How Government Really Works: A Train Wreck III
2010-10-11 - by
After Lanier Cansler figured out how to end run the Medicaid appeals process (so he could cut patients’ home care pretty much however he wanted) he was ready to take the next step.
He’d already given CCME Corporation (his former client from his lobbying days) a $25 million no bid contract, so all he had to do next was say, Now, I’ve gotten the rules changed – go to cutting.
In the old days – before Cansler changed the rules – when a patient’s doctor said they needed care they got it. But no more. Now, CCME – not a doctor – decided who needed care.
Disability Rights, the non-profit, described what happened next in a report it sent the Justice Department in Washington. They said: “Individuals whose physicians have already determined the need for PCS (home care) have entered institutions, been hospitalized or died after waiting weeks and months. Hundreds of individuals have waited months for an initial assessment (examination). Even after completion of the initial assessment process, applicants and patients still wait weeks or months for notification of their eligibility…one applicant was discharged from a skilled nursing facility to her private residence with the understanding that she would receive home health and in-home PCS. After learning how long it would take to begin receiving PCS, the individual’s need for immediate assistance forced her to return to the skilled nursing facility. Another individual died after waiting three months for an assessment (examination).”
Cansler explained the delays in getting patients care by saying CCME was having difficulty hiring nurses. Disability Rights shot back that while it was difficult for any new patient to get CCME to approve their care, CCME didn’t seem to have any problems finding “nurses and time to cut care to patients who already had it” then added, “Of course, for every day CCME drags its feet and does not authorize an eligible individual to receive care, DHHS saves money…
In other words, Cansler put the brakes on approving new patients but put the pedal to the metal when it came to cutting current patients.
To be continued…
How Government Really Works: A Train Wreck III
2010-10-11/
After Lanier Cansler figured out how to end run the Medicaid appeals process (so he could cut patients’ home care pretty much however he wanted) he was ready to take the next step.
He’d already given CCME Corporation (his former client from his lobbying days) a $25 million no bid contract, so all he had to do next was say, Now, I’ve gotten the rules changed – go to cutting.
In the old days – before Cansler changed the rules – when a patient’s doctor said they needed care they got it. But no more. Now, CCME – not a doctor – decided who needed care.
Disability Rights, the non-profit, described what happened next in a report it sent the Justice Department in Washington. They said: “Individuals whose physicians have already determined the need for PCS (home care) have entered institutions, been hospitalized or died after waiting weeks and months. Hundreds of individuals have waited months for an initial assessment (examination). Even after completion of the initial assessment process, applicants and patients still wait weeks or months for notification of their eligibility…one applicant was discharged from a skilled nursing facility to her private residence with the understanding that she would receive home health and in-home PCS. After learning how long it would take to begin receiving PCS, the individual’s need for immediate assistance forced her to return to the skilled nursing facility. Another individual died after waiting three months for an assessment (examination).”
Cansler explained the delays in getting patients care by saying CCME was having difficulty hiring nurses. Disability Rights shot back that while it was difficult for any new patient to get CCME to approve their care, CCME didn’t seem to have any problems finding “nurses and time to cut care to patients who already had it” then added, “Of course, for every day CCME drags its feet and does not authorize an eligible individual to receive care, DHHS saves money…
In other words, Cansler put the brakes on approving new patients but put the pedal to the metal when it came to cutting current patients.
To be continued…