{"id":38302,"date":"2013-11-07T05:46:35","date_gmt":"2013-11-07T09:46:35","guid":{"rendered":"http:\/\/valorguardians.com\/blog\/?p=38302"},"modified":"2013-11-07T09:52:08","modified_gmt":"2013-11-07T13:52:08","slug":"and-in-the-more-affordable-care-act-good-news-department","status":"publish","type":"post","link":"https:\/\/www.azuse.cloud\/?p=38302","title":{"rendered":"And In the “More ‘Affordable’ Care Act ‘Good News’ ” Department . . ."},"content":{"rendered":"

Anyone with three or more working brain cells can see that there are serious problems with the Pathetically Puerile<\/del> Patient Protection and Asinine<\/del> “Affordable” Care Abomination<\/del> Act (PPACA), often referred to as “Obamacare”.\u00a0 Yet it seems that each day reveals yet another little hidden “gem” – now that the law’s been passed and we’ve actually been allowed to read it.<\/p>\n

The latest little “gem” coming to light is a real pearl.\u00a0 In effect, on 1 January 2014 the law changes who can determine whether an individual qualifies for Medicaid.<\/p>\n

No, I’m not talking about the new income limits for Medicaid imposed by the PPACA Medicaid Expansion.\u00a0 I’m literally talking about the law changing who can determine if an individual qualifies for treatment under a state’s Medicaid program at state expense.<\/p>\n

Medicaid is a state program – or, more precisely, a collection of individual state programs – to which the Federal government kicks in a large part of the funding.\u00a0 The fraction of the funding provided by Uncle Sam depends primarily on a state’s per capita income.\u00a0 Wealthier states get less; poorer states get more.\u00a0 (Hmm, that sounds familiar – something about “. . . to each according to his need” keeps coming to mind.)<\/p>\n

Previously, Medicaid eligibility and rules were determined by state legislatures when they passed enabling state legislation and established regulations for the operation of Medicaid within that state.\u00a0 That’s by design; these are state, not Federal, programs.<\/p>\n

The PPACA changes who can make Medicate eligibility decisions.<\/p>\n

How?\u00a0 As of 1 January 2014, under Section 2202 of the Pathetically Puerile<\/del> Patient Protection and Asinine<\/del> “Affordable” Care Abomination<\/del> Act hospitals will be allowed to make something called “presumptive eligibility determinations<\/a>“.<\/p>\n

Sound like a good idea?\u00a0 Really?\u00a0 Does letting a fox guard the hen-house sound like a good idea?<\/p>\n

What this means is that the hospitals themselves<\/span> – not State Medicaid officials – will now be allowed to decide whether someone who comes to them for care qualifies under State Medicaid rules for treatment under Medicaid.\u00a0 They’ll do that based on information provided by the patient at the time of treatment.\u00a0 If the hospital decides correctly, the state pays under Medicaid.<\/p>\n

But if the hospital blows it, or the information provided by the patient is a lie – the hospital eats the cost of the mistake, right?\u00a0 So there’s no problem, right?\u00a0 Just like they do for emergency care for the indigent?<\/p>\n

Wrong.\u00a0 If the hospital is wrong or gets hoodwinked – the hospital still gets paid by Medicaid<\/em><\/a>.\u00a0 For the hospitals, it’s a no-lose proposition.\u00a0 The state pays either way.<\/p>\n

Yeah, you’re hearing that correctly.\u00a0 On 1 January 2014, this abomination of a law hands the authority to write checks against Medicaid programs to every hospital in the country that’s qualified as a Medicaid provider, with effectively no penalty if they abuse the privilege.\u00a0\u00a0 Only blatant criminal fraud will likely be a “showstopper” – and even blatant fraud will likely be damned difficult to prove.<\/p>\n

Think that new authority will get abused bigtime?\u00a0 Is the Pope Catholic?<\/p>\n

Look, I love hospitals.\u00a0 They’ve almost certainly saved my life at least once, and possibly a second time as well.<\/p>\n

But most hospitals are for-profit<\/em> enterprises.\u00a0 Let me translate that term for our “progressive” brethren, who often struggle with basic economic concepts:\u00a0 that means they exist to make money<\/strong><\/em>. So if they have an opportunity to make an extra buck legally – and even sometimes not-so-legally – they will, ethics be damned.<\/p>\n

Further:\u00a0 even the non-profit hospitals out there – really aren’t.\u00a0 They just plow their excess earnings into nicer facilities, newer equipment, better bennies, and other such things rather than call them “profits”.\u00a0 They won’t turn down any extra cash, either.\u00a0 Ditto public hospitals; they have operating budgets too, and extra income lets those operating budgets stretch farther.<\/p>\n

Insurance, Medicare, and Medicaid fraud perpetrated by healthcare providers and hospitals are today already widespread, huge problems.\u00a0 Hell, IMO healthcare billing practices today already are outrageous and come damn close to criminal fraud as it is.\u00a0(Don’t believe me?\u00a0 Get a copy of any detailed hospital bill some time and take a hard look at what hospitals charge patients for routine things like aspirin, generic ibuprofen or acetaminophen, bandages, and other minor medical items – on top of<\/em> their room and nursing charges.\u00a0 Then come back and tell me you don’t believe me.)<\/p>\n

If you don’t think this is gonna be abused, I have a bridge to sell you.\u00a0 Great location, high traffic – and I’ll make you a “really good deal”.<\/p>\n

It’s looking more and more like any state who opts out of this nonsense absolutely has the right idea.<\/p>\n","protected":false},"excerpt":{"rendered":"

Anyone with three or more working brain cells can see that there are serious problems with … And In the “More ‘Affordable’ Care Act ‘Good News’ ” Department . . .<\/span>Read more<\/a><\/p>\n","protected":false},"author":623,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[88],"tags":[],"class_list":["post-38302","post","type-post","status-publish","format-standard","hentry","category-health-care-debate"],"_links":{"self":[{"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=\/wp\/v2\/posts\/38302","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=\/wp\/v2\/users\/623"}],"replies":[{"embeddable":true,"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=38302"}],"version-history":[{"count":0,"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=\/wp\/v2\/posts\/38302\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=38302"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=38302"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.azuse.cloud\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=38302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}