$1.1T: CMS Sets Record for Annual Spending by a Federal Agency

(CNSNews.com) - The Centers for Medicare and Medicaid Services, which runs the federal government’s major health-care programs as well as the Obamacare insurance exchange, spent $1,113,178,000,000 in fiscal 2013, according to the Monthly Treasury Statement for September, which was released last week.

That sets a record for the most money ever spent by a federal agency or department in a single year.

It also means CMS spent more in inflation-adjusted dollars than the entire federal government spent in 1965, when President Lyndon Johnson signed the legislation creating the Medicaid and Medicare programs.

In 1965, the entire federal government spent $118,228,000,000 in 1965 dollars, according to the Office of Management and Budget. That converts to $878,824,380,000 in 2013 dollars, according to the Bureau of Labor Statistics inflation calculator.

In 2010, CMS became the first federal agency to spend more than a trillion dollars, when it spent $1,035,783,000,000. In 2011, CMS spent $1,095,406,000,000; in 2012, it spent $1,052,799,000,000; and, in 2013, it spent a record $1,113,178,000,000.

Via: CNS News
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Feds provide cradle-to-beyond-the-grave 'security'

There are 78 inspectors general toiling away in major federal departments and independent agencies, tasked with exposing waste, fraud and abuse in government.

Few of the IGs become public figures, even when, like Daniel Levinson, they and their staff have saved taxpayers hundreds of millions of dollars over the years.

Levinson is the IG at the Department of Health and Human Services, which means his first job is fighting Medicare and Medicaid fraud.

Two new reports from Levinson this week cast a disturbing spotlight on the depth and durability of corruption in federal health care spending.

Sen. Tom Coburn, R-Okla., himself a medical doctor and the Senate's most devoted advocate of federal spending reforms, summarized what Levinson found:

"The reports show Medicare wasted $23 million in care on the deceased in 2011, $25 million on dead doctors between 2009-2011, and $29 million for prescription drugs to more than 4,000 unlawfully present beneficiaries between 2009-2011."

Really? 'Only' $77 million?

In a $3.5 trillion annual federal budget with a deficit of nearly $700 billion, a mere $77 million might seem like pittance.

But consider just a few things that $77 million could have been spent on instead of dead doctors and other corpses:

— $10,000 education scholarships for 7,700 at-risk kids to give them real hope for escaping inner-city poverty and crime to live rewarding, productive lives.

— 2.2 million flu shots for elderly people most vulnerable to death from the illness (at the $35 retail charge reported by Bloomberg for walk-ins at a commercial pharmacy like Walgreens).

— Provide luxury apartments for a year for 3,208 homeless people (at $2,000 per month rent for 12 months).

Via: Washington Examiner

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Virginia Democrat Calls For Forcing Doctors To Accept Medicare And Medicaid Patients

You would think that when your party is burying a hole that is getting harder and harder to get out of, you wouldn't want to that hole get deeper faster.  But here is Kathleen Murphy, Democrat running for the House of Delegates against Barbara Comstock, telling a forum in Great Falls that she believes it should law to force doctors to accept Medicare and Medicaid patients.  Forced by government decree, mind you.  A birdie sent me this:

FYI last night at the Great Falls Grange debate, Democrat delegate candidate Kathleen Murphy said that since many doctors are not accepting medicaid and medicare patients, she advocates making it a legal requirement for those people to be accepted.  

She did not recognize that the payments are inadequate to cover the doctors' costs.  She also did not recognize there is a shortage of over 45,000 physicians now and that it is forecast to be 90,000 in a few years.  

Democrats appear to want to make physicians slaves of the state, but Democrats don't admit they would just drive more doctors out of practice into retirement and other occupations.  The Obamacare law and regulations are causing millions of people to lose their health insurance, drop many doctors and hospitals. The HHS internal forecast is 93 million Americans would lose their health insurance due to the Obamacare law and rules about adequacy of insurance.

Many more people will be uninsured.   The penalties for being uninsured start at $95 per year, but the penalties can't be collected by the IRS if a person does not have a tax refund to attach.  

The out of pocket costs required by Obamacare's Silver Plan for a non-smoking mother and father with two children making a gross before income taxes of $50,000 (roughly average salary for VA) would be $13,765 per year including the deductible of $10,400.  That's 28% of their gross income -- not very affordable and about the same as guidelines for a mortgage payment.  For such a family making $100,000 of gross income, The cost would be $21,431 including the deductible of $12,700, or 21% of gross income.   

With such high deductibles doctors are stuck with trying to collect cash from the patients, even at regulated charge structures.  Thus is makes sense for primary care doctors not to participate in Obamacare, medicare and medicaid.  They should encourage patients to participate in Concierge Care and insurance programs run by the doctors themselves with patients who can do simple math.  Patients can take out catastrophic insurance with high deductibles for major surgeries.  Tax deductability for individual medical savings accounts would make health care more affordable.  

The head of Obamacare programs, Berwick, loves the socialized medical system in the UK, but never mentions that malpractice insurance is minimal.  In the UK, panels of doctors review and approve malpractice awards, rather than emotional juries misled by trial lawyers.  Malpractice reform like this with caps on malpractice awards would go a long way in making health care affordable.

I hope physicians rise up and speak out for common sense, protecting quality medical care in the US and giving patients freedom to choose

THIS along with the fact that Terry McAuliffe has already said he'd go to the government shutdown mat to get a state exchange in Virginia.  Unbelievable.  Combine the chaos of thousands of people across Virginia losing their health insurance, we are going to add to that on the state level by forcing doctors to accept patients they can't afford to help?  Unbelievable.  Dark days are ahead, but there is still time.    Three days to make sure this does not happen.  

Democrats in Virginia will drive up health care costs, drive doctors out of the state, and then drive health care costs up even more because there will not be enough doctors practicing in the state. 

Via: Mason Conservative

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[VIDEO] Ellison Barber: Obamacare’s Swollen Medicaid Rolls Threaten State Budgets

BY: Washington Free Beacon Staff
November 1, 2013 9:59 pm

The Washington Free Beacon’s Ellison Barber warned Obamacare’s medicaid expansion may ultimately backfire on state budgets across the country Friday on The Kelly File.

Host Megyn Kelly cited medicaid enrollment figures which are thus far outstripping enrollment in the Obamacare exchanges.

The danger with this, Barber said, is that healthy people who would otherwise drive down costs at the traditional exchanges are factored out of the insurance market completely. Thus, prices at the traditional healthcare exchanges will increase.

Moreover, according to Barber, states have not budgeted for the increased costs associated with all of the new medicaid enrollees. Although the federal government will cover the expansion initially, come 2017 the states who have accepted the expanded entitlement will incur increased medicaid expenses. This could compel states to cut spending or raise taxes to cover the new costs, Barber pointed out:

MEGYN KELLY: They say, look, these folks who are rushing onto these medicaid rolls were already going to the hospital, they were getting sick, running up our bill. So that was already something we already were having to pay for. Now it’s just out in the open. The numbers of them and who they are, and the system is working exactly as they expected it to work.

ELLISON BARBER: Sure, I think a lot of states would disagree with that though because I think there are a lot of states that are worried about in terms of the finances of this. Or they haven’t budgeted for having all these extra millions of people in every single state. And states are a little bit different, the thing to remember about states is states are different from the federal government. Every state except Vermont has a balanced budget provision either in their state constitution or state statute. So for Georgia, for example, there is a balanced budget amendment written into the constitution. They cannot expand spending, even if they want to. So to have to care for all these people on medicaid now, when they haven’t planned for it in their budget,  they’re either going to have to raise taxes, raise income payroll taxes or cut things for other spending, like for roads, schools and things like that. There are a lot bigger problems that go with it. It’s one of those ideas that sounds nice, to be like there are a lot of people who still need insurance so let’s expand it to help people get on for free who can’t pay for it. But there are real costs that come with it. And it’s taxpayers — even in the states like we talked about the other day, 26 states signed up for this. But it’s federal money that is paying for the newly eligible people, that’s everyone, if it’s not in your state you’re still paying.

Via: WFB

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ObamaCare Implementation Agency Paid Out $23 Million On Behalf of Dead People

The agency responsible for implementing ObamaCare erroneously paid out millions of dollars on behalf of dead people in 2011, according to a report released Thursday by the Office of the Inspector General (OIG).

The Centers for Medicare and Medicaid Services (CMS) paid $23 million to providers, suppliers, Medicare Advantage organizations and prescription drug plan sponsors on behalf of beneficiaries who died between 2009 and 2011, the OIG found.

That’s less than one-tenth of one percent of total Medicare expenditures, and the report says CMS “has safeguards to prevent and recover” those payments.

The OIG offered a handful of recommendations, such as taking action against providers and suppliers that had high numbers of claims with service dates after a beneficiary’s death, as a way to minimize further inappropriate payments.

CMS said it concurs with all the OIG’s recommendations and is committed to preventing and recovering the payments.

"Agency actions are underway, and in the areas where noted, we are working with law enforcement and other federal agencies, including OIG, to protect the Medicare program, the people using its benefits and services, and using additional resources made available under the Affordable Care Act to detect and prevent fraud from taking place," a CMS representative told The Hill in a statement.

Via: The Hill

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In first month, the vast majority of Obamacare sign-ups are in Medicaid

The first month of the new health law’s rollout reveals an unexpected pattern in several states: a crush of people applying for an expansion of Medicaid and a trickle of sign-ups for private insurance.

This early imbalance — in some places, nine out of 10 enrollees are in Medicaid — has taken some experts by surprise. The Affordable Care Act, which expanded Medicaid to cover millions of the poorest Americans who couldn’t otherwise afford coverage, envisions a more even split with an expanded, robust private market.

“When we first saw the numbers, everyone’s eyes kind of bugged out,” said Matt Salo, who runs the National Association of Medicaid Directors. “Of the people walking through the door, 90 percent are on Medicaid. We’re thinking, what planet is this happening on?”

The yawning gap between public and private enrollment is handing Republicans yet another line of criticism against President Obama’s health overhaul — that the law is primarily becoming an expansion of a costly entitlement program.

Supporters, however, caution against reading too much into the early numbers. Some of the states that set up their own exchanges, including Maryland, are suffering Web site glitches similar to those of the national system, and that is delaying private plan enrollments.

Via: Washington Post

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Medicare paid millions to dead patients, illegal immigrants, probe finds

Medicare paid $23 million for dead patients in 2011 and $29 million for drug benefits for illegal immigrants from 2009 to 2011, according to a report Thursday from the Health and Human Services inspector general.

The investigators said Medicare has safeguards to try to stop payments to dead patients, but it still ended up sending out the $23 million anyway.

The Centers for Medicare and Medicaid Services (CMS) — the same agency that is struggling to fix the broken Obamacare website — acknowledged the problems and said it will try to take steps to fix them.

“We agree that in cases where the information indicates an individual is not lawfully present in the United States, that individual should not be permitted to enroll or to remain enrolled in a Part D plan during the period where he or she is not eligible to receive federal benefits,” Marilyn Tavenner, administrator of CMS, said in response to the report about illegal immigrants getting benefits.

The payouts aren’t large — they amount to just a fraction of a percent of what Medicare pays each year in benefits. Still, the investigators said the agency should take steps to crack down.

In one of its reports the inspector general said 4,139 illegal immigrants were able to make 279,056 drug benefit claims.

Via: Washington Times

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Vermont exchange train wreck

$170 Million and they got nothin'

On Sept. 12 the nationally known consulting group Gartner Inc. delivered a report to the federal Center for Medicare and Medicaid Services. The report assessed the operational readiness of the various state health insurance exchanges as the Obamacare-mandated launch date — Oct. 1 — approached.

Vermont Health Connect, the state’s $170 million exchange, is “one of the most functional in the country,” according to Gov. Peter Shumlin. That’s conceivably true, since most if not all of the other exchanges are in serious trouble, but the Gartner report concluded that Vermont Health Connect “should be considered in RED status due to significant risks to meeting the Oct. 1 deadline for Go-Live.”

The statutory deadline of Oct. 1 has long since gone by, but Vermont Health Connect remains essentially inoperative. You can review the Obamacare-approved insurance plans offered for 2014, but you can’t buy one. Kyle Midura of WCAX-TV observed on the Oct. 18 “Vermont This Week” program that site visitors “almost inevitably get an error message.”

Governor Shumlin first dismissed Vermont Health Connect’s missed opening date as a “nothing burger.” He then said the exchange would be operative by Nov. 1, and that unspecified people were “working 24/7” to get it going. Most recently, he waffled on the Nov. 1 deadline as well, saying it might be ready by Nov. 3. Midura noted that administration officials view this as a “soft deadline” — more a suggestion than a requirement that triggers real-world consequences.

Via: Rutland Herald
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Obamacare FY14 Budget: ‘To Ensure Integrity of Programs That Redistribute Tens of Billions’

(CNSNews.com) - The fiscal 2014 budget justification released by Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner explains that CMS is requesting that Congress appropriate $803.5 million for operations and management of the Obamacare exchanges during the fiscal year so that, among other things, CMS can “ensure the integrity of programs that redistribute tens of billions of dollars.”

Overall, CMS wants $2 billion to run what it calls the “Federal Marketplace” for health insurance. “CMS’ program level request for the Marketplaces totals $2.0 billion in FY 2014, to support the first year of program operations,” says the budget justification. The agency estimates $1.5 billion of that will come from “discretionary Program Management resources” and $450 million from “anticipated user fee collections.”

The “Operations and Management of Marketplaces’ subsection of the justification says that CMS intends to spend $803.5 million in this area. That includes money that will be spent on “data mining techniques” to make sure the right people are benefiting from the new system of health-insurance subsidies set up by the Affordable Care Act.

Via: CNS News

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Obama Praises Oregon’s Obamacare Enrollment Numbers . . . One Problem, They Have Enrolled ZERO People

The 10% he’s inexplicably bragging about is made up entirely of people going on Medicaid.

 

From earlier today:

 PORTLAND, Ore. (AP) — A month after Oregon’s problem-plagued online health insurance marketplace has failed to enroll a single person, concerns are mounting that some of the most vulnerable Oregonians may face a break in coverage if they don’t enroll within the next month and a half.

To date, the state has received just 4,260 paper applications as part of the national health care overhaul law, and the Cover Oregon website still can’t tell people what subsidies they are eligible to receive.

Via: Fox News

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Gov't 'Encouraging People to Sign Up for Insurance and a Subsidy That They May Not Be Eligible For'

(CNSNews.com) - People who depend on tax refunds may be in for "rude awakenings" under Obamacare, Rep. Paul Ryan (R-Wis.) told the head of the Center for Medicare and Medicaid Services on Tuesday.

He said the problem is subsidies and whether people who get them should be getting them.

"The law is, if you are under the age of 26, and you are eligible to stay on your parents' plans, you cannot receive subsidies," Ryan told Marilyn Tavenner, who was called before the House Ways and Means Committee to discuss the Affordable Care Act.

"And there is nothing -- nothing -- on your website that tells an under-26-year-old those facts," Ryan said. "So you're encouraging people to sign up for insurance and a subsidy that they may not be eligible for, and they don't even know this."

Under the law, people who get subsidies they should not have received will have their tax refunds docked.

Earlier, Tavenner told Ryan that the healthcare.gov website includes "clear instructions" that you are completing the application under penalty of perjury. "It's very clear, there's also help instructions on each site to explain each process -- what is credible employer coverage, what happens if you're under 26, it is all available on the website," Tavenner said.

Via: CNS News

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Colorado's health-exchange board is frustrated by slow enrollment pace

State health insurance exchange officials said Monday they have 3,164 enrollments in Obamacare so far, expressing frustration with the slow pace during a special meeting.

More than 44,000 Coloradans have created accounts with the exchange since its launch Oct. 1, but the difficulty of educating new customers in preparation for enrollment has been compounded by a series of computer glitches.

"If we didn't have these glitches, what would that number be?" asked board member Arnold Salazar of Colorado Health Partnerships. He wondered aloud if a better system would have meant current enrollment of "6,000 or 18,000 or 30,000."

"That's what I struggle with," he said.

Exchange officials have said they expect 136,000 enrollments in the first year.

State Medicaid officials, who also serve on the board, are happier with their 25,000 approved applicants who will be enrolled Jan. 1 under expanded Medicaid rules, another key feature of the Affordable Care Act.

They must work with the exchange, though, to hand off people who must complete a Medicaid application even though they will not qualify and want to go directly to the exchange's federally subsidized policies. Medicaid is supposed to supply an "instant denial" of those applicants; instead, that happens only 50 percent of the time now. Others are waiting weeks.

Susan Birch, a board member who oversees Medicaid as director of state Health Care Policy and Finance, said Medicaid is working internally and with federal officials to streamline the application and get instant decisions to 90 percent of cases. Currently, many applicants are required to fill out questions on assets that are not required for Medicaid decisions.

Via: The Denver Post

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[VIDEO] CMS Administrator on Obamacare: ‘We Have a System That’s Working’

(CNSNews.com) – Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services (CMS), testified before the House Ways & Means Committee on Tuesday that the Obamacare enrollment system is “working.”

“So what I can guarantee is we have a system that’s working. We’re gonna improve the speed of that system,” she said at the hearing on Obamacare enrollment.

The Obamacare website, healthcare.gov, has been rife with problems for those trying to enroll in the health care insurance program.

Rep. Kevin Brady (R-Texas) had asked Tavenner if she could guarantee that “no American will experience a gap in their health care.”

Brady interrupted Tavenner’s response, asking, “Excuse me, you’re saying the system right now is working?”

“I’m saying it’s working. It’s just not working at the speed that we want and at the success rate that we want, and those are the things we’re working on,” Tavenner said.

Via: CNS News
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Obamacare Pledge: Info on Applications 'Won’t Be Used For Immigration Enforcement Purposes'

That will be right up there with the "You can keep your current Insurance" 

Beginning with a speech last Thursday, President Obama is seeking to rejuvenate his administration's push to alter immigration laws and perhaps draw some attention away from the Obamacare launch debacle that has been dominating the headlines for much of October. The day following that speech, a new topic appeared on the Healthcare.gov website entitled, "What do immigrant families need to know about the Marketplace?"  While a previous entry listed the various immigration statuses that qualified for Marketplace coverage, the new entry is an extended discussion of the questions immigrants, regardless of status, might have about the insurance exchanges.  Among the subtopics discussed are: "Lawfully present immigrants and private insurance," "Immigrant access to Medicaid and CHIP," and "Disclosure of immigration status."

Under "Disclosure of immigration status," the site goes to great lengths to explain that Marketplaces, whether federal or state, are not permitted to ask for the immigration status of family members who are not applying for coverage or benefits.  States can’t deny benefits because the applicant doesn’t provide the SSNs of people who aren’t applicants for benefits or recipients of Medicaid or CHIP benefits, or those not required to provide SSNs," the site explains.

Via: Weekly Standard

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