Latest / The Ben Ferguson Podcast / 50 Governors Put on Fraud Notice-Clean Up Medicaid or Face the Consequences

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50 Governors Put on Fraud Notice-Clean Up Medicaid or Face the Consequences · The Ben Ferguson Podcast

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  Speaker 1: So the bottom line here is they don't have their
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  Speaker 1: pathway to a nuclear bomb. They're no longer their largest
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  Speaker 1: the region in the world light they used to. This
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  Speaker 1: has been an amazing success and President Trump is right,
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  Speaker 1: and they've been They've had their ass to Let's just
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  Speaker 1: keep saying.
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  Speaker 2: You're listening to the forty seven Morning Update with Ben ferguson.
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  Speaker 3: Good Friday morning. Nice to have you with us in
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  Speaker 3: the forty seven Morning Update, and we've got one massive
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  Speaker 3: story for you. The Trump administration has just announced that
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  Speaker 3: they're requiring all fifty states to explain their plans to
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  Speaker 3: revalidate Medicare and medicate providers. This after massive fraud has
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  Speaker 3: been exposed in many cities and states around the country.
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  Speaker 3: How much money is it costing you? Billions? And we'll
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  Speaker 3: break it down for you. All right, I want to
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  Speaker 3: take a moment and I want to talk to you
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  Speaker 3: to IFCJ dot org. That's IFCJ dot org. It's a
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  Speaker 3: forty seven morning update and it starts right now.
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  Speaker 2: Story number one.
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  Speaker 3: Doctor Oz working obviously with President Donald Trump to put
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  Speaker 3: all fifty governors now on notice. Why I'm over literally
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  Speaker 3: billions of dollars loss to medicaid fraud. Not only is
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  Speaker 3: he putting them on notice, but he's giving the governors
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  Speaker 3: now ten days to verify enrollment data after officials were
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  Speaker 3: able to easily identify more than a billion in unaccounted
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  Speaker 3: for funds alone. Now the Centers for Medicare and Medicaid
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  Speaker 3: Services CMS, the administrator in charge, Doctor Oz said he's
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  Speaker 3: no longer going to allow this to work the way
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  Speaker 3: that it's been working in the past, putting all state
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  Speaker 3: leaders that includes Republican governors, on notice that they better
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  Speaker 3: root out the rampant fraud in each of their states.
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  Speaker 3: He directed them in this letter on Thursday to take
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  Speaker 3: immediate action within days to identify and to remove non
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  Speaker 3: compliant medicaid providers, saying this corrupt individuals and organizations masquer
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  Speaker 3: rating as healthcare providers are defrauding Medicaid and American taxpayers
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  Speaker 3: of billions of dollars each year, placing valuable resources out
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  Speaker 3: of reach for those the program was truly intended to serve.
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  Speaker 3: Doctor Oz went on to say low income, senior citizens, children,
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  Speaker 3: and disabled individuals, classes of providers with less rigorous enrollment
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  Speaker 3: standards are the problem. Doctor Oz, in the letter also
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  Speaker 3: went on to say that all of the nation's fifty
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  Speaker 3: governors must comply. Now. Oz has said, you've got ten
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  Speaker 3: business days, in other words, two weeks to tell cms
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  Speaker 3: whether they will commit to conducting a swift revalidation of
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  Speaker 3: high risks Medicaid providers and provide a proposed timetable alongside
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  Speaker 3: a separate thirty day deadline for a broader provider revalidation strategy,
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  Speaker 3: escalating federal pressure on each state to tighten anti fraud enforcement.
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  Speaker 3: What is very clear from what doctor Oz has said
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  Speaker 3: is this is not just a liberal state problem any longer.
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  Speaker 3: There probably is major fraud in every state in America.
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  Speaker 3: Oz said it is urgent that the action be taken immediately,
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  Speaker 3: and failure, he says, to commit to the revalidation plan
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  Speaker 3: will be considered as we evaluate the likelihood of fraud
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  Speaker 3: in each state moving forward. Now, states must also submit
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  Speaker 3: within thirty days a broader two year strategy outlining how
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  Speaker 3: they will review healthcare providers for legitimacy as well as compliance.
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  Speaker 3: The letter sent to the fifty governors all contain the
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  Speaker 3: same information directions. No one got one letter different than another,
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  Speaker 3: and even states that we know have been actively working
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  Speaker 3: to root out fraud are still on notice across the board.
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  Speaker 3: While the factors contributing to fraud are multifaceted and require
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  Speaker 3: a comprehensive of approach to address, doctor Oz wrote, a
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  Speaker 3: revalidation process for the high risk providers will immediately deter
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  Speaker 3: criminal actors from continuing their fraud schemes as the federal
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  Speaker 3: and state governments closely review and scrutinize the qualifications of
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  Speaker 3: providers to suspend or terminate clearly abuse of actors from
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  Speaker 3: the program.
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  Speaker 2: Now.
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  Speaker 3: These letters target providers that are described as high risk
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  Speaker 3: of waste, fraud, abuse, and corruption, particularly those with less
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  Speaker 3: rigorous enrollment and billing requirements, with CMS directing those states
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  Speaker 3: to include any provider operating without a national provider identifier. Now.
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  Speaker 3: A second letter was also sent out to each state's
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  Speaker 3: Medicaid director, reiterating the call for a revalidation strategy tailored
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  Speaker 3: to each state individually, saying this, our analysis of national
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  Speaker 3: trends strongly suggests a persistent and growing medicaid threat that
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  Speaker 3: is posed by sophisticated actors knowingly exploiting these complex systems
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  Speaker 3: to financial gain. Now, their proposals must include a methodology
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  Speaker 3: and a timeline for off cycle provider revalidation with an
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  Speaker 3: emphasis they say, on high risk providers and those without
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  Speaker 3: the MPIs metrics to measure effectiveness in progress, including public
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  Speaker 3: reporting processes for ongoing verification of provider information, and strategies
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  Speaker 3: they say, to ensure consistency and accuracy of provider data
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  Speaker 3: across fee for service and managed care systems, they say,
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  Speaker 3: including oversight of managed care directories and coordination with relevant
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  Speaker 3: law enforcement partners. Now, the last part of that statement
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  Speaker 3: is what matters to you as a taxpayer? Relevant law
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  Speaker 3: end enforcement partners coordination? Why do they say that, Well,
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  Speaker 3: it's very clear medicaid fraud has been a particular interest
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  Speaker 3: to the Trump administration given the massive fraud scandals that
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  Speaker 3: we've already witnessed in Minnesota and California, and this push
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  Speaker 3: for every state now comes a bit heightened focus on
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  Speaker 3: these large scale fraud cases that included the two hundred
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  Speaker 3: and fifty million, for example, for Feeding our Future scheme,
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  Speaker 3: which became a national flashpoint after servicing in twenty twenty
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  Speaker 3: two and has led to a wave of convictions in
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  Speaker 3: recent years. Now, a separate state commission review of Minnesota's
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  Speaker 3: Medicare program this year identified vulnerabilities across fourteen high risk
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  Speaker 3: services and estimated that up to one point seven billion
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  Speaker 3: in payments over four years were probably improper, findings that
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  Speaker 3: have intensified federal scrutinies and calls for even more reforms.
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  Speaker 3: Now you also asked the question, how the hell do
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  Speaker 3: we send one point seven billion in payments to fraud
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  Speaker 3: in one state? Clearly these numbers were outside the norms
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  Speaker 3: for the nation, and this is why you know the
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  Speaker 3: Democrats deliberately look the other way. Why would they do
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  Speaker 3: it because the same fraudsters that were stealing your tax
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  Speaker 3: dollars were giving some of that money back in campaign
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  Speaker 3: contributions aid in support to liberals that were elected officials.
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  Speaker 3: Now we also are learning this CMS is also weighing
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  Speaker 3: Medicaid deferrals in states including California and New York and Maine,
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  Speaker 3: signaling potential legal battles as federal and state officials are
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  Speaker 3: now clashing over enforcement that's not being done by many
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  Speaker 3: radicals on the left. Now, this goes back to one
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  Speaker 3: of the core points from President Trump's campaign. He was
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  Speaker 3: going to root out waste, fraud, and abuse. And what
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  Speaker 3: we're witnessing right now is it's not just liberal states
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  Speaker 3: where they're focusing. This is now a mandate to every
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  Speaker 3: governor of every state because what they realize is there
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  Speaker 3: are too many bad actors out there. Many of them
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  Speaker 3: may be committing fraud in conservative states. And that's exactly
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  Speaker 3: why the President and doctor Oz are now using law
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  Speaker 3: enforcement and the power of the purse to say you
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  Speaker 3: want federal dollars, you better be in compliance.
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  Speaker 2: Thank you for listening to the forty seven Morning Update
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  Speaker 2: with Ben Ferguson. Please make sure you hit subscribe wherever
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  Speaker 2: and we will see you back here tomorrow.