Boehner Seeks to Curb Obama’s Rules Power

The Child Welfare Industry strongly supports federal deregulation as it would not be in the best interests on the pharmaceutical industry.  The cild protective industry has been unregulated since as one of its theoretical revenue-maximization scheme. 

Children and families would be treated with more compassion under a mafia rule than what is now currently established and legislatively proposed.  Human trafficking is an unregulated component of the Social Security Administration.

It's like that, and that's the way it is...

iThe U.S. House today approved the second in a series of bills to limit the president’s authority to regulate business, a move Republicans called necessary for job creation and Democrats labeled a political power grab.

Children and parents would probably be treated with more dignity 

House Speaker John Boehner, who said the package is a top priority, will face difficulty winning final passage of the legislation, which the White House has threatened to veto. Still, Republicans said the votes would highlight the issue of government’s role in regulating business, which they have made a major campaign issue.

Today’s 253-167 vote would force agencies to adopt the least-expensive version of a regulation. Next week, the House will consider a measure taking away President Barack Obama’s authority -- and that of future presidents -- to issue major rules. Congress would have to approve them first.

“The ‘get government off our backs’ message is red meat for the Republican base,” Larry Sabato, director of the center for politics at the University of Virginia in Charlottesville, Virginia, said in an interview. To moderate voters, he said, “it’s not a full meal. Most people favor at least some regulations. ‘Do you want arsenic in your fruit juice?’ is a great Democratic retort.”

Fewer Regulations

The House voted yesterday, 263-159, to require regulatory agencies to calculate the small-business impact of new rules.

The series of regulatory bills fits with Republicans’ 2010 “Pledge to America” campaign document. Similar reforms appeared in presidential candidate Newt Gingrich’s 1994 “Contract with America,” which helped him become the first Republican House speaker in 40 years.

The package’s centerpiece legislation, scheduled to be voted on next week, is called the Regulations in Need of Scrutiny, or REINS Act. It would require Congress to sign off on every agency rule with an annual cost of $100 million or more on business. Now, Congress must vote to block the president from issuing regulations.

The bill “provides a long-term solution to stopping job- crushing regulations by creating a process to responsibly evaluate whether or not regulations that have a significant economic impact are necessary,” Boehner said in an e-mailed statement yesterday.

The White House Office of Management and Budget said in a statement Nov. 29 it would recommend a presidential veto if it passes both houses of Congress.

Obama’s Regulation Record

The administration works “very aggressively to ensure that we take the necessary action to protect our air and water and that we also issue regulations and reform regulations in a way that makes them as efficient as possible,” Jay Carney, the White House press secretary, said at a briefing yesterday.

Recent reports have questioned the extent to which the administration is regulating business.

Obama has weakened proposed rules at a greater rate than his Republican predecessor, President George W. Bush, according to a study released Nov. 29 by the Center for Progressive Reform.

Obama had imposed fewer regulations on business than Bush through the first 33 months of their tenures, while the cost of those rules had been higher under Obama, according to data compiled by Bloomberg.

Regulations ‘Save Lives’

Democrats warned of the consequences of loosening the regulatory environment too much.

“The trio of public safety-killing legislation would make it harder to control and make safe our products that we count on,” Representative John Conyers, a Michigan Democrat, said on the floor yesterday. “Regulations don’t kill jobs, they save lives.”

Senate Majority Leader Harry Reid isn’t focused on bringing the package to the floor for a vote, Adam Jentleson, a spokesman for the Nevada Democrat, said in an e-mail.

Even if eventually defeated, the House bills on regulation will emerge in the 2012 presidential race because they capture the conservative theme of getting government out of business, Noah Sachs, an associate law professor at the University of Richmond, said in an interview.

“Each presidential candidate will be put on the spot and forced to take a stand,” Sachs said.

Should Republicans capture the White House and Senate while keeping the House, “I would expect regulatory reform to be one of the first things to pass,” he said.

‘Regulators Gone Wild’

Presidential candidates Representative Michelle Bachmann and Representative Ron Paul have signed on as co-sponsors to the REINS Act. Former Massachusetts Governor Mitt Romney endorsed it in his Plan for Jobs and Economic Growth, released Sept. 6.

Regardless of the political party controlling the executive branch, REINS is necessary to stop “regulators gone wild,” Representative Geoff Davis, a Kentucky Republican and lead sponsor of the bill, said yesterday in an interview.

Business groups including the U.S. Chamber of Commerce and the National Association of Manufacturers back regulatory reform.

“Manufacturers of all sizes are impacted by harmful and unnecessary regulations, but small businesses are disproportionately affected,” President and CEO Jay Timmons said in a statement yesterday.

The measure “truly would kick-start our economy,” Representative Rick Berg, a North Dakota Republican who co- sponsored the bill, said in an interview yesterday.

Uncertainty for Business

“Regulatory uncertainty -- there’s not a business that exists that doesn’t think about that,” Berg said. “The goal is to have businesses make decisions based on supply and demand, not out of concern about regulatory and tax burdens.”

REINS and the other two bills “are aimed at bringing the regulatory system to a halt by tying agencies up in knots,” Rick Melberth, regulatory policy director of OMB Watch, a liberal advocacy organization in Washington, said in an interview. He said the bills “usurp” presidential power.

The legislation passed today is H.R. 3010. The bill passed yesterday is H.R. 527. The measure being considered next week is H.R. 10.

Defensive Medicine in Child Welfare Found To Be Fraud Scheme

With the continuous lack of oversight and enforcement in children's health care programs funded through Medicaid, children suffer as privatized contractors reap the financial benefits of false claims.

On of the largest areas for Medicaid fraud, waste and abuse is in Targeted Case Management, particularly under the foster care programs.

Reimbursements are submitted by phantom and ineffective children's programming to provide non-existent health care services and/or extremely poor quality services, by persons who are not qualified, to justify the billing of more extreme and unnecessary evasive medical procedures, more readily recognized as defensive medicine.

As there is little or no redress or recourse for children under the auspices of the state who have been harmed by the relevant aforementioned Medicaid fraud scheme,  the pattern of practice continues, as does the false claims.

There is no medical malpractice liability in child welfare.

U.S. House Judicial Committee recently addressed the issues of the practices of defensive medicine in regards to Medical Malpractice Liability.  Unfortunately, nothing was mentioned regarding States Child Welfare Medicaid Programs.



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Medicaid pays more, kids get less, audits show

Turning in-home and in-school treatment of some of Virginia's most troubled kids over to private providers has resulted in ballooning Medicaid costs, overbilling and treatment by unqualified staff.

Many of the hundreds of firms that jumped into the business also treated children who weren't really eligible for service, according to state records, obtained after repeated Freedom of Information Act requests to the Department of Medical Assistance Services.

Many children were not properly assessed. Providers didn't prepare formal treatment plans and didn't keep progress notes. Providers commonly claimed to provide service in improbable circumstances, including lengthy sessions of up to five hours for young children, as well as treatment after 11 p.m. and on holidays, the records show.

"It's very clear some families and children didn't get the services they needed," said Lester Saltzberg, director of licensing at the Department of Behavioral Health and Developmental Services.

It wasn't for a lack of spending by Medicaid — the joint state and federal health care program for the poor and disabled that's been struggling for years with limited funds.

Medicaid's expenditures on the in-home service has grown 250 percent since 2006, to reach $176.5 million, according to data compiled by the House of Delegates' Appropriation Committee. Just last year, as the state began auditing providers, spending rose 20 percent, according to Medicaid's own data.

Spending on the day-treatment service, generally delivered in schools when children are not in mainstream classes, rose by 418 percent, to $144.9 million. Even after auditing started last year, this spending rose 28.5 percent.

An outside auditor's review of 70 providers' 2008 operations identified $14.9 million of questionable payments. The state attorney general's office prosecuted three cases involving more than $4.6 million of fraud.

"Given the number of new providers and the focus on providing services to children in the community, increasing expenditures were expected," said Medicaid spokesman Craig Markva.

He also said the services were overused as some providers misinterpreted who was eligible and what exactly was required of them.

In July, Medicaid started using a firm to check whether particular children actually need the service for authorizing payment. It strengthened requirements for staff qualifications in September, Markva said.

The two services used to be offered through community services boards, the state's local mental health agencies, usually with staff who held master's degrees or had several years of experience.

In a bid to expand the service, the state opened the service up to private firms three years ago — but didn't update regulations, which meant the private firms could legally send people with only high school diplomas to do clinical tasks in homes and schools, said Saltzberg, at the behavioral health department.

At the $70 an hour Medicaid was paying for the two services, the boards were breaking even on the services provided by their professionals.

But the $70 rate looked like a business opportunity in the private sector. Hundreds of firms signed up for the work — 401, up by nearly 200 in the past two years — and many hired staff with minimal qualifications.

And with nobody in state government checking who the companies were serving, the number of children and families in the system rose too — many were children who were more appropriately served with other kinds of outpatient services, for which Medicaid pays public and private providers $46 an hour, Saltzberg said. It's been tough to keep those programs going, financially.

In one case, Denise McCreary, a suburban Richmond provider billed Medicaid for:

Services the city's Behavioral Health Authority actually provided one child.

Services for three boys, telling Medicaid they were seriously disturbed while telling their guardian she was providing them a Big Brother program. One of the boys was an honor roll student; none had been diagnosed with a mental health issue or been found to be at-risk youth.

Therapy provided a 6-year-old and a 7-year-old, which turned out to be one trip to a Chuck E. Cheese restaurant and another to a city park. Their guardian thought McCreary was providing a Big Brother/Big Sister program; neither of the two were considered at-risk children.

A federal judge last fall convicted her of defrauding Medicaid of $601,580 over a 10 month period.

"The aim was to expand access," Saltzberg said. "But if you expand access without looking at how you regulate, there can be unintended consequences."

Virginia Medicaid Program Costs and Trends 2010

Most Medicaid Children in Nine States Are Not Receiving All Required Preventive Screening 2010