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  • HeadsUp Feb 28, 10:06 a.m.

    This will pale in comparison to the cost, disruption, and political fallout if the state's new half a billion dollar Medicaid payment system fails or falters when it launches this summer, as Governor McCrory has said it might.

  • tigo7 Feb 28, 9:41 a.m.

    Like i said fraud is rampant in medicaid. Health care practices cannot afford to even stay in business if they have more than 40% medicaid patients or clients in their practices. One cannot stay in business because reimbursement is so low. The rest has to be private or self pay patients or clients to pay your salary and staff salaries and rent, insurance etc. Regulations through Obamacare will likely put the small practices out of business.

  • whatelseisnew Feb 28, 9:27 a.m.

    Just another example of why Medicaid AND Medicare should not exist. NO matter HOW hard the Federal and State Governments attempt to uncover fraud it will be widespread and ongoing. It would not surprise me to learn that more than half of all payments are fraudulent. You have the outright thieves, and then you have people that will manipulate billing codes to try to make up for some of the underpayment that they get from the Government. Time to get GOVERMENT OUT OF THE HEALTH CARE BUSINESS. As is usual they are causing vast harm. If you want affordable health care, get rid of ALL GOVERNMENT Programs associated with health care.

  • anonymous99977 Feb 28, 9:02 a.m.

    WRAL staff do your research, do not biased by righ-wing conservative propaganda. The NC-DMA Medicaid Policy manual 8-C allowed "incident to" billing but did not specified who could do this billing until late 2011 or 2012. Do your research. It wasn't until late 2011 - 2012 that NC-DMA clarified "incident to" to note that only Medical Doctors could bill "incident to". I can understand why this doctorate level mental health professional made this mistake. Read the facts. Will NC ever be fair, partcularly to minorities? That is the true issue. I found it truly alarming that a white-male conservative Republican is the one starting this inquisition against minorities owners. How come they haven't target white business owners who have been engaging in these practices or get rid of LME's/MCO's in the state which are a waste of tax payers dollars. I'll tell you why, they are creating a bigger bureaucracy for their "cronies friends" and less services for clients/families.

  • anonymous99977 Feb 28, 8:56 a.m.

    Read facts previously enter. Read NC-DMA Policy Manual 8-c, you will find discrepancies and errors that would have made this licensed professional made the mistake she made. I hope that her legal defense team looks at how the state changes rules in the middle on the game and expect providers to abide by them.

    WRAL staff, the question should be, why a white-male Republican is targeting a female African-American business owner? This is the new institutionalized racism. Clearly, this has been an example of it. Hope her legal defense team picks up this one too.

  • bmac813 Feb 28, 8:56 a.m.

    Like I have told my Wife, Take all the Fraud and Cheating out of Medicare, Welfare,Medicade and the Bad Spending by our Politicans they can Lower our Taxes another 10%.
    ButI only went to the 12th Grade, Never went to College, So I guess I am not so smart as some of the College Grads who went to Harvard and Have no Common Sense. They must of all Flunked MATH.

  • anonymous99977 Feb 28, 8:54 a.m.

    I hope her legal defense team uses the following facts. WRAL staff, please do your research prior to preliminary judging someone or finding them guilty. Are you a right-wing news organization? It will be good to know.

    Fact # 1: NC-DMA on their Policy Manual 8-c for direct enrolled outpatient providers, allowed "incident to" billing but did not specify until on or about late 2012 of who could bill "incident to", which is only for Medical Doctors (MD's) (personal opinion: unfair to other doctorate level professionals in the counseling/mental health field).

    Fact # 2: In the NC-DMA Policy manual dated 12/2/2012 there was another admendment to "Incident to" which reads:
    "Date Section Revised Change
    12/01/2012 Section 6.1 Specified that providers of these services must be licensed in
    North Carolina and be direct enrolled in Medicaid and that
    these providers are prohibited from allowing any other
    individual or practitioner to use their Medicaid number as
    this would be treated as Medica

  • streetglide Feb 28, 8:48 a.m.

    kind of strange how WRAL can get ths insight and knowledge and abuse, but the people handing out the money just can't.. as mentioned below,, makes you wonder, if maybe they don't want to know... follow the money people,, follow the money, in goverment, that is where the truth lies.

  • bmac813 Feb 28, 8:48 a.m.

    corey3rd2, Did you get hit in the Head or What. ACORN a GOP Backer?
    Wall Street, they gave Oblamea More money than anyone before him, $45 Million Dollars. Big Money backers, Do you meanLike George Soros, Or Michael Moore, Or maybe Hollyweed, Sorry I mean Hollywood.
    Cheating in Elections, Do you mean like ACORN, The NAACP,Or maybe the druggies in Ohio And Florida who were given Drugs to fill out Election Forms?
    You and junkmail must get along Fine.
    I think Both of you can only see out of One EYE and that isn't to good.

  • Crumps Br0ther Feb 28, 8:07 a.m.

    It's what every other modern nation in the world does.
    junkmail5

    Yes but thats not what was sold, and you know it. They lambasted anyone who used the words death panels or rationing. But now you are saying it has to be done, but when they were lobbying for it they never told that dirty little secret. And nwo that it was voted on we get to find out whats in it, a big ol do do sammich!

  • Crumps Br0ther Feb 28, 8:04 a.m.

    How about the GOP group that had their NC voter fraud fun last election? Or do you give all "your" people a pass?
    corey3rd2

    Well thats ironic, because according to your liberal brethern on other message boards about voter fraud, they claim it doesnt exist, and there isnt enough proof for it to justify showing ID to vote. So if they dont believe in voter fraud why do you? Is it because you lost? So in addition to your liberal hypocrisy and double standards you also get to have things both ways. I guess that way you are never wrong, it doesnt show much integrity, but then what do you care if you get to be right all the time?

  • TTDD Feb 27, 4:21 p.m.

    Maybe those investigating have something to gain by not investigating. HMMM?

  • corey3rd2 Feb 27, 4:04 p.m.

    You got an issue with Medicare fraud, maybe you need to shut down Wake Med instead of letting them take over Rex Hospital to steal more medicare money with their false billings?

  • corey3rd2 Feb 27, 4:03 p.m.

    Conservatives stole their billions out of "saving Wall Street" and invading Iraq. Liberals wish they could only raid the treasury as fast and hard as a crooked GOP backer. ACORN? How about the GOP group that had their NC voter fraud fun last election? Or do you give all "your" people a pass?

  • Karmageddon Feb 27, 2:59 p.m.

    Just like ACORN did.....Liberal groups just change their names and keep on shafting us

  • sweetcountrygirl32 Feb 27, 2:35 p.m.

    so she got a new medicaid provider # and was billing out with that number? who gave her the #? I am confused.

  • free2bme Feb 27, 1:55 p.m.

    werewolfwoman, this is no example. No one can change people and unfortunately there will always be criminals. There will always be those who try to get over on the system. Medicaid fraud is not a new issue. Should people be denied care to resolve an issue that is not their fault and that will take years to fix. The answer is no. McCrory has an excuse for doing what his friends want him to do. He cares nothing about the working people who need medical care.

  • junkmail5 Feb 27, 1:02 p.m.

    we were told there would be no rationing. We were also told we could keep the insurance we already had, but that has changed as well
    Crumps Br0ther

    Huh?

    The entire point of the remark was that you -must- have rationing to FIX THE PROBLEM.

    Krugman is pointing out that we do NOT have a reasonable rationing NOW but mathematically you MUST have it to fix the system.

    Because there's not an infinite amount of health care available.

    It's mathematically impossible to give everyone all the care they want.

    Right now rationing is purely on money terms. If you're rich, or have good insurance, you can spend (or have insurance spend) 1 million bucks to live a week longer.

    Meanwhile poor people might lose years off their life for lack of a cheap treatment.

    A rational system wouldn't do that. A rational system would ration so that the million bucks adds years to the lives of 100 people instead of 1 week to a single guy.

    It's what every other modern nation in the world does.

  • disgusted2010 Feb 27, 12:20 p.m.

    Where is Roy Cooper's over staffed and over paid Medicaid Fraud Unit, that is led by his failed SBI Director?

  • werrewolfwoman Feb 27, 12:09 p.m.

    This is an example of what Governor McCrory referred to when he supported NOT to expand Medicaid services in this state. There are so many "providers" robbing the system that if DHHS would do the job they need to, we wouldn't have to expand Medicaid. The money is there for people who need it; the problem is the legal crooks are stealing it.

  • batcave Feb 27, 12:08 p.m.

    Governor Pat you are right, it is broken, I guess some are ok with throwing other peoples money away.

  • Crumps Br0ther Feb 27, 11:58 a.m.

    Hey Sarah, Alaska is calling.
    Unbroken

    Im surprised you could read that with your head in the sand. Barry lied to you about healthcare and continues to do so. But I gues you libs dont mind when one of your own lies to you

  • Crumps Br0ther Feb 27, 11:56 a.m.

    You can tell, because every other nation in the world rations health care without

    we were told there would be no rationing. We were also told we could keep the insurance we already had, but that has changed as well

  • Lightfoot3 Feb 27, 11:35 a.m.

    Get'em WRAL, get'em!!!

  • Karmageddon Feb 27, 11:31 a.m.

    Heads need to roll at DHHS......

  • junkmail5 Feb 27, 11:21 a.m.

    Junkmail, what I read is "I really put my foot in my mouth this time. I said death panels, which I shouldn't have, but most certainly mean. I couldn't have been more wrong about the cost of this boondoggle."
    rationality

    then you read incorrectly.

    You can tell, because every other nation in the world rations health care without "death panels" (while spending FAR less and getting similar or better results)

    Plus, he's said the same remark before to cause a reaction, with the exact same explanation.

    he even links to when he previously did so in the article I provided you.

  • Terkel Feb 27, 11:14 a.m.

    "Why isn't the state after this multi-million dollar computer system catching these low lifes?"

    Good question. The same middle mgr at DMA who gigglingly admitted hiring an unqualified Indian (to no one's surprise) to be trained on the software at taxpayer expense, reviewed the software contracts and passed them along.

    But when you ultimately report to the genius who came up with the "counselors" taking kids to the movies at $60/hr paid by Medicaid, I guess you want to keep the bar as low as you can.

  • rationality Feb 27, 11:04 a.m.

    Junkmail, what I read is "I really put my foot in my mouth this time. I said death panels, which I shouldn't have, but most certainly mean. I couldn't have been more wrong about the cost of this boondoggle."

  • pappybigtuna1 Feb 27, 11:04 a.m.

    These thieves of Medicare are among the lowest form of human beings. But, I will add they are but a drop in the bucket of all the low life's doing the same thing.

    What we don't have in dealing with scabs is meaningful laws and penalties. If I was calling the shots, first offender's would receive without parole or retrial 25 years at Fort Leavenworth, KS. This would be very hard time, there would be no excuses, mentally ill, handicapped. They all know right from wrong.

    Or send them to CA, they seem to have a soft place in their hearts for the criminal

  • junkmail5 Feb 27, 11:03 a.m.

    As for rationing of healthcare, what do you think the powerful panel created by 0bamacare is all about?
    retroconsultant

    Which panel is that?

    is it the one that Rush told you about that doesn't actually do any of the things you're about to claim it does?

    But by all means, give us the name :)

  • CestLaVie Feb 27, 11:00 a.m.

    junkmail5: your posts are too rational, intelligent & realistic....the very things governments & politicians CANNOT handle. For them, it's power, control & greed, at all costs.

  • Homeward Feb 27, 10:59 a.m.

    Good question venitapeyton (So, which staff members fast-tracked the application, licensed and approved the company for billing?)- seems pretty likely somebody in state government helped this company with loopholes and sidestepping honest business practices. I can imagine why (kickbacks), hope WRAL finds out WHO.

  • junkmail5 Feb 27, 10:54 a.m.

    Well, Junkmail, I HEARD his words caught on tape where he said that death panels were coming. They weren't out of context. They can't be defended. He said what he said. If his name was Palin there would be mass hysteria coming out of Krugman's mouth right now.
    rationality

    Apparently you didn't bother to read the link I posted either.

    here it is from Krugman himself-

    So, what I said is that the eventual resolution of the deficit problem both will and should rely on “death panels and sales taxes”. What I meant is that

    (a) health care costs will have to be controlled, which will surely require having Medicare and Medicaid decide what they’re willing to pay for — not really death panels, of course, but consideration of medical effectiveness and, at some point, how much we’re willing to spend for extreme care

    (b) we’ll need more revenue — several percent of GDP — which might most plausibly come from a value-added tax

  • retroconsultant Feb 27, 10:43 a.m.

    As for rationing of healthcare, what do you think the powerful panel created by 0bamacare is all about?

  • retroconsultant Feb 27, 10:40 a.m.

    "denying extremely expensive extreme life extension care to everyone but the very rich." - junkmail5

    This is not true. Right now there are regulations that tell nursing homes how they MUST care for their residents. Those regulations are federal and state, and are suffocating. For instance, if you lose an Alzheimer's patient, you face loss of license and steep fines, so the home must take extreme measures to make sure they don't get loose. And Az patients get expensive care even if indigent and even if there is no quality of life.

    Poor government management of our health care is at the root of our expense. 0bamacare only increased the waste.

  • superman Feb 27, 10:36 a.m.

    The state cant control millions. Several years ago when I filed my taxes I forgot to list about $25.00 in income from an old checking account. About 3 or 4 years later I received a bill from the state for about $100 which included the tax due as well interest and pentalty. These people can collect millions and no problems.

  • 75Tarheel Feb 27, 10:31 a.m.

    And why aren't these low lifes who are stealing from you and me (not welfare or public assistance people, those that don't own property and pay NO real estate taxes, those illegals who should be deported, jailed or both) aren't in jail? Why isn't the state after this multi-million dollar computer system catching these low lifes? Why do media outlets have to their work for them?

    If anyone's wondering I'm talking about the N.C. State Government! And that includes the Donkeys and the Elephants.

  • baldchip Feb 27, 10:29 a.m.

    Follow the money. The fed has tooo many tentacles into NC as it is. You see this administration and their manipulation! Get one dime from them -and their will be long hard strings.

    Bevvie-where were your medicaid investigators??? Oh-same place you were-whistling Dixie????

  • rationality Feb 27, 10:29 a.m.

    Well, Junkmail, I HEARD his words caught on tape where he said that death panels were coming. They weren't out of context. They can't be defended. He said what he said. If his name was Palin there would be mass hysteria coming out of Krugman's mouth right now.

  • yankee1 Feb 27, 10:28 a.m.

    Once you realize that those who find nothing wrong with taxpayer money being used to buy votes, steal elections, pay off contributors, pay for fraud and corruption in handout programs and reward cheaters are amongst those benefitting from the waste of taxpayer money, you will understand why no matter what facts you put out in these comments sections, they don't care a bit.

  • dare107 Feb 27, 10:28 a.m.

    Why isn't someone in handcuffs included the state employees that allowed it to happen!!

  • Unbroken Feb 27, 10:28 a.m.

    "Unbroken, you may want to ask Paul Krugman, that liberal defender of Obamacare, about the group he recently addressed where HE ADMITTED death panels were coming. You must have missed that, didn't you?
    rationality"

    Oh "rationality." I would think with your moniker, you would exhibit more levelheadedness. So let's see, is Krugman in the Obama Cabinet? Hmmmmmm. Did he author/contribute to the Obamacare legislation? Hmmmmmmm! You know what they say about people and their opinions, don't you?

    You see, there is a difference between saying, in your words, "they are coming" and an individual hypothesizing it as their personal suggested avenue of action. You know, kinda like saying Hannity, "Rushbo" and Levin are the voice of the GOP... unless of course you would say that they are.

    By the way, did you know that Krugman worked in the Reagan Administration? You must have missed that one, didn't you?

    Oh I stayed away too long. I forgot how much fun this is.

  • dontstopnow Feb 27, 10:26 a.m.

    BORING! Cut deeper, this is just a drop in the barrel.

  • sunshine1040 Feb 27, 10:21 a.m.

    Send the bills to Bev since it was on her watch this happened and she was a great gov . I know this is true because she said so

  • Terkel Feb 27, 10:17 a.m.

    ""what do you expect. any program that looks after people who will not look after themselves is a joke."

    So you think people BLAH BLAH BLAH HYPERBOLE STARVING CHILDREN KILLING GRANNIES AND LICKING THE KNIFE" coreymom

    Do you libs ever have anything besides hysteria to offer when someone disagrees? No wonder you can't fix anything.

  • dontstopnow Feb 27, 10:16 a.m.

    Oh I believe "death panels" in some form will exist in the coming years to 'kill' off the elderly or severely ill to cut medical costs. I know it sounds paranoid, but I prefer to play it safe and just be sick at home...:)

  • junkmail5 Feb 27, 10:08 a.m.

    (continued assuming my previous post was posted)

    The result is that those other countries spend VASTLY less while providing a lot more care, overall, to their citizens.

    That IS rationing, by its definition. But so is what we have NOW. Their rationing provides more care to more people for a lot less money than our rationing does though.

  • junkmail5 Feb 27, 10:06 a.m.

    Unbroken, you may want to ask Paul Krugman, that liberal defender of Obamacare, about the group he recently addressed where HE ADMITTED death panels were coming.- rationality

    this isn't quite what happened exactly unless you wanna consider the quote out of context and without grasping its point

    http://krugman.blogs.nytimes.com/2010/11/14/death-panels-and-sales-taxes/

    Medical care is not infinite. Eventually you MUST ration it.

    We do this now, by denying anything but emergency care to the poor, and denying extremely expensive extreme life extension care to everyone but the very rich.

    Every other civilized nation in the world takes a different approach, and as a result spends MASSIVELY less per person on healthcare, and ends up with similar, or better, overall results.

    Their approach is to offer the most cost effective care to the most people. But not cover the most expensive care that typically comes at end of life to do things like let you suffer an extra month.

  • weakened back Feb 27, 10:05 a.m.

    i loved obama sticker on her bumper.

  • weasel2 Feb 27, 10:02 a.m.

    Wheres all the inspectors and monitors of the program that Bev promised??? In the back room lining their pockets.

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