Congressional Super Debt Committee Receives Plan to Reduce Medicaid by $2 Trillion Dollars Without Harming Beneficiaries

A Fax sent to the Joint Select Committee on Deficit Reduction on Sunday evening                  September 11, 2011

To: Sen. Patty Murray, Co-Chairwoman Joint Select Committee on Deficit Reduction; Sen. Max Baucus of Montana; Sen. John Kerry; Sen. Jon Kyl of Arizona; Sen. Pat Toomey; Sen.Rob Portman and
Rep. Jeb Hensarling, Co-Chairman Joint Select Committee on Deficit Reduction; Rep.Fred Upton; Rep. Jim Clyburn; Rep. Dave Camp; Rep.Xavier Becerra; Rep. Chris Van Hollen.

Re: Proposed law for Easy Debt Reduction with Medicaid beneficiaries unharmed.  Save $200 billion dollars a year, right now, and reduce the need to borrow and save $2 Trillion in ten years. 
The winners: USA taxpayers, California and 24 other States, NY State's local taxpayers
The losers: crooked state employees, other Medicaid fraudsters/profiteers.
Score unchanged: Medicaid recipients

Honorable Senators and Representatives on the Joint Select Committee on Deficit Reduction and others in Congress:

        Senator Kerry asked for suggestions to reduce debt. Obama wants you to reduce debt by an additional $450 billion dollars and wasn't specific, leaving the details to your committee.    But this proposal is specific.  Here is a plan to reduce debt right now, with $200 billion this year and $2 trillion in ten years.  Since neither Republicans, nor Democrats need or want to fund Medicaid fraud, this Committee can cut $200 billion a year without harming the needy on Medicaid.  Medicaid block grants will shift responsibility for fraud control to the States.    Andrew Cuomo and Eric Holder are knowledgeable of the billions of dollars frauds reported below.  And you would reward California, as well as saving municipal and local/county New York State taxpayers the cost of matching the fraudulent money taken.

     The Wall Street Journal reported how $1 billion disappeared in one part of NY Medicaid fraud; "The state spends $700 million a year to house about 1,400 disabled people in the facilities. But it bills Medicaid more than three times that amount. By taking advantage of federal matching funds, the state pockets approximately $1 billion extra every year on just this one item—and uses it to subsidize other areas of the budget."
http://online.wsj.com/article/SB10001424052748704013604576247300936116610.html?mod=WSJ_NY_LEFTTopStories

Proposed law: Each state shall receive a block grant for all said state's Medicaid costs determined by multiplying the number of Medicaid recipients in the year 2010 in said State by the average of the rates paid in 2010 year to the 25th and 26th ranked states when all the states are ranked in order by their average Medicaid per recipient of federally received Medicaid money.

     Such Medicaid block grants at the median rate of the present Medicaid grants would save $200 billion a year ($2 trillion dollars in ten years) and shift responsibility for overcharges, frauds and other misuse of Medicaid funds to the individual States.    In example: in New York State, let Andrew Cuomo deal with the NY State crooked employees already known to him. NY State's corrupt stealing of Medicaid funds has gone on for years, since before 1994.   As described in prior faxes: "In the case of NY, the Feds keep auditing NYS for fraud. The frauds keep getting bigger and bigger and more and more secretive. While NYS gets fined time and time again, the people running the fraud from the safety of their administrative offices and are under the protection of the NYS Attorney General who uses taxpayer money to defend these white collar government criminals who were ripping off the [Federal government]."
http://governmentrico.wordpress.com/2010/09/20/nys-22-billion-dollar-medicaid-fraud-nys-health-department-and-research-foundation-for-state-university-of-new-york-suny/

"The scandal reaches into the upper levels of management for the SUNY Research Foundation and the state Health Department, according to sources briefed on the case.   At stake is more than $22 billion in annual matching federal funds for Medicaid."
http://www.timesunion.com/local/article/Feds-probing-Medicaid-fraud-at-SUNY-firm-557890.php

      Block grants at the present median rate would shift criminal prosecution responsibility to NY State, where Andrew Cuomo and the new AG, Scheiderman, can act as prosecutors, instead of defending the criminal conduct of State employees in federal court. A State like California and 24 others would benefit from this change.  
http://cuomotarp.blogspot.com/2011/05/congress-asked-to-seek-special.html

    With block grants, beneficiaries would be unharmed as money received is comparable and greater than in 25 states, such as California.   Medicaid benefits per individual would remain above the amount paid in California, which State we know is not stingy with helping the needy,   The spendthrift States could then police their own Medicaid expenditures, while federal dollars for federal investigations and funding for the Justice Department investigations would be reduced.

     This letter is a condensed recap of an earlier post on CuomoTARP.blogspot.com entitled, Deal With Debt Limit With $200 Billion A Year In Real Cuts In Medicaid Which Don't Hurt Beneficiaries  which is included with this fax and has links for confirming data.  Another post, dated July 5, 2011, was sent to Congress and dealt with the need for Federal prosecution to get back the money already stolen:  Save $2 Trillion Dollars In Federal Budget Right Now And Let Eric Holder Fumble Later With NY State Medicaid Fraud

Witnesses available.

                                         Sincerely yours,

                               CuomoTarp.blogspot.com,

[please access web site for working links]

cc:  Michele Bachmann, Ron Paul, Allen West, Thaddeus McCotter, US Representatives; Rand Paul, David Vitter, Jim DeMint, Senators;
and Harry Reid, Majority Leader; Mitch McConnell, Minority Leader; John A. Boehner, Speaker; Eric Cantor, Majority Leader; Darrell Issa, Chair House Oversight and Government Reform; Lamar Smith, Chair House Judiciary; Patrick J. Leahy, Chair Sen. Judiciary; Charles E. Grassley, Sen. Judiciary; Paul Ryan, Chair House Budget; Harold Rogers, Chair House Appropriations; Kent Conrad, Chair Sen. Budget; Jeff Sessions, Sen. Budget; Daniel K. Inouye,Chair Sen. Appropriations; Thad Cochran,Sen. Appropriations; Tom Harkin, Chair Sen. Health; Michael B. Enzi, Sen. Health; Chris Van Hollen, House Budget; Spencer Bachus,House Financial Services; Barney Frank, House Financial Services;  Chuck Grassley, Sen. Finance

Congress Informed Of $2 Trillion Dollars Budget Savings Without Harming Medicaid Needy While Ending State Fraud

Copy of Letter faxed:
CuomoTARP.blogspot.com    June 27, 2011

To: Harry Reid, Majority Leader; Mitch McConnell, Minority Leader; John A. Boehner, Speaker; Eric Cantor, Majority Leader; Darrell Issa,Chair House Oversight and Government Reform; Lamar Smith, Chair House Judiciary; Patrick J. Leahy,Chair Sen. Judiciary; Charles E. Grassley,Sen. Judiciary; Paul Ryan, Chair House Budget; Harold Rogers,Chair House Appropriations; Kent Conrad, Chair Sen. Budget; Jeff Sessions, Sen. Budget; Daniel K. Inouye,Chair Sen. Appropriations; Thad Cochran,Sen. Appropriations; Tom Harkin, Chair Sen. Health; Michael B. Enzi,Sen. Health; Chris Van Hollen, House Budget; Spencer Bachus,House Financial Services; Barney Frank, House Financial Services; Max Baucus,Sen. Finance;Chuck Grassley, Sen. Finance

Re: Saving $2 trillion dollars over ten years or $200 billion a year, without harming poor beneficiaries and eliminating fraud.   Witnesses and documentation available for quick action.

Dear Congress:
                    A chance to save $2 trillion dollars over ten years without harming any needy beneficiaries of Medicaid.  A quick action on a Medicaid funding change would save federal taxpayers $200 billion a year without affecting services to present beneficiaries and would eliminate massive fraudulent billing of Medicaid. In addition, it would save NY local taxpayers $32 billion dollars spent matching fraudulent NY State Medicaid claims.

        Medicaid Block Grants can be enacted with payments at the same average present rate for all States. In NY State, the major beneficiary of Medicaid fraud is NY State itself. Andrew Cuomo, who was NY Attorney General litigating these frauds, is aware of the fraud perpetrators in NY State.

        Eric Holder, 18 years ago as DOJ Attorney for the District of Columbia in 1994, obtained a refund of $26.97 million dollars from NY State.    But, Holder has been unable to make any progress for the last two years on the massive NY Medicaid fraud. NY State's twenty year spree of stealing from the Medicaid trough can be ended with block grants which will save $200 billion a year in federal expenditures or $2 trillion dollars over ten years. And, a side effect would save DOJ expenditures litigating against NY State. A prodigal NY State could then straighten out its own corruption.    Other States with honest dealings, such as California, will receive increases.

   Witnesses and documentation are available for immediate hearings and action.  Below are links to my blog CuomoTarp.blogspot.com where additional information is available, specifically involving NY Medicaid fraud and its costs.

Sincerely yours,

CuomoTarp.blogspot.com

Links to further data:

1. Congress Is Informed Of NY Medicaid Corruption Results in Death And Beatings

Copy of letter sent:
CuomoTARP.blogspot.com                June 10, 2011

http://cuomotarp.blogspot.com/2011/06/congress-is-informed-of-ny-medicaid.html

2.   Congress Asked To Seek Special Prosecutor For Multi-Billion Dollar NY Medicaid Fraud By State Employees

Copy of letter sent:
CuomoTARP.blogspot.com                May 23, 2011

http://cuomotarp.blogspot.com/2011/05/congress-asked-to-seek-special.html

  

3.  Medicaid Block Grants Would Save NY Taxpayers $32 Billion Dollars Without Affecting Services To Present Beneficiaries

Letter to Congress:
   CuomoTARP.blogspot.com         BY FAX                         5/12/2011

http://cuomotarp.blogspot.com/2011/05/medicaid-block-grants-would-save-ny.html

4.   News Reports Of NY Medicaid Excesses And Block Grants Will Sink Cuomo's Budget Into $32 Billion Dollar Default.

      "New York spent $2,903 per person on Medicaid in 2010 — a third more than any other state. The U.S. average is $1,364. Nevada spent the least: $666 per person."

http://cuomotarp.blogspot.com/2011/04/news-reports-of-ny-medicaid-excesses.html

5.  Three Billion Dollar Medicaid Fraud By New York State In Cuomo Budget Sent To Congress For Oversight And Demand That Eric Holder Be Replaced By Special Prosecutor

Copy of letter sent:  CuomoTARP.blogspot.com           April 13, 2011


   Re: Multi-billion dollar fraud: Special Prosecutor required for the Major Criminal Fraud by NY State officials and others taking billions of dollars a year in federal Medicaid funds.   Eric Holder and the NY Offices of the US Attorney have failed to prosecute and obtain refunds.   Holder has an 18 year history of covering up for Andrew Cuomo when billions of dollars are missing.    Congressional oversight of the Justice Department is needed.  Congress must end misappropriations and deduct past fraudulently obtained funds from present appropriations. Block grants would shift policing to the State. 

 http://cuomotarp.blogspot.com/2011/04/three-billion-dollar-medicaid-fraud-by.html

Medicaid Block Grants Would Save NY Taxpayers $32 Billion Dollars Without Affecting Services To Present Beneficiaries

Letter to Congress:

   CuomoTARP.blogspot.com         BY FAX                         5/12/2011
               To:  Darrell Issa, Chair House Oversight and Government Reform; Lamar Smith, Chair House Judiciary; Patrick J. Leahy, Chair Sen. Judiciary; Charles E. Grassley, Sen. Judiciary; Paul Ryan, Chair House Budget; Harold Rogers, Chair House Appropriations; Kent Conrad, Chair Sen. Budget;  Daniel K. Inouye  Chair Sen. Appropriations

Re: Save $200 billion at federal level by block granting Medicaid money to NY and not harm nor eliminate services for poor NY Medicaid recipients, while ending massive over-billing fraud by NY State.

Re: Block granting will save local NY property taxpayers $8 billion, because NY splits its Medicaid expenses 50/50 with the Counties.

Dear Sirs:
      This blog has reported:   "New York spent $2,903 per person on Medicaid in 2010 — a third more than any other state.   The U.S. average is $1,364.   Nevada spent the least: $666 per person."  That means that if Medicaid is block granted to the States at the National average, NY will receive less and must fund its Medicaid corruption out of its budget and tax revenue. New York's Medicaid is capped at $60.4 billion. So calculating, we have $28.38 billion (1,364 divided by 2,903 x $60.4 billion) as block grant eligible total Medicaid expense.  Thus, New York would reduce its total Medicaid expenditure by $32 billion ($60.4 billion - $28.4 billion) of fraud and/or false or excessive billing.


       New Yorkers cannot afford to pay its average cost of all government benefits in New York at $9,442 per person.  New York has the highest state and local debt of $31,536 which must be added to USA debt per person of $44,805.   For New Yorkers, it's a combined local, State and Federal debt of $76,341 per person.  link 1

 
    The following newspaper reports show many billions of dollars of fraudulent criminal taking of federal funds by NY State.

    1. "Daily rate for Medicaid patients tops $5,000 in nine institutions in NY and was described as a "cash cow for the State."   "Introne, Gov. Andrew Cuomo’s liaison, said state officials were working with the U.S. Centers for Medicare and Medicaid Services to analyze and resolve the matter."
http://lonelyconservative.com/2011/04/new-yorks-per-diem-medicaid-rate-four-times-higher-than-other-states/  link 0 
    2.It was reported in Wall Street Journal that, "The state spends $700 million a year to house about 1,400 disabled people in the facilities. But it bills Medicaid more than three times that amount. By taking advantage of federal matching funds, the state pockets approximately $1 billion extra every year—and uses it to subsidize other areas of the budget."

http://online.wsj.com/article/SB10001424052748704013604576247300936116610.html?mod=WSJ_NY_LEFTTopStories   link 1

   And 3.  $22 billion dollar fraud as NYS Keeps Getting Caught For Committing Fraud, But There Never Seems to Be Any Consequences
http://governmentrico.wordpress.com/2010/09/20/nys-22-billion-dollar-medicaid-fraud-nys-health-department-and-research-foundation-for-state-university-of-new-york-suny/   link 2

     Using #2 above as an example, we determine that NY spends per these Medicaid recipients: $500,000 ($700 million divided by 1,400 people).  If instead, these recipients were in a NY nursing home, where the daily rates range from a high of $376 to a low of $253 (link 3),  and a full time aide was assigned for two eight hour periods at $30 per hour total cost for $480 a day.  The combined cost per recipient would be a maximum of $856 per day or $312,440  a year.   But most recipients would not need so much attention and the Medicaid federal reimbursement rates for NY nursing homes are much lower than the average nursing home rates used.

      Summary for this example:  NY bills Medicaid for $1.5 million per these Medicaid recipients for services which could be better supplied at a maximum $312,440 per recipient or at one fifth the cost.

      Worse still for NY residents, NY State uses this excess Medicaid billing to bill its Counties and ultimately their property taxpayers for these fraudulent and excessively expensive services, which do nothing for the Medicaid recipient, but do enrich the State's bloated government.

   Conclusion: Block granting Medicaid to the States would be a giant benefit for NY taxpayers, have no effect on services provided to Medicaid beneficiaries and would substantially reduce Federal expenditures by $16 billion dollars a year for just NY State.  A rough estimate could be made by using one half ($8 billion) of the NY share of excess of $16 billion federally paid expenditure and multiplying it by half the number of states (25 states would be over the median Medicaid reimbursement rate).   The federal government would save a minimum $200 billion per year or about a minimum 14% of this year's projected deficit ($1.4 trillion) without harming Medicaid recipients.

    And collaterally, you would save the NY property taxpayers $8 billion dollars a year, which is approximately 45 percent of property tax levy  (link 4)     While at the same time, benefiting 25 States, including California, which would be rewarded for their honest services

                                     Sincerely yours,

                                    CuomoTARP.blogspot.com

CC: others

link 0
http://lonelyconservative.com/2011/04/new-yorks-per-diem-medicaid-rate-four-times-higher-than-other-states/
link 1
http://online.wsj.com/article/SB10001424052748704013604576247300936116610.html?mod=WSJ_NY_LEFTTopStories
link 2
http://governmentrico.wordpress.com/2010/09/20/nys-22-billion-dollar-medicaid-fraud-nys-health-department-and-research-foundation-for-state-university-of-new-york-suny/%20
link 3
http://www.health.state.ny.us/facilities/nursing/estimated_average_rates.htm
link 4
http://uticadailynews.com/election_releases/17474-Hawkins-Outlines-Plan-Reduce-Local-Property-Taxes-for-State-Takeover-Medicaid-More-State-Funding-for-Schools-Opposes-Property-Tax-Cap.html

Federal Medicaid Block Grants Will Destroy Cuomo's Budget By $47 Billion Dollars

         The party's over.

    At least $46.8 billion dollars will be added to New York's Medicaid expenditures, when Congress in the next budget year beginning in October changes to a block grant for Medicaid as proposed in the next federal budget, and California will support block grants for Medicaid.

      Last year's New York State's share of Medicaid expenditures was $13.8 Billion and the cap on next year's expenditure will be $15.1 Billion (+9.4%), which is matched by an equal contribution of $15.1 billion by NY Counties.

Here are the Medicaid comparisons by State.
Medicaid Cost Per Person Served, 1998
(Red States less than half New York's cost)
New York ~  $8,961
California $2,386
Washington $2,563
Oregon $3,652
Virginia $3,740
Florida $3,607
Texas $4,419
Illinois $4,435
Delaware $4,440
Michigan $4,494
Ohio $5,346
Massachusetts $6,870
Wisconsin $5,457
Pennsylvania $5,808
New Jersey $6,856
Rhode Island $6,603

       If the federal Medicaid block grant rate is at the Texas rate per recipient (Texas $4,419), New York's Medicaid total Federal Reimbursement (State +County) will be reduced ($4,419 divided by $9,861 x $30.2 billion) to $13.6 Billion.  But, New York's total predicted Medicaid expenditure (Federal+State+County) cap was $60.4 billion, or New York needs to find an additional  ($60.4-$13.6)  $46.8 billion dollars.  And New York will find no sympathy or support from California for replacement with Medicaid block grants, as California will gain tremendously due to California's $2,386 lower rate.

      Now add that $46.8 billion to all the delusional revenue predictions in Cuomo's budget.    Will that  additional $2,412 per person ($46.8 billion divided by NY population of 19.4 million) or $9,648 for a family of four be funded with new taxes or added to the New York's Debt per person including local debt of $24,195?    Where will the Counties get their increased share? And this will be repeatedly added in future years.

Oh, somewhere in our favored land the sun is shining bright;

The band is playing somewhere, and somewhere hearts are light,

And somewhere men are laughing, and somewhere children shout;

But there is default in Albany — mighty Cuomo has struck out
link to poem

Andrew Cuomo's Business Friendly Puff Pieces Fizzle As Reality And Medicaid Block Grants Close In

The February 7, 2011 post is updated, condensed and Medicaid Block Grant Implications added:   Updates are in purple.

Andrew Cuomo's Business Friendly Puff Pieces Fizzle As Reality Closes In

 Oh what a tangled web we we weave, when first we practice to deceive ~ Shakespeare

    Andrew Cuomo's business friendly with no tax increases puffing is about to burst.   His lackeys got puff pieces in the Wall Street Journal describing Cuomo as a “national spokesman for fiscal sanity” and in the National Review entitled “Cuomo the Conservative”   Cato Institute was fooled with "Cuomo the Conservative." 
They forgot Ronald Reagan's, "Trust, but verify."


   As of January 21, 2011, New York State, one of 30 States, borrowed $3,343,758,375.70 from the federal government for paying Unemployment Insurance.  Six States, Maryland, New Hampshire, South Dakota, Tennessee and Texas, have repaid their loans in full.    And since Cuomo didn't budget for this in his budget, he must be planning to pass it through to NY businesses. From NY Dept. of Labor, "the numbern average $478 per worker is due from employers."  How much more is New York borrowing this year to add to this $478 per worker?   Is this NY as business friendly?

       Did Cuomo fool his conservative/tea party supporters by having only a property tax cap passed by his request in the NY Senate?    Not really, when a County's Medicaid share is to rise 9.4%.   Where's the money coming from?  "UNYTEA’s Board of Directors has voted unanimously to endorse Governor Cuomo’s proposal for a 2% cap on property taxes, but only if it is accompanied by mandate relief."    And there is a $100 million dollar surcharge tax on medical procedures. passed on through business health insurance premiums

 Now a wake up call concerning Medicaid block grants and the Government posts biggest monthly deficit ever.


     Cuomo's budget plan calls for $30.2 billion to be given to New York by federal government for Medicaid.  New York matches this with $15.1 billion contribution by the State and a $15.1 billion paid by NY Counties paid in property taxes.   New York's 2008 Medicaid per person is $8,961 and the average State per person is $4,307.   If the federal government were generous and gave Medicaid Block grants at the rate received by the average State, NY would receive 4,307 divided by 8,961 x $30.2 Billion = $14.5 Billion.   New York budgets $60.4 billion, so $60.4 minus $14. 5 billion = $44.9 billion additional to be spent out of State money.  And if the federal Government were very frugal and used California's per person rate of $2,386, the block grant would be $8.04 billion  and $50.36 billion additional would need be spent out of State money. 
Any wise businessman would run for the border.



        Ian Welsh describes Cuomo and his cronies as "the people who hollowed out the US economy and caused the financial crash don’t pay the price of their evil, but in fact stay in charge of society despite causing a Depression and being  bankrupt."   Welsh asks, "Andrew Cuomo: stupid or evil?"   It doesn't matter, because he won't continue to fool people for much longer. 


      Bob Brinker, this weekend, after hearing of all the great retirements for government employees, now recommends that people move out of the high tax States with cooked Pension books.     Who's going to be left to pay for Cuomo's plans?  Medicaid recipients, government workers?   So the advice for residents of  budget challenged States is dump their bonds and move out. 
     
   So the advice for residents is to move out and dump the bonds and Andrew Cuomo and his deceived media calls this "Business Friendly."