Tuesday, February 9, 2010

Kansas-Nebraska Act Just Alike

Before I even start, you have to watch this to even begin to understand what I am experiencing at this moment.



Here you have Kansas State Representative Pete Degraaf (R. Mulvane) in legislative inquiry, surviving the ad nauseum horrific-feces-filled-shovel-tossed-testimony Secretary of the Kansas Department of Social and Rehabilitative Services Don Jordan.

My deepest condolences, Rep. Degraaf.

Never in my life, I have I ever heard such, back-stepping, arrogant ignorance, idiocy, shall I continue?  And to think this man gets paid with tax-payer dollars!

The Secretary stated he did not believe Kansas was doing as doing as bad as the rest of the country. Secretary Jordan said he would "check it out".

Don't worry, Secretary Jordan, I checked it out for you.

Whenever I hear a person allow themselves to intentionally place contradictory rhetoric on public record, my fraud senses begin to tingle. I remembered the Department of Health and Human Services and the Department of Justice Health Care Fraud and Abuse Control Program Report for Fiscal Year 2008, and my eyes lit up. Here is the section I pulled for your viewing enjoyment:

HHS/OIG estimated that for State FYs 2001 and 2003 Kansas did not ensure that its $62 million ($37.2 million Federal share) in TCM claims for recipients of child welfare services was within the limit specified in the State’s Medicaid plan. Because the State could not produce the rate and cost data necessary to apply the limit, HHS/OIG was unable to express an opinion on the reasonableness of the claim, and recommended that the State work with CMS to determine the allowability of the $62 million claimed for the audit period.

TRANSLATION: The pattern of child welfare fraud had previously been tagged by the DHHS OIG that it was put on the hot plate for H.E.A.T. making it the fifth report submitted in its Targeted Case Management fraud report. The fraud was so bad in Kansas that the Centers for Medicare and Medicaid are going to be all over Kansas, or rather Secretary Jordan, as he is close to the state Medicaid Directors Andrew Allison, former, and Barbara Langner, Acting Medicaid Director. 

And that, my dear readers, is the reason why Kansas SRS Secretary Jordan was talking out the back of his neck, because the feds are breathing down his neck.  Perhaps that is why there has been musical chairs at the Kansas Health Policy Authority.

See for yourself, Kansas-Nebraska Act just alike, always did, always will, but this time its fraud. No wonder Secretary Jordan offered to write federal law.

DHHS Audit of Foster Care Nebraska 2003



Wendy M. Keats, Attorney, U.S. Department of Justice, argued the cause for appellants. With her on the briefs were Peter D. Keisler, Assistant Attorney General, Kenneth L. Wainstein, U.S. Attorney, and Barbara C. Biddle, Assistant Director. Claire M. Whitaker, Michael J. Ryan, and R. Craig Lawrence, Assistant U.S. Attorneys, entered appearances.

Phyllis D. Thompson argued the cause for appellee. With her on the brief was Jon C. Bruning, Attorney General, Attorney General's Office of State of Nebraska.

Before: GINSBURG, Chief Judge, and GARLAND and BROWN, Circuit Judges.

Opinion for the Court filed by Chief Judge GINSBURG.

GINSBURG, Chief Judge.
1

The United States Department of Health and Human Services (HHS) appeals from a judgment of the district court vacating three policy announcements for lack of notice and comment rulemaking and ordering approval of a cost allocation plan (CAP) submitted by the State of Nebraska Department of Health and Human Services (Nebraska). Because Nebraska challenged only HHS's rejection of its proposed CAP, the district court erred in vacating the announcements. The court also abused its discretion when it determined the CAP should be approved rather than remanding the matter for the Department to reconsider its decision without reference to the policy announcements.

I. Background
2

The Congress has enacted several statutes aimed at improving child welfare services provided by the several States. Title IV-E of the Social Security Act, 42 U.S.C. § 670 et seq., makes funds available to state programs that offer "foster care and transitional independent living programs for children" and "adoption assistance for children with special needs." Id. § 670. Title IV-B of the Act, id. § 620 et seq., offers federal funds to "State public welfare agencies in [order to] establish[], extend[], and strengthen[] child welfare services." Id. § 620(a). The amount of money a State may receive under Title IV-B is capped, see id., whereas under Title IV-E a State may obtain reimbursement without limit for 75% of the costs it incurs to train employees, see id. § 674(a)(3)(A).
3

In order to obtain reimbursement under Title IV-E, a State must submit to the HHS Division of Cost Allocation (DCA) a CAP detailing the State's expenditures. See 45 C.F.R. § 95.517(a) (limiting financial assistance to that provided "in accordance with [a State's] approved [CAP]"). A question that arises when a State prepares its CAP is how it should allocate expenditures that benefit more than one federal program. See id. § 95.507(a)(4) (DCA evaluates "correctness and fairness" of State procedures for "allocating all costs to each of the programs operated by the State agency"). For example, each child protection and safety worker (PSW) in Nebraska handles cases under Title IV-B and, we are told, is "expected to handle" cases under Title IV-E. Nebraska therefore must determine how to allocate the costs of training PSWs between the two programs. Title IV-E cases constitute only 21.5% of all child welfare cases the PSWs manage but, left to its own devices, Nebraska could allocate all PSW training costs to Title IV-E and thus avoid the cap on reimbursement under Title IV-B....more

Kansas is next.

February 25, 2010 UPDATE: I STAND CORRECTED.  MAINE WAS NEXT IN LINE.

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