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Federal Government
Federal Government Made $100 Billion In Improper Payments PDF Print E-mail
Federal Government
By Administrator   
Wednesday, 09 July 2014 14:10

WASHINGTON (AP) — By its own estimate, the government made about $100 billion in payments last year to people who may not have been entitled to receive them — tax credits to families that didn't qualify, unemployment benefits to people who had jobs and medical payments for treatments that might not have been necessary.

 
Congressional investigators say the figure could be even higher.
 
The Obama administration has reduced the amount of improper payments since they peaked in 2010. Still, estimates from federal agencies show that some are wasting big money at a time when Congress is squeezing agency budgets and looking to save more.
 
"Nobody knows exactly how much taxpayer money is wasted through improper payments, but the federal government's own astounding estimate is more than half a trillion dollars over the past five years," said Rep. John Mica, R-Fla. "The fact is, improper payments are staggeringly high in programs designed to help those most in need — children, seniors and low-income families."
 
Mica chairs the House Oversight subcommittee on government operations. The subcommittee is holding a hearing on improper payments Wednesday afternoon.
 
Each year, federal agencies are required to estimate the amount of improper payments they issue. They include overpayments, underpayments, payments to the wrong recipient and payments that were made without proper documentation.
 
Some improper payments are the result of fraud, while others are unintentional, caused by clerical errors or mistakes in awarding benefits without proper verification.
 
In 2013, federal agencies made $97 billion in overpayments, according to agency estimates. Underpayments totaled $9 billion.
 
The amount of improper payments has steadily dropped since 2010, when it peaked at $121 billion.
 
The Obama administration has stepped up efforts to measure improper payments, identify the cause and develop plans to reduce them, said Beth Cobert, deputy director of the White House budget office. Agencies recovered more than $22 billion in overpayments last year.
 
"We have strengthened accountability and transparency, saving the American people money while improving the fiscal responsibility of federal programs," Cobert said in a statement ahead of Wednesday's hearing. "We are pleased with this progress, but know that we have more work to do in this area."
 
However, a new report by the Government Accountability Office questions the accuracy of agency estimates, suggesting that the real tally could be higher. The GAO is the investigative arm of Congress.
 
"The federal government is unable to determine the full extent to which improper payments occur and reasonably assure that appropriate actions are taken to reduce them," Beryl H. Davis, director of financial management at the GAO, said in prepared testimony for Wednesday's hearing.
 
Davis said some agencies don't develop estimates for programs that could be susceptible to improper payments. For example, the Health and Human Services Department says it cannot force states to help it develop estimates for the cash welfare program known as Temporary Assistance for Needy Families. The program is administered by the states.
 
The largest sources of improper payments are government health care programs, according to agency estimates. Medicare's various health insurance programs for older Americans accounted for $50 billion in improper payments in the 2013 budget year, far exceeding any other program.
 
Most of the payments were deemed improper because they were issued without proper documentation, said Shantanu Agrawal, a deputy administrator for the Centers for Medicare & Medicaid Services. In some cases, the paperwork didn't verify that services were medically necessary.
 
"Payments deemed 'improper' under these circumstances tend to be the result of documentation and coding errors made by the provider as opposed to payments made for inappropriate claims," Agrawal said in prepared testimony for Wednesday's hearing.
 
Among other programs with large amounts of improper payments:
 
—The earned income tax credit, which provides payments to the working poor in the form of tax refunds. Last year, improper payments totaled $14.5 billion. That's 24 percent of all payments under the program.
 
The EITC is one of the largest anti-poverty programs in the U.S., providing $60.3 billion in payments last year. Eligibility depends on income and family size, making it complicated to apply for the credit — and difficult to enforce, said IRS Commissioner John Koskinen.
 
"EITC eligibility depends on items that the IRS cannot readily verify through third-party information reporting, including marital status and the relationship and residency of children," Koskinen told a House committee in May. "In addition, the eligible population for the EITC shifts by approximately one-third each year, making it difficult for the IRS to use prior-year data to assist in validating compliance."
 
— Medicaid, the government health care program for the poor. Last year, improper payments totaled $14.4 billion.
 
Medicaid, which is run jointly by the federal government and the states, has seen a steady decline in improper payments since 2010, when they peaked at $23 billion.
 
The program is expanding under President Barack Obama's health law.
 
—Unemployment insurance, a joint federal-state program that provides temporary benefits to laid-off workers. Amount of improper payments last year: $6.2 billion, or 9 percent of all payments.
 
The Labor Department said most overpayments went to people who continued to get benefits after returning to work, or who didn't meet state requirements to look for work while they were unemployed. Others were ineligible for benefits because they voluntarily quit their jobs or were fired.
 
—Supplemental Security Income, a disability program for the poor run by the Social Security Administration. Amount of improper payments: $4.3 billion, or 8 percent of all payments.
 
Social Security's much larger retirement and disability programs issued $2.4 billion in improper payments, according to agency estimates. Those programs provided more than $770 billion in benefits, so improper payments accounted for less than 1 percent.
Last Updated on Wednesday, 09 July 2014 14:10
 
Medicare Providers: Federal Government's Auditing Procedures Ineffective PDF Print E-mail
Federal Government
By Administrator   
Wednesday, 09 July 2014 14:06

MIAMI (AP) — Health care companies say they're losing millions of dollars that are tied up in appeals because of increasing numbers of Medicare audits. But the rise in the often duplicative audits has failed to reduce Medicare fraud, according to a report released Wednesday.

 
In recent years, the Obama administration has added manpower to investigate cases, increase audits and analyze more data to fight fraud in the taxpayer-funded Medicare program. Yet a report from the U.S. Senate Special Committee on Aging criticized the government for not targeting its resources more effectively.
 
Improper payments within Medicare's largest sector increased for the first time in five years, jumping from $30 billion to $36 billion, despite the Obama administration's all-out campaign to prevent fraud. Medicare fraud in the fee-for-service program had steadily declined since 2009, but improper payments rose between 2011 and 2012, according to the report that cites the most recent data available. During that same time, federal health officials launched a $77 million technology screening system designed to proactively prevent fraudulent providers from joining the system and prevent bogus claims from being paid in the first place.
 
But the committee expressed concern that the government's "strategy to reduce improper payments is actually a strategy aimed more at identifying and recovering improper payments that have already occurred," according to the report.
 
Federal health officials said in the report that new policy changes confused providers. They also noted the new screening technology prevented $210 million in fraudulent payments in its second year of operation.
 
The Medical Equipment Suppliers Association said some providers experienced between 24 and 228 audits in one year, according to a letter to federal health officials included in the report.
 
Ascension Health had 66,613 claims audited and about half were alleged to be improper payments. The company says the government withheld about $200 million in payments while it appealed. Less than one-fourth of appealed recoveries were upheld, according to the report. Catholic Health Initiatives said it's appealed 87 percent of cases and won the vast majority, but complained significant funds were withheld during the process.
 
"What has been created is an overly complicated system with duplication where virtually any (durable medical equipment) claim payment can be recouped," according to prepared testimony from Walter Gorski, head of Gorski Healthcare Group LLC, during a round table Wednesday with Sen. Nelson and health care stakeholders, including the American Hospital Association.
 
The report also blamed the federal government for lax oversight of its confusing maze of private fraud prevention contractors, noting a fundamental flaw in the way certain contractors are paid because they are paid based on the dollar amount of fraud they identify. Experts say a more effective system would incentivize contractors by paying them based on their ability to reduce fraudulent payment instead of merely identifying large amounts.
 
Medicare has been a highly sensitive political issue for the Obama administration partly due to a backlash from seniors over program cuts to help finance the president's health care overhaul. Top officials have since emphasized the administration's stewardship of Medicare, touting better benefits and oversight.
 
"Despite doing more audits than ever before, Medicare just isn't getting the job done when it comes to preventing payment errors," said committee Chairman Bill Nelson (D-FL).
 
Last Updated on Wednesday, 09 July 2014 14:06
 
On Heels Of CDC Anthrax Exposure, NIH Finds Vials Of Smallpox In Storage Room PDF Print E-mail
Federal Government
By Administrator   
Tuesday, 08 July 2014 13:53

ATLANTA (AP) — A government scientist cleaning out an old storage room at a research center near Washington made a startling discovery last week — decades-old vials of smallpox packed away and forgotten in a cardboard box.

 
The six glass vials of freeze-dried virus were intact and sealed with melted glass, and the virus might have been dead, officials at the Centers for Disease Control and Prevention said Tuesday.
 
Still, the find was disturbing because for decades after smallpox was declared eradicated in the 1980s, world health authorities believed the only samples left were safely stored in super-secure laboratories in Atlanta and in Russia.
 
Officials said this is the first time in the U.S. that unaccounted-for smallpox has been discovered.
 
It was the second recent incident in which a government health agency appeared to have mishandled a highly dangerous germ. Last month, a laboratory safety lapse at the CDC in Atlanta led the agency to give scores of employees antibiotics as a precaution against anthrax.
 
The smallpox virus samples were found in a building at the National Institutes of Health in Bethesda, Maryland, that has been used by the Food and Drug Administration since 1972, according to the CDC.
 
The scientist was cleaning out a cold room between two laboratories on July 1 when he made the discovery, FDA officials said.
 
Officials said labeling indicated the smallpox had been put in the vials in the 1950s. But they said it's not clear how long the vials had been in the building, which did not open until the 1960s.
 
No one has been infected, and no smallpox contamination was found in the building.
 
Smallpox can be deadly even after it is freeze-dried, but the virus usually has to be kept cold to remain alive and dangerous.
 
In an interview Tuesday, a CDC official said he believed the vials were stored for many years at room temperature, which would suggest the samples are dead. But FDA officials said later in the day that the smallpox was in cold storage for decades.
 
Both FDA and CDC officials said more lab analysis will have to be done to say if the germ is dangerous.
 
"We don't yet know if it's live and infectious," said Stephan Monroe, deputy director of the CDC center that handles highly dangerous infectious agents.
 
The samples were rushed to the CDC in Atlanta for testing, after which they will be destroyed.
 
In at least one other such episode, vials of smallpox were found at the bottom of a freezer in an Eastern European country in the 1990s, according to Dr. David Heymann, a former World Health Organization official who is now a professor at the London School of Hygiene and Tropical Medicine.
 
Heymann said it is difficult to say whether there might be other forgotten vials of smallpox out there. He said that when smallpox samples were consolidated for destruction, requests were made to ministers of health to collect all vials.
 
"As far as I know, there was never a confirmation they had checked in with all groups who could have had the virus," he said.
 
Smallpox was one of the most lethal diseases in history. For centuries, it killed about one-third of the people it infected, including Queen Mary II of England, and left most survivors with deep scars on their faces from the pus-filled lesions.
 
The last known case was in Britain in 1978, when a university photographer who worked above a lab handling smallpox died after being accidentally exposed to it from the ventilation system.
 
Global vaccination campaigns finally brought smallpox under control. After it was declared eradicated, all known remaining samples of live virus were stored at a CDC lab in Atlanta and at a Russian lab in Novosibirsk, Siberia.
 
The labs take extreme precautions. Scientists who work with the virus must undergo fingerprint or retinal scans to get inside, they wear full-body suits including gloves and goggles, and they shower with strong disinfectant before leaving the labs.
 
The U.S. smallpox stockpile, which includes samples from Britain, Japan and the Netherlands, is stored in liquid nitrogen.
 
There has long been debate about whether to destroy the stockpile.
 
Many scientists argue the deadly virus should be definitively wiped off the planet and believe any remaining samples pose a threat. Others argue the samples are needed for research on better treatments and vaccines.
 
At its recent annual meeting in May, the member countries of the WHO decided once again to delay a decision.
 
Last Updated on Tuesday, 08 July 2014 13:53
 
N.J. Democrat Sen. Menendez Wants Federal Probe Of Cuban Role In Allegations Of Impropriety PDF Print E-mail
Federal Government
By Administrator   
Tuesday, 08 July 2014 13:48

WASHINGTON (AP) — Sen. Robert Menendez said Tuesday that he has asked the Justice Department to investigate whether the Cuban government had a role in allegations against him that have made him a target of a federal probe.

 
Among the charges are so far unsubstantiated allegations that Menendez, D-N.J., flew on a plane provided by a friend and campaign supporter for rendezvous with prostitutes.
 
In an interview with The Associated Press, Menendez said his attorney has asked the Justice Department to investigate what he says were long-running rumors about a Cuban role in the allegations.
 
The lawmaker said he doesn't know if Cuba was involved. But Menendez, chairman of the Senate Foreign Relations Committee, cited his decades-long role as a persistent critic of the Cuban government as potential motivation for Havana to act against him.
 
"To the extent they'd like to see the United States engage them more on their terms, which is not to observe democracy and human rights, they probably feel that I'm the single most significant impediment to their goals," Menendez said.
 
He added, "It would not be surprising at all for the regime to hold the view that we have to do whatever we can" against him.
 
Menendez cited a Tuesday report in The Washington Post that the CIA obtained evidence linking Cuban agents to the claims about Menendez and prostitutes and to trying to persuade American news organizations to pursue those claims.
 
While declining to provide details about his attorney's letter, Menendez said, "It is clearly to ask them to investigate the charges, some of which appeared in Post."
 
Menendez said the Post story makes clear that the federal government has information about the Cuban connection. Initial reports of Menendez's problems surfaced before his 2012 re-election.
 
"They should pursue their information," he said about the federal government, "because I think it is incredibly troublesome that a foreign government would try to interfere either with a federal election or the seating of a senator on a specific committee in order to pursue its foreign policy goals. And that should be troublesome far beyond my circumstances."
 
Last Updated on Tuesday, 08 July 2014 13:49
 
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