Friday, May 22, 2009

More on Fraud

They are now investigating several cases of In Home Support Services fraud. IHSS provides the necessary help to keep people at home instead of in a nursing home, and as such, saves the government a lot of money – nursing homes cost upward of $3000 a month.
There is a maximum amount of time per pay period that your assistant is allowed to claim they have worked. Since most of these assistants are family members who have had to give up "real jobs" in order to care for their loved one, many of them work far more hours than they are paid for. This is not pleasant work, folks – it's wiping a paraplegic's nose, cleaning up a dementia patient's urine and feces, changing dressings on open wounds, lifting feeble patients from bed to wheelchair to toilet. Stuff that you wouldn't do if I offered you a mere $10 an hour.
Here's the kicker ... these cases of fraud are only $1000 to $6000. There's not a doctor out there accused of committing Medicare/Medicaid fraud who's done it in such a minimal amount. Yet the letters to the editor and reader comments on the website are particularly venomous about the people committing this sort of fraud, more so than with the article the other day about medical practitioners committing fraud, accusing these poor women of being criminals and societal leeches for providing necessary services, backbreaking work.
Let's repeat this concept: medical practitioners are committing government fraud in the Billions. A few impoverished families who rely on IHSS wages to put food on the table took an extra thousand or so. Am I the only person who considers it a bigger deal to stop the exponentially bigger problem of $60B Medicare fraud than this much smaller problem of a few thousand in IHSS fraud? Am I the only one who considers a doctor who enriched himself to the tune of a million bucks to be a bigger criminal than a poor woman who put in for an extra grand?
More than likely, in March she provided more hours of care than she was paid for, and in April made a claim for the extra hours she worked in March. Put her in jail and the taxpayers not only have to pay $3000 a month to put her in jail, but another $3000 a month to put her loved one in a nursing home because there's no one to care for him. It'll cost us far more to punish her (and give her a well-deserved vacation from 24/7 caregiving) than the fraud she's accused of.
I'm not saying I condone fraud, I'm saying that in this era of limited government resources, let's stop wasting big bucks investigating some little old lady who got an extra $1000 for caring for her disabled son, an investigation and trial that will cost the taxpayer far more than the amount of fraud she's accused of. Let's focus on the bigger fish: the billions in Medicare/Medicaid fraud perpetrated by medical providers, the billions (or trillions) in overcharges by the military-industrial complex, the things where the government can make a profit by getting their money back (which won't happen with a poor family with no assets).
Stop beating up on the poor and disabled, and aim instead at the more expensive (and extensive) fraud at the other end of the economic spectrum. It exists, and should be punished far more severely than a small amount of extra payment to a woman who's doing a job that most people wouldn't want to do at any price.
N.B. To get IHSS, you must have either been declared disabled by a judge or be over a certain age. This is not something where your doctor just signs a form and you're automatically entitled. We, as taxpayers, are guaranteed that the people who are receiving services are either officially disabled or officially elderly. I had, at one point, been told that I just needed to get the doctor to write a note that I needed household help, but Social Services told me that there was no program I qualified for -- if I'd been legally ruled to be disabled and collecting SSDI, maybe then the doctor could just write a note, but since I've been denied Disability benefits, there's no program to help me, even though Social Services agrees that I need help. Meanwhile, a doctor can just generate all the fraudulent billings he wants and no one has to rule that he is legally entitled to put in for that extra money.

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