in an extortion scheme. The TENN group was arrested under the federal Hobbs Act, charging extortion, conspiracy to extort and attempted extortion, and accepting bribes as agents of the state. The Hobbs Act covers extortion by public officials, as follows: 2403 Hobbs Act -- Extortion By Force, Violence, or Fear
SOURCE October 1997 Criminal Resource Manual 2403 http://www.usdoj.gov/usao/eousa/foia_reading_room/usam/title9/crm02403.htm
9-131.000 THE HOBBS ACT -- 18 U.S.C. § 1951
9-131.020 Investigative and Supervisory Jurisdiction
Primary investigative jurisdiction of offenses in 18 U.S.C. § 1951 lies with the Federal Bureau of Investigation. The Inspector General's Office of Investigations, Division of Labor Racketeering (formerly the Office of Labor Racketeering), United States Department of Labor, is also authorized to investigate violations of 18 U.S.C. § 1951 in labor-management disputes involving the extortion of property from employers by reason of authority conferred on investigators as Special Deputy United States Marshals. Supervisory jurisdiction over 18 U.S.C. § 1951 is exercised by the following offices with respect to the offenses noted:
1. Extortion under color of official right or extortion by a public official through misuse of his/her office is supervised by the Public Integrity Section, Criminal Division.
2. Extortion and robbery in labor-management disputes is supervised by the Labor-Management Unit of the Organized Crime and Racketeering Section, Criminal Division.
3. All other extortion and robbery offenses not involving public officials or labor-management disputes are supervised by the Terrorism and Violent Crimes
Public officials on the government payroll misusing your tax dollars are engaged in fiduciary negligence and have placed the financial interests of tax-exempt investors and bondholders of your state's transportation and highway bonds, municipal school bonding, and utilities bonding, in jeopardy.
WHen elected officials ignore illegal aliens registering to vote using phony documentation, and ignored illegal aliens fraudulently voting on bond issues referenda, that might be classified as a felony, and could negate a state's school and municipal subdivisions' tax-exempt bond issues.
The SEC wants to know when the financial interests of tax-exempt bondholders have been jeopardized, and whether other illegalities occured. They should be advised of these concerns. EMAIL enforcement@SEC.gov
Bonding agents, and banks, doing business with states and their municipal subdivisions are registered broker-dealers and members of the National Association of Securities Dealers (NASD) and the Securities Investor Protection Corporation (SIPC). NASD and SIPC should also be contacted regarding your concerns about fiduciary negligence, and use of tax funds for illegal activity.
Banks doing business with your municipalities that are conducting illegal activity are jeopardizing bank patrons, shareholders, and depositors and should be reported as follows:
The Office of the Comptroller of the Currency (OCC) is the primary federal regulator for national banks. The OCC's Customer Assistance Group is available to assist customers with questions or complaints concerning national banks. Email to Customer.Assistance@occ.treas.gov.
You can reach one of the OCC Customer Assistance Specialists by calling toll free number, 1-800-613-6743, Monday-Thursday, 9-4, and Friday 9-3.
Moreover, if banks excercised fiduciary negligence and misused the sanctioning power of the FDIC in improper ways, and engaged in illegal activity with government funds, that should also be pursued with the FDIC.
And of course, elected officials fiduciary negligence conducted in collusion with state agencies, banks, and securities dealers that jeopardize tax-exempt bondholders should be reported to the IRS.
EMAIL THE DEPT OF JUSTICE: ASKDOJ@USDOJ.GOV
PHONE THE IRS IN YOUR AREA
ICE Phone 1-866-347-2423 http://www.ice.gov/graphics/about/index.htm
Because they have the power of the purse---and control your tax dollars---public officials who represent you are required to be bonded. They might have incurred imprisonment, fines, or other criminal penalties for violating the terms of bonding by misusing your tax dollars.........specifically by aiding and abetting the activities of illegal aliens, and failing to report that crimes were being committed.
PARTIAL LIST OF IMMIGRANTS' FEDERAL CRIMINAL FELONIES
1 - Use of illegal ID or documents
2 - Federal income tax evasion
3 - Re-entry into USA after deportation
4 - Obtain/Operate vehicles with illegal ID
5 - ID theft/fraud - Social Security fraud
6 - Knowingly gaining employment fraudulently
7 - Recruiting other illegal aliens workers
8 - Transporting illegal aliens
9 - Harboring &/or housing illegal aliens
10 - Undermining US national security
11 - Registering/Voting using fraudulent documentation
12 - Conspiracy to violate federal statutes
13 - Uttering false statements to public officials
14 - Obstructing law enforcement
Public officials might have lied on insurance bonding applications, and may have filed false bonding applications and/or insurance claims. Similar penalties apply to insurance organizations. St. Paul Fire and Marine Insurance Co--is one such company that provides bond insurance for public officials. Check it out in your area.
yes and that is my largest gripe about the illegal alien thing. They are actually "stealing" services from American citizens.
Think about it I believe there are up to 30 million illegals here and we supposedly have a population of 300 million. That means one in 10 people in this country is illegal. Wouldn't we like to cut the healthcare budget, local on up by 10%? How about education...10% automatic cut, you could go on and on.
Freepers, start your printers!
Thanks for the informative and constructive post.
My daughter cannot get insurance at all, even tho she works and pays taxes. She has to pay all her med bills. Illegals don't.
(How was the fishing?)
You're very welcome.
We get the kind of governance we allow. It's time to reverse the equation----as the Founders intended----and go after the governance we deserve.
Pass the word far and wide.
The Rep administration in Colorado canceled presumptive prenatal eligibility for Medicaid prenatal care a couple of years ago because it found out that about 1/2 of the people being certified for the program were ineligible--usually because they were illegals. Was costing tax payers $6 to $9 million annually depending on the estimate you believe.
Dem legislature immediately passed statute reinstating presumptive eligibility. Told citizens peope would have to prove citizenship. In fact, all that was required was that a woman state that she was eligible, a so-called "presumptive declaration."
Federaly qualified community health clinics were main offenders. If person was Medicaid client they could charge "reasonable costs" under federal law--about $130 a visit. Plan old doctors seeing patients could only charge $30 for same thing.
It's outrageous especially when you look at Mexico and how American Citizens are treated in that country.
Great info Liz.........has there been any feedback from anyone using this info to nail some of these public officials yet? As time permits, I plan to make some inquiries with my local officials and I was curious how we get around their stories about having to follow federal law when it comes to dealing with illegals.....such as health care, Motor voter, etc.?
Washington ping list?
Obtain/Operate vehicles with illegal ID
No problem...er...problemo... here in old Washington, we give illegals drivers licenses, tell police don't ask-don't tell, , have bank loans etc. /s
ILLEGALS--just sucking up health care dollars that won't be spent on our citizens.