Wednesday, January 12, 2011

Bloomberg Defrauds Feds

What the CityTime guys were doing to Bloomberg?

Bloomberg is doing the same thing to the feds:

The federal government has accused New York City of overbilling Medicaid by “at least tens of millions of dollars” by improperly approving 24-hour home care for thousands of patients.

In a lawsuit filed Tuesday, the United States attorney’s office in Manhattan also insinuated that the city had cheated the federal government after a 2006 change in Medicaid rules relieved the city of having to contribute to the cost of the round-the-clock care. In many cases, the government said, the city enrolled patients who did not need such services. And in some cases, the lawsuit alleged, the city approved in-home care for people who needed more intensive services, like nursing home care, but which would have required the city to contribute to the cost.

In one example, the government said a 75-year-old woman with dementia who tried to jump out her window several times a day and who punched her daughter was kept in the home care program when she should have been in an “appropriate facility,” like a psychiatric center.

The lawsuit, which followed a whistle-blower’s complaint, also said the city ignored rules requiring recommendations from doctors, nurses and social workers before patients could be enrolled in the home care program, or sometimes rejected doctors’ findings that the services were not needed. The lawsuit did not say exactly how much overbilling the federal government believed had occurred, but it asked the court to award it triple damages.

“It goes without saying that ultimate medical decisions about patient care should be made by doctors and nurses, not government bureaucrats, and they should be based first and foremost on the best interests of the patient,” Preet Bharara, the United States attorney in Manhattan, said in a statement. “The allegations here are serious and unfortunately reflect a systemic failure to responsibly administer the Medicaid program.”

Connie A. Ress, a spokeswoman for the city’s Human Resources Administration, which administers Medicaid in the city, declined to comment except to say that the agency was reviewing the complaint.

The investigation goes back ten years, but it sounds like the city ratcheted up the fraud after 2006, when the laws were changed and NYC was no longer on the hook for the Medicaid program in question.

It's amazing how these fiscally prudent managers like Bloomberg and Christie love to point fingers at "waste" except when they're, you know, engaging in it.

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