Josh Brecheen
One bill I have reserved on this subject will aid Department of Human Service (DHS) fraud investigative officers with more information on fraud and abuse. Currently, there is a state fraud investigative hotline but it is unknown to most, and therefore underutilized. Many people who know of an example of fraud never take the time to search for this information online due to the busyness of their own lives. Even those who do search out the information find it is not an easy discovery and give up prematurely. My bill would provide a personal financial incentive for Joe Public to take the time to persevere (in finding the correct contact personnel) and turn in those engaged in abuse, such as “Medicaid million heirs.”
We often see waste of tax dollars as abstract and not our own money. We must bridge the gap so that more Oklahomans take ownership in waste of tax dollars (money they pay through income tax, etc.) Under my bill’s provisions, there would be a payment or a “bounty” that would be paid to those who report such abuse. The payment, formulated upon a percentage of one year’s savings based on the history of taxpayer loss linked to the abuser, would have a budget neutral impact and not cost the state a dime. Since I reserved this bill, the DHS and the Oklahoma Health Care Authority are working out the specifics on percentage calculation.
I will also be offering another bill concerning Medicaid fraud. During my years spent interviewing thousands of Oklahomans concerning ways to tackle welfare related fraud, I found a recurring theme. Many times I was told how DHS employees have encouraged prospective clients to quit a job or to not declare cash income in order to qualify for state aid (if the prospective client’s income surpassed the eligibility threshold). This is not just an isolated event. It occurs often. Many DHS employees do not engage in this but some do, and it must be addressed.
We can all put ourselves in a DHS worker’s shoes and the heartbreak that might occur if we had to be the one to say, “I’m sorry, but you make too much to qualify.” It is a very hard job and a very hard situation. However, the guidelines are set for a reason. These guidelines are set to ensure that those who have the ability to solve their own problems do so.
My wife and I can relate to financial difficulty and the trouble with financing healthcare. We have experienced firsthand how pre-existing conditions left us without health insurance in a scary situation. However, the inner strength we gained to forge through and solve our problems, even when extremely difficult, is priceless.
Our Founding Fathers knew the importance for boundaries of government involvement because of their personal understanding of struggles. The struggles of our lives prepare us. Resistance builds strength in the weight room and in life in general. No pain, no gain, no test, no testimony, no cross, no crown. Knowing this, we must not let government steal the independent spirit that birthed our nation and is the backbone of our success.
The specifics of my bill are simple. Of the 30 fraud investigators under the scope of the Oklahoma DHS Inspector General’s office, we will ensure that at least one serves as an “undercover shopper.” This person will randomly travel the state posing as a prospective DHS client. They will carry a tape recorder and if a DHS employee is found to be encouraging fraud, the employee will face a misdemeanor charge and a fine. Currently the DHS office policy states that termination of employment is the consequence of such action, but this has not hindered the many times this policy has been breached. Also, the ability to catch this action is difficult in the face of “he said, she said” conflict. This change is needed to encourage some state employees to see taxpayer monies (provided under such programs) as precious and at the same time, their own money. This is a way to do just that.
I have recently met with expert DHS state officials concerning this idea. They have indicated support and need for this change. The dollars saved in fraudulent awards will be better utilized to serve those deserving assistance. For those who currently know of Medicaid fraud, please contact the Office of Inspector General for Oklahoma DHS at (800) 784-5887.
My wife and I want to wish each of you a prosperous New Year!
Josh Brecheen
And, yes, I have been frustrated at some of Senator Brecheen's early priorities. I hope he will seek advice from local citizens and leaders to develop his legislative agenda. Whether it is at the coffee shop or from the leaders in his district, I believe that Senator Brecheen has the ability to adequately represent SD6 and southeastern Oklahoma. However, the early stated goals - most notably forcing religious-based beliefs to be presented in the science classroom - have proven to be nearly universally criticized. It seems likely that I will disagree politically with Senator Brecheen on most issues. However, I want the new senator to succeed for the good of SD6 so long as his priorities are consistent with needs of his constituents.
By following his logic, one must also then review the donors to the former state senator's campaign and wonder about their reason for donating. "tmarcum" is then calling under the magnifying glass an awful lot of lawyers, and making suspect their reason for supporting him, as they were among the highest majority of donors to the former senator's campaign.
FYI, there are laws against doctors already on the books who cheat medicare/medicaid.
It's time to stop tearing local neighbors down and allow our community to move forward...the election is over and the comments denigrating others are quite undignified.
Medicaid is the wholly owned province of the Oklahoma Health Care Authority, not OKDHS.
While OKDHS still does some eligibility determination for OHCA, OKDHS is being quickly phased out of the Medicaid eligibility determination business. Applications are now completed on-line with web-based applications directly to the OHCA, but if the applicant has trouble they can still call OKDHS workers for assistance and guidance.
The Senator might be surprised to learn that applicants can access the OHCA Medicaid program in any location having web access, including tribal medical facilities, libraries, schools, from home, you name it.
Mr. Brecheen had best get with the program. The reforms he is planning have already passed the good Senator by through automation and tecnnology.
Hopefully, with Senator Brecheen's investigators on the job, that DHS worker will get fired the next time she makes such an irresponsible recommendation.
Thanks for the window dressing legsilation. Most of the fraud that you are talking about is committed in the hospitals, clinics, and doctors. Accusing the citizens of OK as the major culprit of fraud is irresponsible.
You are confused as to the "gaming" of the system. Most people that game the system in order to receive Medicaid or Medicare, do not have the ability to purchase medical insurance due to pre-existing conditions or other issues.
Just research the PBS show NOW and the episode that they filmed in Tulsa in the summer of 2009. The parents had a child with severe asthma and unable to have medical insurance for her. So they both quit their full time jobs which allowed them to get her placed in medicaid system. She does recieve medical treatments for this life threatening condition. But now her parents are without insurance coverage, but it was their choice. This is a prime example of gaming the system.
But you advocate for the repeal of the federal heath care bill that prevents insurance discrimination due to pre-existing conditions.
So now you are trying to have it both ways. Make criminals out of parents who are seeking medical coverage for their children and repealing health care legislation for political gain.
Go after your big donors and you will find a treasure chest of medicare and medicaid fraud. Stay away from the struggling families that you do not want to represent.
It would be more valuable for you to work to stop tax shelters and tax breaks for the wealthy, rather than trying to ensure that more and more people are bankrupt due to medical bills.
I notice you never provide specific details, just generalizations without proof. Welcome, people, to the craziness you elected.
If you are serious about tackling fraud in the State of Oklahoma you would focus your efforts in expanding the number of investigators looking into such crimes. With a third of Oklahoma's population on public assistance and an estimated 5% receiving by fraud simple mathematics would show that "30" investigators won't even put a dent in the amount of fraud occurring simply because there aren't enough people to investigate the crime...
Companies will be barred from instituting caps on coverage when your costs for treatments goes up due to sickness, you can now get insurance with out caps on coverage at "Wise Health Insurance" search them online.