Marcia Nielsen, executive director of the Kansas Health Policy Authority, issued a valuable caution about a recent audit of the state’s Medicaid system. Though the audit found irregularities that need further review, some media reports of substantial fraud were “not supported by the facts,” Nielsen said. The audit used data processing techniques that looked for anomalies in billings but did not look into individual cases. Most of these anomalies were caused by data entry errors and were not the result of “unethical or intentionally criminal behavior,” Nielsen said. The state needs to follow up with these red flag and make sure that the Medicaid system is operating efficiently and has proper safeguards. But, as Nielsen noted, “the process needs be driven by solid, data-driven analysis, not anecdotes or cursory reviews.”
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11 Comments
There are so many checks and balances within the system, I can’t imagine anyone getting away with intentionally abusing government services for any lenght of time…if anything, it’s harder to get services that people are qualified for because of the beuracratic hoops one must jump through. Especially for the mentally ill…if they have no one to advocate for them, it’s almost impossible to get services. Right now there is a 6-12 month waiting period for Home and Community Based Services for those manage to qualify. Those agencys who provide services are rountinely and extensively examined for possible abuses. If anything, I’d guess that there are more people who are underserved rather than taking advantage of the system.
When children in the system are put on Medicaid instead of being left on their parents insurance – which the parents request because they get the bill from SRS and Youthville – THAT’S MEDICAID FRAUD!!!! This is done by SRS and Youthville because they want the 5-6 $’s that are paid back to them for every $1 dollar spent.
FRAUD FRAUD FRAUD!!!!!
THIS NEEDS TO BE INVESTIGATED – parents write into the post legisaltive audit and marcia Neilsen and let them know what SRS and Youthville and the other contractors are doing.
They also drug children that shouldn’t be drugged for the money – THAT’S FRAUD!!
Nielsen makes a good point. Stehen is wrong and his inflammatory and insulting remarks should not be taken seriously by any reasonable person. Youthville is an excellent resource that struggles to provide for youth. Someone may be drugging themselves with their ideas but it’s not the resident children.
LonnythePlumber – and you know this how? You’ve had personal experience? or are you part of the system? Youthville is struggling so hard to provide for youth – that the Director Shelly Duncan is paid $149,000 yearly salary plus $6700 in benefits – plus the top 7 employees wages equal 1/2 a million dollars. Some struggle huh?
Children are being drugged – some with as many as 9 anti-psychotic drugs. What child needs 9 anti-psychotic drugs?
When you and others ignore what is really happening to the children in the custody of the state and youthville – then you are insulting those children with YOUR remarks.
You’ve insulted the children by your remarks.
stehen_immer,
I am curious about your sources of information and expertise on this subject, care to share those?
I am sure it is possible for children to be over medicated. Youthville, from the word I hear, are getting children with more and more problems, too.
Youthville is a non-profit organization and their wages are open to the public – although seeing what the top officers are paid – I question non-profit.
As for the children being “over medicated” If they don’t have problems at the time of removal – they soon will after Youthville “medicates” them.
After suffering rape and abuse in “some” of the foster homes many children will have problems for the rest of their lives.
SRS and Youthville have all been made aware of what is happening to these children – the abuse is being ignored. This is all about money.
I say – stop building schools and start building prisons – for what is being created by the Child protective system. Many of these children go from looking like well groomed, happy children to children that look like they come from a 3rd world country.
I think that the pictures need to be put out.
Although from what I have been told – Youthville and SRS many times deny parents the right to take pictures so the world can’t see what has happened to their children while in the custody of the state..
There is that intimidation factor also- you tell – they’ll remove all visits and you’ll never stand a chance of getting your child back..
I say – you’re not going to get them back anyway – go for it!
After all, they just upped the incentive for adoptions – it’s been doubled – more money for the state.
And the bottom line fact is:
Medicaid fraud is not committed by the recipients of such aid, but by the for-profit corporations gaming the system.
A few years ago I happened to be standing next in line behind a woman who was handling December 31 transactions on behalf of the Galichia Medical Group. She had a stack of checks, each duly time-stamped and processed which transfer red money from individual accounts to corporate accounts back to Galichia sons’ and daughters’ accounts to stock purchases back to this entity then the other.
It really was an eye-opening experience.
Poor ol’ Doctor Joe gained and lost dozens of hundreds of thousands of dollars with each transaction, processed by a typical bank teller’s efficiency every 20 seconds or so.
As we have come to see in this post-Enron, MCI, Fanny Mae, Freddy Mac, AIG, Bear-Stearns, Big Three, mortgage bubble, credit crisis, trebled National Debt nation George WMD Bush is leaving us with, the scandal isn’t what illegal but what’s (technically, anyway) “legal!
Or, as we’re learning everyday, the Shrub Administration simply chose not to enforce black-letter laws on the books because Dumbya’s buds were breaking them and making out like bandits.
Exactly like bandits.
stehen immer..I’m not sure what your agenda is, but I think you’re making some pretty serious accusations with no facts to back it up. The type of abuse you speak of doesn’t usually go unnoticed or unaddressed for very long. There are too many people watching.
Mary_Caruso
The type of abuse that I am speaking of has not gone unoticed – it has been ignored by the very individuals that should make sure that this doesn’t happen. There are facts to prove what is going on – and they have been presented to those in power to make changes.
Hypothetical – why do you think that these types of abuses would be ignore? What reasons could you give for something like this happening and the powers that be ignoring it? Give it your best shot. What would be the reason that these problems are ignored and why aren’t they corrected?
Let me ask you this – what should happen to a arnp that prescribes a psychotropic drug for an 8 year old without seeing the child until a week later on the request of a counselor?(not following protocol) A child that has never had problems with anyone except the placement that was beating the child up and the statement was made that the child had gone past the 6 month adjustment period and had to be given a dianosis to drug that child and keep the child in that evnironment. What should happen to a psychiatrist whose prescription pad was used to drug the child – but NEVER saw the child or monitored the prescribing of that psychotropic drug?
You sound like a person that should know what should happen when these types of abuses occur.
By the way there are recordings to prove all of this.
I don’t believe in giving drugs to children unless they have a seizure disorder or other physical condition. I have never approved of psychotropic meds for kids who only have behavior problems. That is one reason why I got out of child and adolescent treatment.
You have many concerns that should be addressed, I suggest you keep voicing your concerns to SRS and anyone else who will listen.
I’m not that familiar with Youthville, so if you’ve actually seen these atrocites, you have a resposibility to do something about it. Good luck.
Mary_Caruso
We all have a responsibility to do something about it – it is being covered up – they have a concern about liability – but what they don’t realize is that all of the parents just want their children to have a chance at life. Not be destroyed by drugs.
This isn’t an isolated incident – this child was not unique – and it’s very painful when that realization hits you.