House considers bill to crack down on Medicaid fraud

By | February 15, 2012 | 0 Comments

The House Judiciary Committee is considering a bill to help crack down on Medicaid fraud. It passed the Senate with bipartisan support.

“This measure is one of the best and most important healthcare reform measures,” said Larry Shannon with the Washington State Association for Justice. “It works and it’s proven that it works.”

The bill creates a civil liability for defrauding Medicaid. It also protects whistleblowers and creates an account to fund fraud prevention services. Shannon said this bill creates a strong enforcement mechanism and a strong partnership with whistleblowers.

He said there’s been some fear of frivolous claims, but he said the law would require that claimants demonstrate fraud — not just negligence — in their filings.

But Tim Layton with the Washington State Medical Association said if you look through the data, states with similar protections don’t necessarily fare better. Plus, he says, the program would cost more than $300,000 this budget cycle. He said there are other programs that would be worth funding. (more…)

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This week’s Q&A: Sen. Adam Kline on religious objection to autopsy

By | January 16, 2012 | 0 Comments

Tomorrow, a bill that would provide for religious objection to an autopsy is scheduled for a hearing. I’ll be covering this hearing for TVW tomorrow. Today, I spoke with the bill’s prime sponsor, Sen. Adam Kline about this bill and a bill related to fraud punishment that he is behind.

Q: What prompted you to take up the issue of religious objection to autopsy? 

Kline: Well, the issue was brought to us actually. A tourist a few months ago, in the fall was climbing Mount Rainier. The gentleman … died on Mount Ranier. Could have been any number of causes, people die on Mount Rainier with amazing frequency. … An orthodox rabbi suggested to the King County [medical examiner] that respect should be given to the fact that the orthodox follow the Jewish tradition of burying the dead with dignity and quickly … that’s tradition, and it does have a basis in the Torah. I understand that there are various religious traditions have this, it’s not just Jews; there are others… I believe Muslims believe the same way. I respect that, but at the same time we have to balance that with the authority, not just of the medical examiner, but of the prosecutor. … Whenever there is any death at all, law enforcement understands that most deaths are not foul-play, but we have to look. There has to be some examination … you have to look. In the vast majority of cases, there is no foul-play, but you can’t bury the body until you make that inquiry. 

Q: Would this bill allow any family with a religious objection to forgo autopsy in any circumstance? Or would some suspicious deaths merit an autopsy no matter what? 

Kline: Those are two extremes. For the first one, the answer is obviously no. You don’t just dictate because of your own religious beliefs or even the beliefs of the diseased … it simply asks the prosecutor to balance religious considerations with law enforcement considerations. And by the way, the court is given that jurisdiction if the two parties disagree. There has to be a compelling necessity [to require an autopsy]. That phrase means there has to be some law enforcement interest that has not been resolved

Q: How open do you think lawmakers will be to this bill?

Kline: I don’t know. I’ve got to confess, this is not a bill on which I’ve counted noses.  The reason is, I think there will be a willingness to accept this. It won’t affect this balance of two interests, both of which are important to all legislators … [who] understand the need to accept and balance needs from religious organizations and religious bodies with those of law enforcement.

Q: Any other bills you’re sponsoring to keep an eye on?

Kline: 5310. Fraud, waste, and abuse. Everyone’s against it. What this bill does is it allows the Attorney General to be better equipped in recouping losses the state has incurred by fraud, by cheaters. People who have cheated the state. The AG has been ill-equipped to chase them and collect their money. This bill increases the AG’s ability to do that. Let me give you an example … many states and the federal government have laws that if you report fraud that has already been perpetrated against the public, if you give all the facts that allow the US attorney or in some states the Attorney General the information from which to sue the fraudulent party … a bounty hunter reports that information, the Attorney General sues, and the bounty hunter is given a very small portion of the proceeds. It encourages people to come forward. Anyone can be a bounty hunter …  and that includes the perpetrator of the fraud … even the guy who was a participant in the fraud, he’d get a reduced amount, but he’d at least get an amount that would make it worthwhile to come forward. 


Unemployment benefits office finds thousands of cheaters

By | April 12, 2011 | 0 Comments

The Employment Security Department — the agency that distributed unemployment benefits — found 7,000 people lied in order to get benefits last year. That’s out of the more than 500,000 unemployed workers who received benefits for the year.

The 7,000 claimants grabbed $14 million in benefits. Now that they’ve been caught, they’ll have to pay it all back — plus face penalties or jail time.

In 2010, ESD uncovered about $10 million in fraud. The department says the increase is in part due to increased efforts to catch cheaters. One improvement: They’ve been cross-matching more records with other state agencies.

How do people cheat to get unemployment? One man cited in the press release was depositing checks twice — once via a phone app that allowed him to deposit checks via photo, another in person. The same person filed unemployment claims for his infant.

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After millions were withdrawn from state-issued benefit cards at casinos, Carrell proposes anti-fraud office

By | March 31, 2011 | 0 Comments

The Senate Ways and Means Committee is considering a bill to create the Office of Fraud and Accountability within the Department of Social and Health Services. The office would be responsible for sniffing out fraud.

Sen. Mike Carrell, the bill’s sponsor, told the committee that when welfare reform was passed in 1997, employees were testifying about the large number of fraud cases with food stamps. “Now we have an EBT, electronic benefit transfer card — a debit card,” he said. On that card, food stamps and cash can be loaded. “Well last fall, King 5 TV came to me and they had found that these cards were being used at gambling casinos,” he said — about $2 million was cashed out in casinos. He says the state has since worked with casinos to make sure that doesn’t happen — but there are other abuses.

“Now we only have four real prosecutors that have criminal justice experience,” he said — this bill would increase that to 10. “I think it will pay for itself.”

He also showed a Craigslist post, offering the sale of an EBT card. “I understand that DSHS is there to help people and they should help people, but if somebody is defrauding the system … we need to do something about it.” He said 29 percent of those with EBT cards were issued three or more cards last year. He says he suspects those people are selling their cards.

Dennis Eagle with the Washington Federation of State Employees said his group is supportive. “Front line workers see examples of waste, fraud and abuse all the time and they really aren’t empowered to do anything about it. It’s frustrating, they feel helpless and it drives them nuts,” he said. He said he applauds the way the program would be set up to preserve independence — and it has whistleblower protections, too.

Sen. Rodney Tom asked why front line employees aren’t empowered to report fraud. “There’s two elements to that,” Eagle said. “Maybe you see something that looks funny, you send it up the chain, you never see anything happen … it’s disheartening in that regard. And then I think the other issue is that rightly, wrongly … most employees are afraid to say anything that might be deemed as negative or critical of the agency.”

No one else signed up to testify on the bill.

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Sen. Adam Kline on early release bill: Take out least likely to re-offend, increase programs for others

By | March 22, 2011 | 0 Comments

This week’s Q&A is with Sen. Adam Kline, whose “early release bill” gets a hearing this afternoon at 1:30. I talked to him about the bill — and other cost-cutting measures.

Q: First, tell me what the bill does in  your words?

klineKline: What it does is to reduce the sentence of people primarily who are not dangerous, who are not likely to re-offend — even in nonviolent cases… We’re going to give them as many as three or even four months off. In return, we’re going to fund the kinds of programs that have a track record of reducing re-offense generally or recidivism.

What we’re doing, in effect, is taking out the least likely offenders … and then increasing the kind of services for those who would likely re-offend. We could take the low likelihood offenders out to our hearts content without increasing the likelihood of more crime.

What we really have to do is focus the programs on those who are really in danger of recidivism. To some extent, even the high risk of nonviolent offenses – people who are rated high likelihood and violent, forget it. But the higher likelihood nonviolent offenders — those are the people for whom these programs have the most benefit. If we didn’t approach them, what’s the point?

Q: Last week, Gov. Chris Gregoire said early release is the last place she’d go. Can you respond?

Kline: You know something, we are at the last place. This budget looks awful. This bill does no harm, in fact it does good. It reduces recidivism 36 more times than not doing anything at all. We’re at that desperate spot where we have to try something that may be politically risky, but that actually works — and this is it.

Q: Have you spoken to the Governor about it?

Kline: No, but I will. I’m going to have to talk to her about it.

Q: Do you think part of the danger of this bill is that people hear “early release” and react out of fear?

Kline: Yes, it has that danger. In fact I think that’s maybe why the Governor is a little skittish about it. (more…)

Tuesday Q&A: Rep. Jim Moeller on waste, fraud and abuse

By | March 1, 2011 | 0 Comments

Yesterday, Rep. Jim Moeller sent out a press release calling for an independent office in the Department of Revenue that would investigate fraud. He cited real-life tax avoidance examples, including a person who leased himself art through an out-of-state ghost corporation, another person who registered his yacht in the Cayman Islands through an LLC and only pays a fraction of taxes to Washington, and someone who bought a Learjet with an LLC then leased it to himself, avoiding taxes in the process.

I called Rep. Moeller for this week’s Q&A to talk more about his idea. Here’s the full interview:

Q: First, what are you proposing?

Moeller: What I’m proposing is if we’re going to go after the welfare fraud, which obviously there is some, and I agree we need to go after that, but at the same time if we’re going to do that, let’s pay an equal amount of attention to the other end of the spectrum because we have over 300 “tax incentives” on the books and we want to make sure that those are being used properly, too.

We want to make sure that people aren’t taking advantage of taxpayers.

Q: Do you plan to introduce a bill to create this new area?

Moeller: No, a bill wasn’t introduced by the Republican senator from the 18th, so I’m not going to introduce a bill at the moment either. So, if we’re going to be suggesting that we expand government to do this, then let’s do it bipartisanly, let’s do it in a bipartisan fashion and let’s take a look at all kinds of fraud.

Q: What kind of response have you heard to this idea?

Moeller: Well … when I bring it up to the people who contact my office about fraud, waste and abuse, they’re primarily focused on welfare and when I bring up the aspect of the examples that I cite in the press release, they’re surprised, they haven’t thought about that, then they get angry and say, you bet, this needs to be addressed, too. Not that people have contacted my office about my press release, but when I talk with my constituents, I always bring this up and they’re always very supportive. They just haven’t thought about it before. I don’t think they see it. I don’t typically go in those circles. And you know, I don’t have art that I have on loan from a ghost corporation from an out of state area, but I do see people in front of me in the grocery line who use their card that gives them food stamps inappropriately.

Q: I’ve heard Republican and Democratic lawmakers say the amount of fraud, waste and abuse is tiny relative to the budget. Is it worth expanding government to address? (more…)

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Legislative Review: Your guide to the show

By | February 4, 2011 | 0 Comments

In this week’s show, which you can watch at 6:30 on TVW, we covered a dozen or so of the week’s biggest topics in the Legislature. If you need more information once you’ve watched the show, look no further.

Budget: Once again, the budget is our top story. The House passed its version last week and sent it to the Senate. Instead of passing that bill, a bipartisan group in the Senate drafted their own version and, by today, passed that off the floor. Gov. Chris Gregoire’s budget director had previously said she needed a budget on her desk by today in order for maximum savings to go into effect.

Unemployment rate decrease: This bill would reduce employers’ unemployment insurance rate – saving businesses $300 million this year. But in order for that savings to go into effect, the bill has to make it to the governor’s desk by Tuesday. This proposal also allows the federal government to continue paying extended unemployment benefits. Though it passed the Senate, it had a snag earlier in the week.

Fraud: Lawmakers are looking at reducing fraud to boost the bottom line. One bill would go specifically after Medicaid. Another bill, which had its first hearing today, would include all government fraud and give cash awards to whistleblowers.

Heart attacks: Police officers and firefighters told lawmakers this week that the adrenaline they experience on a daily basis increases their risk for heart attack and stroke. For that reason, they’re asking for those conditions to be considered work-related illnesses – in some cases.

Capital budget: The Great Recession isn’t just affecting the operating budget – with reduced bonding capacity, the capital budget is also smaller. This week, schools, ports and others told lawmakers what will happen if they don’t get funding.

Red light cameras: Cities and towns like red light cameras because they make people think twice about breaking the law – and they bring in some money. But lawmakers in the House looked at regulating cameras via several bills this week. One would outlaw the cameras, while others would give voters more say. Here’s one bill, and another, and another. And this one.

Department of Corrections: After an officer was strangled last weekend, the Department of Corrections is reviewing its policies. We have the story about the governor’s response, and you can read more about the department’s next steps here.

Dorn reshuffle: Gov. Chris Gregoire wants to restructure the way education is administered – starting with the state schools chief position. Her proposal, which Superintendent of Public Instruction Randy Dorn opposes, got a hearing this week.

Social emotional learning: Some education advocates say if students learned more about their emotions, they’d do better in school. But in a hearing on the bill this week, some parents worried that the curriculum may not match up with their own values, or that it would take time away from more critical lesson plans.

Online university: Sen. Jim Kastama wants to establish a public online university. The proposal had a hearing this week and we’ve got the details.

Proposal to wrangle-in fraud against the government would award whistleblowers

By | February 4, 2011 | 0 Comments

The Senate Judicial committee is looking at a bill right now by Sen. Adam Kline that attempts to crack down on fraud against the government.

Under the measure whistleblower would be encouraged to tell the Attorney General’s Office if they know about any fraud taking place. If their efforts led to a successful prosecution and recovery of funds, the private party would be awarded a percentage of the cash. After making a claim, the Attorney General’s Office would have to investigate and decide if they wanted to pursue the case. If they decide to pass it by, the private citizen may bring suit against the person they are accusing of defrauding the government.

“This very much in accord with our theme this year of reforming government,” said Sen. Kline. He added that he wants to give people a financial incentive to take the risk  and come forward to tell the AG everything he or she knows about the fraud. ”We’ve considered this bill before … our fiscal crisis demands that we must be more effective in running our government.”

The AG has been notified that the federal government will subsidize 75 percent of the cost of this bill. (more…)

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