Sebelius to unleash Bounty Hunters on Hospitals and Doctors with new edict

In what starts out as a headline Sebelius Releases Privacy-Protected Data that could be interpreted as an effort to get rid of fraud and abuse there is much more of a nefarious intent.  Stick with me for the ride as we go down the rabbit hole and understand that this is the final attack on demonizing and destroying physicians and hospitals.

“The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns”

In a move the administration is promoting as providing consumers “unprecedented transparency on the medical services physicians provide and how much they are paid,” Health and Human Services has released new physician-specific data which had formerly been protected under privacy laws, detailing services, procedures, and billing of individual healthcare providers.

Is there fraud and abuse in Medicare reimbursements? You bet there is. But, as posted back January 6, 2011 –  Obamacare hires Bounty Hunters to come after Doctors, the intent is to unleash private mercenaries on the healthcare industry,

It has created a new interagency task force called HEAT (Health Care Fraud Prevention and Enforcement Action Team) under which health-care officials will collaborate with the FBI to go after Medicare fraud. In addition, it has expanded to several cities the Medicaid Fraud Strike Force that authorizes FBI and Drug Enforcement Agency agents to jointly analyze Medicare claims data in real time to detect and investigate irregularities by area doctors.

More chillingly, however, the administration is defining Medicare fraud down to include “unnecessary” and “ineffective” care. And to root this out, it plans to make expanded use of private mercenaries—officially called Recovery Audit Contracts—who will be authorized to go to doctors’ offices and rummage through patients’ records, matching them with billing claims to uncover illicit charges. What’s more, Obamacare increases the fine for billing errors from $11,000 per item to $50,000 without the government even having to prove intent to defraud. Full story here at Reason/a>

And how are they going to find this fraud and abuse?  The way is to make it almost impossible to figure out how to “code” or bill using the appropriate number.

Medical Service Codes Go From 18,000 to 140,000 September 16, 2011. Check out the post for the absurdity. A more in-depth look at coding can be found at fellow blogger’s post  Prolonging The Agony Or Averting Disaster? by McNorman’s Webblog.

“What’s more, Obamacare increases the fine for billing errors from $11,000 per item to $50,000 without the government even having to prove intent to defraud”

If you wonder why so many physicians have threatened to quit their practice, here is the number one reason. Bounty Hunters. Looking for a missing “bullet point” in the documentation or an inaccurate digit in the billing code.  Best part, no legal redress of any dispute. Guilty as charged. Here tis:

Medicare’s billing codes are a complicated, convoluted mess and deciphering them can sometimes be more art than science. Both Republicans and Democrats huff and puff against “waste, fraud and abuse” in Medicare. And they have already enacted Stasi-style laws such as the False Claims Act offering nurses, patients and other whistleblowers 15 percent to 30 percent of any money recovered if they report improper billing practices by providers.


Sebelius Exempts Health Exchanges from Anti-Fraud Standards

In an October 30 letter, Secretary of Health and Human Services (HHS) Kathleen Sebelius revealed that the Obama administration has determined that programs created by the Affordable Care Act (ACA) are not federal health care plans. This decision, which flies in the face of common sense, exempts the Qualified Health Plans (QHPs) and state-based and federally facilitated Marketplaces from laws banning kickbacks and various forms of semi-legal fraud perpetrated by pharmaceutical companies and other interested parties. Why was this issue not raised at the hearing yesterday?

While the writer of the post I am quoting had the intentions to portray the Healthcare industry as – greedy and corrupt, the usual meme, the intention is missed entirely. The intention is to devastate Hospitals and physicians reimbursements. The Cleveland clinic has recently indicated it would not accept Obamacare patients and for good reason. They will lose money. The end game is bankruptcy forced on it by the regime.  No Hospital or physician’s group will be able to survive on the miniscule payments that will be negotiated. So it is Katy bar the door as our healthcare system becomes the wild west. Unregulated, lawless, and corrupt. Negotiating contracts and sending patients to those who could care less about the quality of service, just give them a few bucks. Drugs? Same thing. It’s pay to play on steroids the Chicago way. Our lives simply of little value. The end game? A Single Payer system that they so crave. They will implement the very evil they rail against. Here we go:

As the New York Times wrote November 4, “The surprise decision, disclosed last week, exempts subsidized health insurance from a law that bans rebates, kickbacks, bribes and certain other financial arrangements in federal health programs, stripping law enforcement of a powerful tool used to fight fraud in other health care programs, like Medicare.”

The Wall Street Journal pointed out that the anti-kickback rules “went into force in 1991 and broadly bar companies from making payments to beneficiaries or other firms to induce business paid for by Medicare and other federal programs. That could range from paying rebates to Medicare beneficiaries for buying specific drugs to paying physicians to refer their patients to a specific imaging facility.”

H/T and more at:Global Research

Sebelius ‘I don’t work for those who don’t like me’

While hundreds of thousands of Americans are losing their insurance, or get news that their policies are skyrocketing, our gal can’t make the Congressional hearing but can make a “Gala” the night before, and the day of the hearing is out pimping this albatross that hangs around our necks. Better yet, she apparently is not clear about who she works for. It gives new meaning to tone death. Do you think maybe she could have at least listened to the hearing? Her scheduled appearance next week should be worth the price of admission.

Via NRO:

“The majority of people calling for me to resign I would say are people who I don’t work for and who do not want this program to work in the first place. I have had frequent conversations with the president and I have committed to him that my role is to get the program up and running and we will do just that.”

Keep reading…

Credit Scores impacting Obamacare approval and price UPDATE

UPDATE: Apparently the story is incorrect. It was created by Channel Six T.V. in Orlando. This should be a lesson to us. A so-called Navigator got this so wrong and giving out this info? What else are they telling people. Drudge and the Weekly Standard carried the story as well, so it seemed to be well vetted. If you haven’t caught the Sibelius –  Jon Stewart “interview” it is located at the bottom of the page.

Lead health care navigator in Florida provides wrong information on credit scores

Ann Packham tells Local 6 she was incorrect about Affordable Care Act

After receiving numerous emails about the story, Local 6 contacted Packham on Wednesday, and she said her statement was incorrect, adding that users do not need their credit scores to apply for the Affordable Care Act.

Local 6 is investigating how the person in charge of providing information about the Affordable Care Act could make such an error.

Meanwhile, the government website continued to be bogged down on Tuesday, oftentimes showing users a message saying, “We have a lot of visitors on the site.”

The link is at the bottom of the post. In case you haven’t had the pleasure of watching Sibelius make a A** of herself, I include this as well. Yep, Obamacare moving right along


Many people signing up for health care in Florida through the Affordable Care Act have been shocked when they have to give proof of their credit score before they finish the process.

Anne Packham, one of many people licensed by the state to help people navigate the government’s website, said on Tuesday that the credit check occurs so providers can make an educated decision about who to insure.

“If someone is defaulting on all of their bills they may not want to have them as part of their health plan,” said Packham, the lead Navigator in Florida.

Participants with low credit scores could end up paying higher premiums, according to Packham, who said that ultimately the insurance company makes the call.

H/T:  Video of the story over at: Click Orlando

Now on to Kathy:

For someone who’s been highly critical of Republicans opposed to Obamacare, Jon Stewart was really adamant in pressing Health and Human Services Secretary Kathleen Sebelius about issues he has with the health care bill, from the website bugs to the one-year business delay that individuals didn’t get. He repeatedly pressed that last point and got noticeably frustrated at the lack of a clear response.

Obamacare: Corruption reigns supreme with millions in handouts

On the face of this, the story may seem to be a yawner. No surprise. Really? Have we become so jaded that the story doesn’t rise to the point of a mention most places? These navigators will come from the corrupt center of Obama’s power base. So let us take a spin and take a look:

In a frightening glimpse of the potential for corruption in Obamacare, the government is giving dozens of leftist organizations $67 million to help people “navigate” health insurance exchanges that haven’t even been fully established.

The money will be divided between 105 mostly leftist groups (surprise, surprise) that will help the uninsured sign up for coverage and understand their options. Here are a few examples of the community organizations receiving navigator grants from the government; an Arizona nonprofit called “Campesinos Sin Fronteras” that provides services to farm workers and low-income Hispanics; a south Florida legal group that will provide navigators in “racially, ethnically, linguistically, culturally and socioeconomically diverse” communities; three Planned Parenthood branches—in Iowa, Montana and New Hampshire—got a combined $655,000 to serve as navigators.

Here are a few other grant recipients worth mentioning; the Arab Community Center in Michigan is getting nearly $300,000 to reach out to and engage uninsured community members through “multicultural” media. A Black Chamber of Commerce in South Carolina is receiving north of $230,000 to “provide outreach around new coverage options” and a Hispanic aging group in Texas will receive over $646,000 help members that are “socially isolated due to cultural and linguistic differences.”

Also, this week HHS announced a contest that awards cash prizes—$30,000 in all—to those who create hip videos promoting Obamacare. More at Judicial Watch if you can stand it.

Where is the GOP? Where is the Media? Where is the outrage?

Recall Obama striked the CLASS act portion from Obamacare?

Now there are questions about the legality of Obama picking and choosing portions of Obamacare? And this is just a delay supposedly.Wait, wait. Am I the only one who remembers the CLASS Act that is part of the bill? That was the long-term care plan that was included. Not one peep from the GOP when this was summarily dismissed from the bill by Sebelius. Even better is the clip I have.The very same people who were extorting the miracles of Obamacare’s CLASS portion. Now?  Enjoy.

In October, 2011 I posted Obamacare’s Class Act – fully paid for, oh wait! No??

Health and Human Services Secretary Kathleen Sebelius announced Friday in a blog post on the liberal Huffington Post website that the administration did not see a way to make the program sustainable. Sebelius indicated her agency hadn’t been able to figure out a way to ensure the program providing long-term care paid for itself as required by law

“Friday the Department of Health and Human Services announced the CLASS Act portion of Obamacare was a no-go“.

In March of 2010 we were told that the CBO estimated the CLASS (long-term care) provision of Obamacare would reduce the deficit by $70 billion. Today the Obama administration announced that CLASS is being eliminated because it’s too expensive, the Wall Street Journal reported.

Uploaded on Oct 17, 2011

Democrats praise CLASS Act

(Recall earlier the administration warned it would veto the bill without the CLASS Act)?

Today, White House officials suggest that President Obama would veto any bill repealing the measure, according to The Hill.

“We do not support repeal,” the official said Monday. “Repealing the CLASS Act isn’t necessary or productive. What we should be doing is working together to address the long-term care challenges we face in this country.”

Over the weekend, The Hill has learned, an administration official called advocates of the Community Living Assistance Services and Supports (CLASS) Act to reassure them that Obama is still committed to making the program work. That official also told advocates that widespread media reports on the program’s demise were wrong, leaving advocates scratching their heads.. More at  Lonely Conservative

Obamacare will share personal health info with other state and fed agencies

How long does anyone think that our personal health information will remain private? Of course, this was the usual Friday news dump. Our gal Sebelius comes up with another 253 pager to add to the thousands of pages of “implementation” rules. There is a 30 day period for comment, but don’t hold your breath that there is anyone in Congress that has any interest in the matter. Throw in the IRS and Big Brother knows all.  Here we go:

A new 253-page Obamacare rule issued late Friday requires state, federal and local agencies as well as health insurers to swap the protected personal health information of anybody seeking to join the new health care program that will be enforced by the Internal Revenue Service.

Protected health information, or PHI, is highly protected under federal law, but the latest ruling from the Department of Health and Human Services allows agencies to trade the information to verify that Obamacare applicants are getting the minimum amount of health insurance coverage they need from the health “exchanges.”

The ruling, explained on pages 72-73 of the book-thick guidance, does not mention any requirement that applicants first OK the release of their PHI. HHS already allows some exchange of PHI without an individual’s pre-approval, especially when for a “government program providing public benefits.” Officials said the swapping of information is simply meant to help figure the best insurance coverge of Obamacare users.

“The exchange would submit specific identifying information to HHS and HHS would verify applicant information with information from the federal and state agencies or programs that provide eligibility and enrollment information regarding minimum essential coverage. Such agencies or programs may include but are not limited to Veterans Health Administration, TRICARE, and Medicare,” said the new rule, which HHS is seeking public comment on.

Full Story at Washington Examiner

Dem Congresswomen Pelosi, Sebelius, Dance For Dingell…need instruction from IRS

Something for a Sunday respite. Almost. Apparently they could use some help from the kind folks over at the IRS who got their line dancing moves down. Politicians dancing and singing with a celebrity while surrounded by statues of some of the Founding Fathers of our country. I wonder what they would say… And the song? STOP in the name of love. Quite apt!

Sebelius: ‘Some live some die’ – Kidney patients told to forget Dialysis

By now most have heard of the child in desperate need of a lung transplant. Am I the only one to recognize the absurdity of this story? Lawmakers and Mothers on bended knee begging for the life of another from a government worker? An unelected government worker, a drone, perhaps in the future an IRS agent who came out of La Raza, (WH wants to hire political hack to head office of Personnel) making the decision?  But this is not the first, nor will it be the last. As she says

“Someone lives and someone dies.”

Sebelius says it isn’t her place to pick and choose transplant recipients— The plight of a dying 10-year-old girl in urgent need of a lung transplant has  been taken up by some GOP lawmakers, and it’s shining a light on what critics  say is a questionable policy that puts children further down the waiting list.

Read more: Politico

Recall this? Kidney Patients told to accept death, forgo Dialysis –  Asking Kidney Patients to Forgo a Free Lifeline

As they calmly say:

“It was meant to keep young and middle-aged people alive and productive, many of the patients who take advantage of the law are old…  Full story: New York Times

Kidney specialists are pushing doctors to be more forthright with elderly people who have other serious medical conditions, to tell the patients that even though they are entitled to dialysis, they may want to decline such treatment and enter a hospice instead. In the end, it is always the patient’s choice. But for how much longer?

One idea, promoted by leading specialists, is to change the way doctors refer to the decision to forgo dialysis. Instead of saying that a patient is withdrawing from dialysis or agreeing not to start it, these specialists say the patient has chosen “medical management without dialysis”.  ”That is the preferred term,” said Nancy Armistead, executive director of the Mid-Atlantic Renal Coalition, a Medicare contractor that collects data and patient grievances.

Of all the terrible chronic diseases, only one —end-stage kidney disease — gets special treatment by the federal government. A law passed by Congress 39 years ago provides nearly free care to almost all patients whose kidneys have failed, regardless of their age or ability to pay. Just guess how much longer this is going to be the case.

So of course if you are no longer productive, you are really of no use to the Progressive Society. Just add the word Life in the clip below:

Any health care funding plan that is just equitable civilized and humane must, must redistribute wealth (Ed. and life) from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional.

Feds spend $402,721 on smoking detecting underwear

Oh brother, I mean big brother is here, or soon to be here. Just ask, why would the government need to develop such a thing? Just let your mind roll on that point. Anyone one want to bet that one of the Obamacare mandates will be for smokers to be hitched up to one of these gadgets?

The National Institutes of Health (NIH) has awarded  more than $400,000 to a research project involving underwear that can  detect when a person smokes cigarettes.

“The modern methods of monitoring smoking, primarily you rely on  self-report,” said Dr. Edward Sazonov, an associate professor at the  University  of Alabama who is leading the project. “There are few  devices which actually allow a more computerized health report,” he told We can’t have that can we??


The Personal Automatic Cigarette Tracker, being developed with taxpayer money, aims to put a breathing sensor in conventional underwear and a “hand gesture” sensor in a bracelet to detect and record when a person smokes. (Photo from University of Alabama website)

The University of Alabama has received two grants totaling $402,721  for the project, which so far has produced a “very early prototype” of  the monitoring system, which — in its current state — fits like a  vest.

The Personal Automatic Cigarette Tracker (PACT for short) is intended to accurately measure when and how often  people smoke as well as how deeply they inhale. The real-time  information would be used to design strategies for smoking cessation.

“We are trying to eliminate the need for self-report from people  about how much they smoke, when they smoke, how many puffs they take  from the cigarette,” he said.

More at CNS

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