Earlier this month, the Attorney Generals of Illinois and Arkansas announced the arrest and/or conviction of three individuals in different cases for Medicaid fraud.
Going to jail for $1,000
The amounts of the fraud involved were around $1,000 per party (Illinois woman faces up to 10-year sentence, Texas man arrested in Arkansas, Arkansas Attorney General Announces Arrest).
The fraudsters, generally low-paid home care workers who padded their hours on the job, (looks like they made $10 per hour), are looking at sentences up to 10 years in jail and fines up to $250,000. One was from Texas.
While they shouldn’t have done it, that’s pretty tough for a G note.
No contact from FBI and Public Integrity Unit in 10 months
In contrast, in Texas, it was learned this month too, via a front page story in The Statesman, that individuals who work in state government in Texas, such as someone employed as chief counsel for the Health and Human Services Commission, apparently don’t even get contacted by law enforcement agencies when they have been implicated in directing state business to friendly contractors, costing the state and Medicaid $20 million.
Jack Stick, former chief counsel of HHSC and former deputy inspector general for enforcement HHSC-OIG, told The Statesman in his first interview since he resigned last December that neither the FBI nor the state’s Public Integrity Unit has contacted him on the 21 CT affair over the last 10 months.
$20 million misspent and he is apparently left alone.
Big lesson to be learned
Rather unbelievable that Stick wasn’t contacted and perhaps he is dissembling. But if he is telling the truth, there is a lesson here somewhere.
Perhaps if those small timers in Arkansas and Illinois had purchased some expensive executive chairs with their ill-gotten gains, they would have faired similarly with their investigators.
But unfortunately, they didn’t even steal enough to buy one of Stick’s $2,800 chairs.
The lesson becomes clear – apparently it is okay for individuals to “pad” their butts as long as they don’t “pad” their hours, in Medicaid.
it is my belief that the controlling political party doesn’t want to loose votes by decreasing social program budgets therefore strong arm health care providers into settling cases by using their strong arm tactics, usually offering resolution at 60-80 percent less for services provided. The result is the same without having to risk votes upon re-election cycle. They hold all payments until you consider bankruptcy vs lengthy litigation with little to no justice. My credentials were reviewed by Denta Quest, only to be informed three years later that my level I sedation reimbursement would be deducted from any current billings submitted, I have little or no recourse to justice and if resubmit code change to nitrous oxide it would likely trigger an investigation!