Arrests bring drop in Seattle VA hospital travel claims

Other veterans stopped filing for so much reimbursement and the hospital begain saving money.

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SEATTLE (AP) — A funny thing happened after federal authorities arrested several military veterans last year and accused them of lying about how far they drove to get to medical appointments at the Veterans Administration hospital in Seattle.

A bunch of others who didn’t get busted stopped filing for so much money in mileage reimbursements, and the VA hospital began saving tens of thousands of dollars a month, officials say.

“We are taking this benefit-travel fraud seriously because of the amount of money that’s going out the door,” says James O’Neill, the VA’s assistant inspector general for investigations. “When we can publicize the ramifications of committing this fraud and being prosecuted, we can really reduce it.”

Ten people, including two VA clerks who admitted taking kickbacks, were charged in federal court in Seattle, and several are due to be sentenced this week. Others have already been given prison terms of up to two years.

They acknowledged abusing a national program that allows veterans to be reimbursed for travel expenses if they meet certain income and disability-related criteria. Some reported driving across the state to appointments even if they lived nearby, and some reported traveling when they didn’t have appointments at all. Their haul: more than $180,000 from late 2010 to mid-2012.

The number of investigations into such activity has soared nationally since 2008, when the VA’s rate for mileage reimbursement jumped from 11 cents, where it had been set for 30 years, to 41.5 cents, O’Neill says. There was one investigation in 2006, one in 2007, and one in 2008. In the past 18 months, the VA’s Office of the Inspector General has opened 225 investigations of benefit travel fraud and made 125 arrests.

Among the recent cases:

16 people were indicted in Cleveland last year and charged with stealing a combined $250,000 in fraudulent mileage reimbursements.

A veteran in Maine pleaded guilty last September to charges of falsely claiming more than $17,000 in travel reimbursements.

Last April, a veteran in Oklahoma City was sentenced to probation and ordered to return more than $36,000 in false mileage claims.

The investigation into the Seattle case, which began in early 2012, determined that two of the four VA clerks who then processed travel benefit claims, Nick Hall and Keishjuan Daniels, had been recruiting veterans to submit false mileage forms. The veterans would frequently claim they had traveled to their appointments from addresses in Eastern Washington, hundreds of miles away.

The veterans would then take vouchers from Hall and Daniels, go to another window and walk away with cash. They’d meet up with Hall or Daniels nearby — in the restroom, or a stairwell, or the VA canteen — and fork over half the money.

“It was policy that nobody on the clerk’s side would check,” said Hall’s lawyer, Stephan Illa. “If you went and said you were driving in from Wenatchee, the clerks would just pay it.”

The VA’s inspector general released a review of the travel benefit program early this year that criticized a lack of controls to prevent fraud and said the VA has been taking steps to improve the program. O’Neill cited new posters that warn about fraud, additional training and additional certification forms.

Prosecutors are seeking sentences of three and a half years for Hall and Daniels, both of whom had lengthy noncombat military careers and no prior criminal record.

“Hall and Daniels stole over $180,000 from VA funds, which are used to pay physician and nurse salaries, for mental health counseling, and other services for needy veterans,” Assistant U.S. Attorney Kate Vaughan wrote in a sentencing memo.

Since the arrests, the number of veterans claiming reimbursements of more than $500 per month has dropped by one-third — even though those arrested represent just 6 percent of that population, O’Neill said. The amount of money the Seattle VA pays for claims made by veterans in that group has dropped from $104,000 per month to $51,000.

Comments

PearlY 8 months, 3 weeks ago

And yet, we are implementing Obamacase subsidies strictly on the honor system because there's "no time" to put safeguards in place. That should work out well. /sarcasm off.

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paco1234 8 months, 3 weeks ago

Wrong! Obamacare includes an aggressive program to prevent fraud, waste and abuse! We've already been getting billions back from Medicare/ Medicaid fraudulent claims from doctors, nursing homes and many other health practices, in unprecedented numbers.

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MyFamNews 8 months, 2 weeks ago

Recovery of approximately 4 billion a year (2010-2011-2012)equals over 12 billion. Simple google search.

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PearlY 8 months, 3 weeks ago

Wrong! Obamacare throws a little more money at enforcement $25 million a year over 10 years - a very little more money, but its fraud detection provisions didn't even go into effect until mid 2010, which means they had to be staffed and implemented before they actually started accomplishing anything. If they were really effective, there should have been a big jump in fraud recovery between 2011 and 2012. Instead, the recovery went up by a mere 2% - from $4.1 billion to $4.2 billion. Out of an estimated $75-$250 billion of fraudulent expenditures. Not hugely impressive.

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downhillracer 8 months, 3 weeks ago

Way to stay focused and on-topic, or is this just another chance to take a swipe at legislation already proven to be saving money and lives? Care to provide a reference to your statement?

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PearlY 8 months, 3 weeks ago

My source is that hotbed of Radical Right propaganda, the Washington Post. http://www.washingtonpost.com/national/health-science/health-insurance-marketplaces-will-not-be-required-to-verify-consumer-claims/2013/07/05/d2a171f4-e5ab-11e2-aef3-339619eab080_story.html

And yes, it is on focus to highlight how rampant fraud is in federal benefits programs and how that bears on one of the least thought-out and most ambitious benefit program in the last 50 years. Care to cite a reference for your claim that Obamacare is 'saving money and lives'?

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PearlY 8 months, 2 weeks ago

Figures don't lie, but liars figure. Sure, Obamacare saves SOME people money; the question is whether on a NET basis it saves more than it costs.

The CBO now puts the net cost of Obamacare’s insurance coverage provisions at around $1.38 trillion over the next 10 years. That's not pocket change.

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downhillracer 8 months, 2 weeks ago

Is that the best you can do? More baseless blather without facts or reason, unable to defend the indefensible.

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PearlY 8 months, 2 weeks ago

Not sure why CBO projections wouldn't count as facts, biased though they are by the precise wording of what they've been asked to measure. (GIGO) But if that's too forward-looking, then I can point you to the fact that my own premiums have seen a more than 50% increase in the last two years because of the mandated additions to coverage in Obamacare, all for things I didn't want.

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NewInWW 8 months, 2 weeks ago

It seems a bit of a stretch to make the comment thread about veterans scamming the VA on mileage reimbursements about Obamacare, but there we are.

Your $1.38T number is impressive, but you haven't said anything about what health care would cost the nation in the absence of Obamacare. That's the real measure of whether the law is good or bad.

As for your personal experience, that seems utterly irrelevant to a discussion of public policy. Surely we all recognize that even though millions may be helped, some may be hurt. That's the case with virtually every law enacted anywhere.

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PearlY 8 months, 2 weeks ago

NewInWW,

My health care wasn't costing the nation anything, and how much it cost me was nobody else's business. Funny how politicians insist that the government must pay for various things, and then insist they must control every aspect of those things because they cost "the nation" so much money.

If my personal experience is irrelevant to public policy, then what was the relevance of all the sob stories we heard over the past two decades of individuals denied coverage or losing health insurance or forced into bankruptcy by medical bills? If it matters that the old system didn't work for some people and this new system might work better, then it also matters that the old system worked very well for some people and this new one sucks for them.

The real measure of whether a law is good or bad is not whether it saves "the nation" money in the aggregate. On that basis, think how much money "we" could save if we: banned pets; strictly controlled the square footage and energy consumption of everybody's housing; required everyone to exercise 30 minutes a day; banned alcohol and cigarettes; etc., etc. North Korea "saves money" hand over fist.

Totalitarian measures can save "the nation" money. That doesn't make them good laws.

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NewInWW 8 months, 2 weeks ago

The "sob stories" which you dismiss were people dying, going bankrupt or otherwise having their lives severely impacted by uninsured medical costs. Frankly, somewhat more severe consequences than your rising premiums.

You will survive under Obamacare, but much more importantly millions of other people will also be insured and have a better chance of survival because of Obamacare. I don't know when this country became a nation of "I got mine, the heck with you" folks, but it's an ugly and destructive trend.

It's time this country joined the ranks of civilized nations of the world and acted as if it cared about the welfare of its citizens.

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PearlY 8 months, 2 weeks ago

So that's your standard of liberty? Each of us is an object for the use of the government to aid someone it decides is more valuable or more needy? My right to live my life is at the mercy of anyone who can persuade the government they "need" what I've earned, or will be benefitted if I'm damaged?

You do realize, I hope, that people die because you choose to spend money subscribing to the Union-Bulletin instead of giving that money for their aid. They die because you spend your money on organic foods instead of conventional, or vacation instead of working more, or live in a house bigger than 300 square feet, or heat it above 50 degrees in winter. What gives you the right to decide those things are more important uses of your money than aiding those who are more needy, but my choices for the use of my money are "ugly and destructive"?

If you minded your business, your health care, and your charities, and I minded mine, we would actually still BE the country that has been more generous than any other in the history of the world.

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PearlY 8 months, 2 weeks ago

Ohio is reporting individual health insurance plan premiums will rise on average 41% because of Obamacare, Indiana 72%, Georgia 198%. The answer according to HHS is, "Let them eat crumbs," in other words, they can buy a "bronze" plan instead of a "platinum" plan, meaning that, in order to pay for the coverage provisions Obama requires us to have whether we want them or not, we can cut back on the benefits that we DO want, to "save money".

Imagine going to the grocery store and buying exactly what you want and need, for $100. Then along comes a politician and, because some people want tofu, and the politician likes them or their choice best, you have to buy $50 worth of tofu, no matter what you want or need. You still WANT your $100 worth of your own choices, but to get that, your grocery bill would go up 50%. And along comes HHS and tells you, no problem, just buy less of what you want, and you'll keep your shopping bill reasonable.

But no doubt all of this is irrelevant to public policy, because no matter how many millions are hurt, some millions may be helped.

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marketinsider 8 months, 2 weeks ago

If Obamacare is savings money why did Obama postpone the full implemation of the program by one year? Is it because: 1) Obama wants to postpone his own program because it saves money, or 2) Obama wants to postpone his own program because the program actually hurts small business, which the weak economy can't handle right now.

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NewInWW 8 months, 2 weeks ago

I assume the first point was sarcastic. Your second point, I assume the real point, completely ignores that the provision which has been postponed only affects businesses with 50 or more employees - hardly anyone's definition of "small business."

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PearlY 8 months, 2 weeks ago

"hardly anyone's definition of "small business.""

Except for the Small Business Administration's. They apply different standards to different industries, but the most typical size they consider a small business is anything under 500 employees, and the lowest is under 100 employees.

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NewInWW 8 months, 2 weeks ago

If we want to agree that small business is anything below 500, I've suddenly lost a lot of sympathy for the pleas on behalf of "small business." Five hundred employees sure sounds like a pretty big business to me. From now on, whenever I hear the phrase "hurting small business" I'll think "500 employees" and move on to something that actually matters.

As to the point I was making, the administration was providing an exception for those (small businesses) least able to comply with the mandate. Did you have a point with respect to the postponement of the requirement or did you simply want to discuss the definition of "small business"?

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PearlY 8 months, 2 weeks ago

Ah, one of those! I (and I'm sure every other small business person who ever heard it) well remember Hillary Clinton's remarks during the first major push to destroy private health care in the 1990s that she "couldn't be responsible for every undercapitalized entrepreneur in America." Nice to know you hold in contempt the enterprises that provide jobs, services and products to millions of Americans. After all, they don't actually matter.

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NewInWW 8 months, 2 weeks ago

Two observations:

First, if you can find anything resembling "contempt" for small business in my post, please point it out, I don't see it.

Second, why is "private health care" sacrosanct, as many health insurers are being required to repay their policy holders a portion of premiums paid to the extent the insurer spent less than 85% of premiums on actual medical care? I'm not sure why we should tolerate 15% of our health care spending going mostly to marketing, corporate G&A and private corporation profits, none of which improve health care, and a little toward claims processing, which needs to be done to reduce fraud and waste. Perhaps you can explain?

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PearlY 8 months, 2 weeks ago

  1. Second sentence, first paragraph: The needs of a business that has 500 employees (or maybe just more than 50) don't matter.

  2. I'm not sure I could explain anything to someone who thinks that marketing, G&A and profits are simply wasted money. First, I'd have to explain to you why that isn't so, and how both customers and society benefit from those expenditures. But more basically, I disagree with your premise that there is or ought to be any "we" about it. If you can't tolerate 15% of your HC spending going to that stuff, take your business to an insurer who spends less (non-profits, for instance), and I'll take mine to the one I want.

Private health care is sacrosanct to me, because I do not want such a private and major part of my life to be collectivized, even if it WERE cheaper. And I especially don't want it when it is much more expensive.

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NewInWW 8 months, 2 weeks ago

  1. If you believe that a "loss of sympathy" equals "contempt," we have very different understandings of the meanings of ordinary English words.

  2. Please do explain how customers and society benefit from healthcare insurer marketing, G&A and profits. I'm pretty conversant with micro and macro economic concepts, can read a corporate balance sheet and have a handle on healthcare issues at large. I'd be interested in what you had to say.

Moreover, isn't the very idea of insurance "collectivization?"

Finally, it's simply too soon to say whether Obamacare is going to be more expensive than what we were doing before Obamacare. Anyone who is drawing definitive conclusions on that point is guided by something other than "evidence."

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PearlY 8 months, 2 weeks ago

Do you actually read the stuff you cite?

The ThinkProgress article doesn't say premiums are lower than they used to be, they're higher. They're lower than they had been PROJECTED to be. The HHS article says pretty much the same thing. Lower than projected.

And that's only being accomplished, as the TP article says, by denying 50% of insurers' rate increases, which guarantees that some insurers will abandon those markets, reducing options and inevitably driving premiums higher down the road.

And again, this is only being accomplished by forcing people to give up benefits they want in exchange for benefits they don't want. The benefits they give up are, primarily, lower maximum out-of-pocket coverage. In my case, my maximum annual out-of-pocket went from $3,500 to $10,000 a year. So if I get seriously ill, my health costs could be $6,500 a year higher than what I had. What did I get in exchange? Free annual check-up (used to cost me $200), and four low- co-pay office visits per year (about 3-1/2 more than I need). And for that, I'm paying 50% more. I could go with a platinum plan and approximate the coverage I used to have, but then I'd be paying 300% more instead of 50% more.

But, you know, I've just had an epiphany.

Instead of devoting my mental energies to productive work (or playful commenting), I could devote them to figuring out how to maximize my take from the government. On an income basis, if I quit working I'll qualify for subsidized premiums, senior discount on my property taxes, and probably even for food stamps, although I think my assets put me in the top 5%. Why sell my investments and take $$ from my retirement savings when I can hand my bills to you, who are so happy to pay them?

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MyFamNews 8 months, 2 weeks ago

As long as you have investments and retirement savings, you qualify for nothing, so keep you job and be thankful that you have one, plus retirement and investments. And remember, there are lots of people working two jobs, making minimum wage, who will never have what you have including health care coverage.

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PearlY 8 months, 2 weeks ago

You are mistaken. I can, if I choose to organize my finances appropriately, qualify for the three items I mentioned: subsidized premiums, senior discounts and food stamps.

For one thing, a home, even if it's worth $500,000 and paid off, isn't counted. Retirement plans are not counted.

I'm well aware that I'm very fortunate. My beliefs require that I share that good fortune with others, and I always have. Statistically, conservatives are much more generous with charity and I'm right there driving the statistics. My beliefs do not, however, require me to delegate the decision as to whom and by how much I should share. Nor do I believe the government is better suited than I am to make those decisions.

By the way, someone working two jobs making minimum wage earns nearly $3,200 a month. That is more than enough to purchase health insurance, or at least, it was before the government started helping us. There were many years during which I made far less than that (even adjusted for inflation) and I've paid for my own insurance every month of my life since I started college.

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downhillracer 8 months, 2 weeks ago

Where do you come up with those fine statistics? What state? How many hours/week? How many dependents? Bluster and nonsense about how wonderful you are.. now, back to Faux and Friends..

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PearlY 8 months, 2 weeks ago

Full-time work (40 hours per week) = 172 hours per month x 2 = 344 hours x $9.19 (Wn. Min. Wage) = $3,161.36.

Typical individual family plan (parents in their 30s, two kids) through Regence about four years ago (pre-Obamacare) with $1,500 deductible and $3,500 maximum OOP (out-of-pocket) = about $480 a month (I'm going from memory of the rate sheets I used to get; since I'm in a different age group, I didn't study them closely). A couple of years before that, before the state added a few heavy-duty mandates, it was probably about $350.

I didn't realize the simple act of buying health insurance made me 'wonderful'. Thanks. And I don't watch Fox News.

By the way, I checked the current Regence plan that most approximates the plan I had before Obamacare, and it would now cost me $994, versus $256 cost back then. A small amount of that is changing age groups, and a small amount is inflation, but most is because of the destruction of pure insurance options and changes in the pre-existing conditions coverage, i.e., Obamacare.

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downhillracer 8 months, 2 weeks ago

Those are gross wages, not even close. Nor do you address the number of dependencies and region-specific details.. someday you might realize no one reads past the 4th line of your exhaustive, self-important drivel.

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downhillracer 8 months, 2 weeks ago

PS, your math sucks. For people paid every two weeks, there are 26 pay periods in a year. Two weeks makes 10 business days, for a total of 260 working days, not accounting for vacation time that you take. In the US people commonly say there are 260 weekdays/work days in a year or 2080 work hours in a year based on 52 weeks per year. (260 = 5wkdys/wk52wks) (2080=40hrs/wk52wks/yr) The number can vary by year. For example, 2012 had 261 weekdays and 366 total days. Few people work every single weekday so the "work day" count is skewed when you take into account holidays that happen to fall on weekdays (up to 6 major US ones per year), vacation time, and sick time. In other words: best case scenario = 1,733/mo before taxes.

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PearlY 8 months, 2 weeks ago

$1733/mo x 2 jobs = $3466/mo. (You were talking about people working two minimum wage jobs.) And I said parents and two kids = two adults, two dependents. So obviously, each parent could work just one minimum wage job, and the family would earn $41,600 a year.

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downhillracer 8 months, 2 weeks ago

Obviously, you're late for a meeting of the Flat Earth Society. Good. Grief.

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MyFamNews 8 months, 2 weeks ago

PearlyY: Assuming a person could actually find a 40-hour week job at federal minimum = 290 a week . Washington minimum = 367.00 a week gross. The difficulty is most minimum wage jobs usually provide between 20 and 32 hours a week. The other problem with your math is you assume there are two people, who can both work a regular 40 hour week. If there is only one provider, then your math assumes that person should be able to work 80 hours a week. Really? Using your $3466 per month, X 12 months = $41.592 per year. Except when you divide that by $9.19 (Wa. minimum) it works out to 4,525 hours. That is equal to two full time jobs, plus another 365 hours per year. And before you assume fast food outlets and retailers are the only ones offering 20 hours a week, check with your local bankers and some other traditional employers and you will find few offer an old fashioned 40 hour work week.

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PearlY 8 months, 2 weeks ago

And with the requirements of Obamacare, on top of all the other employment mandates of recent years, there will be lots more part-time jobs. You know, conservatives have been telling liberals for decades exactly what will happen as a result of liberal programs, and yet, when those things happen exactly as predicted, it's just another excuse for you to double down. Good night.

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downhillracer 8 months, 2 weeks ago

BS. Pure BS. There were plenty of full-time jobs when manufacturing was still active, along with a greater show of Union support. It's the result of outsourcing, off-shoring and general greed of the top 3% income "earners". Us "liberals" can't wait for the midterms to flush much of the Tea-Party-Driven GOP, OUT.

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