California isn't the only one gaming the system this way. I found 19 states doing this. I think New Mexico was exceptionally good at it. In addition to insurer's premiun taxes there are taxes on providers that get taxed.
The Federal Government should withhold the future funds for California that come from gaming the system, and funds that are provided to Criminal Illegals (Illegals are all Criminals).
Kirsten, Regarding "Medicaid fraud" That's anybody's guess. I've worked with Medicaid for 40 years, providing good and empathetic care to thousands of moms and babies with NO maternal mortality and no permanent or significant morbidity. $1500 for all prenatal care and delivery. By giving good results I saved them tons of money. Nary a thanks or, "Good job!" One time I had to submit a bill 11 times...they had the stupidest and most incredible "reasons" for refusing the claim, reasons you wouldn't or couldn't even believe. No good deed remains unpunished. In the last ten years I've kept at least fifteen patients in their homes and out of the nursing home, saving Medicaid $ 225,000 per month (a conservative estimate). As thanks they ascended on my office, and said they didn't like my notes, which were all honest and real, and because of that they said I didn't make any notes and because of that I'm accused of Medicaid "fraud" and fined $10,000 per note, for a total of $413,000. This is all imaginary, but that doesn't matter. As I said, with Medicaid and CMS, no good deed remains unpunished. Whenever I see Docs accused of Medicaid fraud, I wonder what the real story is. We will probably NEVER KNOW!
I believe it, I believe good people go out of their way everyday to make the lives of others more comfortable, less painful, less alone,etc... but I also know that most don't recognize your sacrifice because they can't comprehend it.
They don't know what sacrifice is because they haven't experienced it, for a child, or family member, sure, but for another human being? Nah, probably not.
Maybe because up until that moment, nobody had ever done anything for them before, not without payment or special favors, or they were being bribed to perform a service.
Maybe it's because they're mentally ill, functional, but mentally ill nonetheless.
But I do know one thing. Our Creator, who sits on the throne, He sees everything you do, He hears everything you say, and you will wear many crowns, and be given many gifts by Him.
If people thank you and praise you here, then you've received your reward. Celebrate no thank yous and no rewards here. His gifts are much better!
Thanks Kim for the words of wisdom and warmth. Our "thanks" on earth is knowing we've done the right thing for the right reason. "Even though you do it onto the least of them you do it onto me." Thanks Alan L
New Trump fan. Thanks for the coverage, I learned a lot. We could save $83 to $88 BILLION PER YEAR, that's with a "B" by ridding ourselves of Medicare Advantage (MA), which could be recommended by DOGE, or eliminated by President Trump or HHS Sec RFK Jr. with the stroke of a pen or one week of a congressional pissing contest, at which they excel. Years ago, I had a patient hospitalized for one week. The MA plan sent a check for the entire stay that was less than the cost of the stamp to send the letter. Each year MedPAC, a special congressional "advisory board", headed by PhD Michael Chernew, is happy to report that MA provides less care for more money, which goes to insurance agents, $1000/month per head, but not to providers or to hospitals. So once again, it is the insurance agents and private equity owners who profit at the expense of tax payers, providers and hospitals. STOP THIS!
In a prior life, I worked in insurance, and the sad part is these advantage plans are paid for by the elderly at high prices because the plan pays for what the Medicare Parts A and B don't. These plans are pushed on them with fear mongering by whomever is getting commissions. This could be the agent, a doctor, a nursing home, etc. it's sad because most of them will pay for these plans before they buy food.
I worked in healthcare and I saw people push the envelope on billing rules. I can see that it's fairly easy to bill for services that aren't rendered in that system. If you get caught my patients who know what services were rendered, by coworkers (who can financially benefit from turning in fraudsters), or by a Medicaid or Medicare audit, you're toast. I'm not sure how much manpower is spent catching those fraudulently billing.
Phenomenal coverage of this issue, thank you, and I just wanted to add this one anecdotal example.
I know someone taking DUI classes in order to get their driver's license back. This individual informed me that his "Obamacare" pays for the classes. Now, I would like to know how many of your readers would like to fund this endeavor? Not me. I think it's ridiculous how supposed healthcare is funding this. And, we need a way to stop this kind of thing if we can. Why should we pay for it?
California isn't the only one gaming the system this way. I found 19 states doing this. I think New Mexico was exceptionally good at it. In addition to insurer's premiun taxes there are taxes on providers that get taxed.
The Federal Government should withhold the future funds for California that come from gaming the system, and funds that are provided to Criminal Illegals (Illegals are all Criminals).
Kirsten, Regarding "Medicaid fraud" That's anybody's guess. I've worked with Medicaid for 40 years, providing good and empathetic care to thousands of moms and babies with NO maternal mortality and no permanent or significant morbidity. $1500 for all prenatal care and delivery. By giving good results I saved them tons of money. Nary a thanks or, "Good job!" One time I had to submit a bill 11 times...they had the stupidest and most incredible "reasons" for refusing the claim, reasons you wouldn't or couldn't even believe. No good deed remains unpunished. In the last ten years I've kept at least fifteen patients in their homes and out of the nursing home, saving Medicaid $ 225,000 per month (a conservative estimate). As thanks they ascended on my office, and said they didn't like my notes, which were all honest and real, and because of that they said I didn't make any notes and because of that I'm accused of Medicaid "fraud" and fined $10,000 per note, for a total of $413,000. This is all imaginary, but that doesn't matter. As I said, with Medicaid and CMS, no good deed remains unpunished. Whenever I see Docs accused of Medicaid fraud, I wonder what the real story is. We will probably NEVER KNOW!
I believe it, I believe good people go out of their way everyday to make the lives of others more comfortable, less painful, less alone,etc... but I also know that most don't recognize your sacrifice because they can't comprehend it.
They don't know what sacrifice is because they haven't experienced it, for a child, or family member, sure, but for another human being? Nah, probably not.
Maybe because up until that moment, nobody had ever done anything for them before, not without payment or special favors, or they were being bribed to perform a service.
Maybe it's because they're mentally ill, functional, but mentally ill nonetheless.
But I do know one thing. Our Creator, who sits on the throne, He sees everything you do, He hears everything you say, and you will wear many crowns, and be given many gifts by Him.
If people thank you and praise you here, then you've received your reward. Celebrate no thank yous and no rewards here. His gifts are much better!
Thanks Kim for the words of wisdom and warmth. Our "thanks" on earth is knowing we've done the right thing for the right reason. "Even though you do it onto the least of them you do it onto me." Thanks Alan L
New Trump fan. Thanks for the coverage, I learned a lot. We could save $83 to $88 BILLION PER YEAR, that's with a "B" by ridding ourselves of Medicare Advantage (MA), which could be recommended by DOGE, or eliminated by President Trump or HHS Sec RFK Jr. with the stroke of a pen or one week of a congressional pissing contest, at which they excel. Years ago, I had a patient hospitalized for one week. The MA plan sent a check for the entire stay that was less than the cost of the stamp to send the letter. Each year MedPAC, a special congressional "advisory board", headed by PhD Michael Chernew, is happy to report that MA provides less care for more money, which goes to insurance agents, $1000/month per head, but not to providers or to hospitals. So once again, it is the insurance agents and private equity owners who profit at the expense of tax payers, providers and hospitals. STOP THIS!
In a prior life, I worked in insurance, and the sad part is these advantage plans are paid for by the elderly at high prices because the plan pays for what the Medicare Parts A and B don't. These plans are pushed on them with fear mongering by whomever is getting commissions. This could be the agent, a doctor, a nursing home, etc. it's sad because most of them will pay for these plans before they buy food.
I worked in healthcare and I saw people push the envelope on billing rules. I can see that it's fairly easy to bill for services that aren't rendered in that system. If you get caught my patients who know what services were rendered, by coworkers (who can financially benefit from turning in fraudsters), or by a Medicaid or Medicare audit, you're toast. I'm not sure how much manpower is spent catching those fraudulently billing.
Thanks for your great reporting! 🙏🏼💜
PLAIN ENGLISH. They know what to do. They know how to do it. They just won’t.
And yet we taxpayers would end up in jail if we protested by withholding our “hand over the money” checks to federal, state, and local jurisdictions.
So much crime going unpunished. The pattern is huge and I for one am sick of it.
Thanks for all you do.
Phenomenal coverage of this issue, thank you, and I just wanted to add this one anecdotal example.
I know someone taking DUI classes in order to get their driver's license back. This individual informed me that his "Obamacare" pays for the classes. Now, I would like to know how many of your readers would like to fund this endeavor? Not me. I think it's ridiculous how supposed healthcare is funding this. And, we need a way to stop this kind of thing if we can. Why should we pay for it?
I absolutely agree with you on this.
Over to Open the Books and to DOGE!!!