Posts Tagged ‘Fraud’

Democrats Turn Waste, Fraud and Abuse Commission into Partisan Issue

By James Wigderson
Special Guest Perspective for the MacIver Institute

Governor Scott Walker’s Waste, Fraud and Abuse Commission (WFAC) has issued their report and found a potential $445 million in savings for Wisconsin’s taxpayers annually. But as if to prove Weiss’ Law, Democrats in Madison are already complaining about the report.

Weiss’ Law was named after former New Berlin School Board member Matt Weiss who made the observation, “Nobody ever thanks you for not spending money.” Given the history of past efforts to root out waste and fraud in government including the Grace Commission and other commissions and reports, Weiss knew what he was talking about.

The Commission identified $82.6 million in local government savings and $373 million in state government savings annually. Hardly small change.

Some of the savings identified are already being implemented, such as changes in overtime for correctional officers. Those changes were made possible by the reforms in Act 10, which allowed the state to set the work rules outside of collective bargaining.

Other changes were spurred by the release of the interim report last year. For example, the Wisconsin Department of Health Services is examining how they will implement Patient Protection and Affordable Care Act program integrity provisions. They will also be contracting with private auditors to conduct audits of Medicaid suppliers on a contingency fee basis.

But what seems to have inspired the ire of the Democrats on the Commission, Democratic State Representative Mark Pocan and Democratic State Senator Chris Larson, was the emphasis by the commission to focus on the waste, fraud and abuse in programs for the needy.

In an interview with WTMJ-TV in Milwaukee, Larson said, “Where they go after people who are receiving food stamps and quest cards. They wouldn’t do the same thing for contracting or where money’s going to for the economic development corporation.”

But as the commission’s report makes clear, even as the amount of assistance spending has dramatically increased in Wisconsin, the amount spent on rooting out fraud has dramatically decreased. The report says, “At the same time benefit spending and recipient levels have risen, funding for recipient fraud prevention and detection has dropped.  In 2002, state spending on recipient fraud detection and program integrity efforts was $2.7 million. Between 2004 and 2009, funding to identify and 22 prevent recipient fraud decreased by 76 percent, from $2,340,000 to $561,892, while at the same time program eligibility expanded and new public assistance programs were created.”

As for why the Commission did look for savings in assistance programs, as Willie Sutton was famously misquoted, “That’s where the money is.” The Commission identified that increasing program integrity for assistance programs would result in $177,000,00 in savings.

Even Pocan and Larson recognized that’s where the money is in their alternative report. They suggested hiring more front line staff and administrative efficiency could result in $116.8 million to $177 million in savings each biennium.

One of the Commission’s recommendations for stopping fraud was the requirement of a photo id for aid recipients using Quest debit card for FoodShare. As the Commission says in the report, there have been a number of high profile cases of Quest card fraud, including the re-selling of Quest cards for cash. Requiring a photo id at the register (the same requirement if writing a check or purchasing decent cold medicine) would deter the reselling of Quest cards and their unauthorized use.

Pocan and Larson consider requiring a photo id to be an unnecessary burden on the state’s poor. Apparently the poor need not apply to assist Pocan’s and Larson’s fellow Democrats’ “Recall Processing Strike Force,” which also requires a photo id of participants.

Pocan and Larson also misstate in their report that the commission did not consider the question of using more in-house engineers at the Department of Transportation. “Unfortunately, these conversations were not part of the commission process.”

Actually, the question was dealt with quite extensively in section F on pages 50 – 57, including the Legislative Audit Bureau report that Pocan and Larson cite in their alternative report. The commission pointed out that the LAB report did not look at contractors vs. in-house engineers in the larger sense of continued pay and benefits even after a project was completed, only on the cost for a particular project to make the comparison. The Commission pointed out there was actually conflicting data and called for more study of the issue, even as the DOT is adding more in-house engineers to address the imbalance.

Perhaps that was because Pocan and Larson were in a hurry to try to score other partisan points. Seemingly forgetting the purpose of the commission, which is to ultimately reduce the burden on the taxpayers, as part of their alternative report on Waste, Fraud and Abuse, Pocan and Larson actually called for a tax increase on Wisconsin businesses. They complain that with the tax breaks given to businesses under Walker, “Wisconsin will loose (sic) $212 million in lost revenue.” Larson and Pocan call for raising taxes on Wisconsin businesses $46.4 million in the current biennium and $80 million in the biennium to follow.

But Pocan and Larson saw their alternative report as an opportunity to actually add back more waste in government spending. They call for the return of regional transit authorities that would raise taxes on local communities for passenger rail projects.

And if that was not enough, they also call on the state government to beg the federal government for the money for “high-speed rail.” While they see the $800 million in lost federal revenue, they are ignoring the long-term costs of the project and the likely additional burdens to the taxpayers.

California was a supposed beneficiary of Wisconsin’s refusal of federal stimulus “high-speed” rail money, but they are experiencing buyer’s remorse. California voters in 2008 approved selling $9.95 billion in bonds for the train’s costs. Recent polling indicates that the same referendum would not pass today. Costs are ballooning and the bonds aren’t selling.

Now the CEO of the California High-Speed Rail Authority, Roelof van Ark, and the Chairman of the Board, Tom Umberg, are stepping down as calls mount to abandon the wasteful project.

Judging from the alternative report, Pocan, who made headlines last year claiming the state was not in a fiscal crisis, seems bound and determined to send Wisconsin back into one. The alternative report is a reminder of the thinking that led to the state’s fiscal crisis before the reforms enacted by Governor Scott Walker and the legislature in 2011.

Credibility of Doctors in Fake Sick Note Scam Forever in Question, Attorney Says

By James Wigderson
Special Guest Perspective for the MacIver Institute

One of the more controversial stories to come out of last year’s protests in Madison was the handing out of notes excusing people from work by several doctors right in the Capitol Square. Working out of a tent, the doctors advertised they were handing out medical excuses to the protestors.

First reported by the MacIver News Service, the story of the doctors handing out medical excuses for missing work to protestors in Madison in such a brazen fashion made national news.

Many of the protestors were public school teachers who had been warned they could face disciplinary action for unexcused absences. Mass absences by teachers caused several school districts to close during the protests in February.

The Madison School District closed for four days as a result of the unplanned absences. An investigation by the Madison School District uncovered 84 teachers used what they considered fraudulent sick notes.

Spurred by reports from the MacIver Institute and other organizations about the doctors handing out excuses to the protestors, investigations were launched by the UW School of Medicine and Public Health and by the state Medical Examining Board into the doctors’ conduct.

The state Medical Examining Board disciplined seven doctors with a reprimand for poor record keeping and issued a warning to two other physicians. The board found that they could not determine whether a proper evaluation was done of the patients to justify handing them a medical excuse.

The UW School of Medicine and Public Health had a number of employees involved in handing out medical excuses at the protests but denied any involvement by the school. After an investigation, they told the Wisconsin State Journal that at least a dozen doctors were disciplined for their actions on the mall. The discipline “range from written reprimand to loss of pay and leadership position.”

A further investigation by the Wisconsin State Journal revealed that ten more doctors who were not disciplined by the state also signed sick notes that the district considered fraudulent for Madison School District teachers.

One of the people who saw the tent with doctors handing out medical excuses that day was Milwaukee-based personal injury attorney Kelin Olson.  Despite serious concerns about what he perceives as an anti-trial lawyer bias among Republicans controlling Madison, Olson attended an Americans for Prosperity Rally with family and friends before walking around the Capitol Square to check out the protests.

In an interview Saturday, Olson described his reaction when he saw the tent.

“My first reaction was, I can’t believe they’re doing it so openly. Really, I cannot believe they were so ballsy to just stand there. They’re wearing lab coats, they’ve got clipboards and they’re walking up to people saying, `Do you need an excuse?’”

Comparing them to, “street hawkers,” Olson was shocked at how casual it was.

“They were joking about, `Oh, no, Scott Walker’s got you so stressed you need a day to relax.’ I felt like this was a hippy festival and this was a big joke like you’re going to Woodstock and they’re writing prescriptions to stay off the brown acid or something.”

“I was like, really? You guys are professionals and you have a certain trust from the people of Wisconsin to do the right thing – and this isn’t the right thing. And maybe in their mind they thought it was but it clearly wasn’t the legal thing to do.”

In Olson’s practice as a personal injury attorney, one of the questions that he has to deal with is the credibility of witnesses. In the interview, Olson was asked about that issue with the doctors involved and how it would affect his decision making as an attorney.

Regarding the School of Medicine’s lack of openness regarding the discipline of the doctors involved, Olson said he understood that many disciplinary situations are kept confidential by employers.

However, “If I was going against a doctor in a legal proceeding I would want to know if he participated because it goes to his credibility as a witness. So that’s where my concern would come in.,” Olson said. “If I had a malpractice action or something against the UW doctor and if I didn’t think he was being truthful about what happened, I would want to know if he had lied in the past. Because that’s evidence of character, that’s evidence of, people that commit fraud, that’s a crime you can tell a jury about because it goes to the person’s veracity or credibility.”

“If there’s a doctor who is willing to lie about this, what else is he willing to lie about? People say that it isn’t that big of a deal but it’s still committing fraud.”

Whether Olson would feel comfortable using any of the doctors involved as witnesses, he said that while he would have to interview the doctor, it would be something that could benefit the other side. “If they have been disciplined for fraud, that would be something that I would want to know as an attorney because it does go into whether they would lie to benefit themselves or someone else.”

“Whether or not I would use one of them it depends on the person, depends on the situation, depends what I needed them for. I might, but then again I’d rather not have to deal with that issue.”

Olson also explained that it would depend on the venue. “If you’ve got a jury of people that supported the protesting, you may not mind that you’ve got this doctor because they may give him more credence. So it’s a two-edged sword.” Olson said that Madison, for example, would be more forgiving of the doctor’s actions, while he definitely would not want them as witnesses in Waukesha or Washington County.

In an article for Atlantic Monthly, Dr. Ford Vox said of the physicians handing out the excuses, “They’ve managed to belittle a public trust between physicians, employers and patients.” He added, “These doctors sacrificed a slice of the medical profession’s credibility for a political cause. Was it worth it?”

They also damaged their personal credibility in ways they might never have imagined. Just ask a lawyer.

State’s UI Fraud Crackdown Moves Forward

MacIver News Service | October 24, 2011

[Madison, Wisc...] A Wisconsin Senate committee quickly and quietly approved a bill Monday Morning aimed at cracking down on unemployment insurance fraud.

The Senate’s Labor, Public Safety and Urban Affairs committee unanimously approved SB 219.  Under the bill, anyone who commits unemployment insurance fraud would forfeit payments for those weeks, plus a penalty of 15 percent of the payments.

The fines would be used to set up the unemployment program integrity fund, which would then monitor unemployment insurance fraud in the state.

This move marks a continued effort on the part of the legislature to counter unemployment fraud.  Over the summer the legislature approved a one week waiting period before new beneficiaries could begin collecting benefits.  Supporters said that was an important tool in catching fraudulent claims.

As the MacIver News Service previously reported, unemployment benefit fraud in Wisconsin has skyrocketed over the past few years.  Between 2008 and 2010, the amount of fraudulent payments shot up from $21 million to $78 million. The number of cases increased 130 percent. The amount of overpayments over $1,000 that were intentionally concealed went from $9.25 million in 2007 to $40.5 million in 2010, a 338 percent increase.

Even with the cases of fraud increasing, few people have been successfully prosecuted for it.  In order to face punitive action, a person must have fraudulently received more than $5000 in benefits and committed 5 acts of concealment. In 2010, 2,169 people met those requirements, yet only 31 of them were prosecuted. That resulted in 11 convictions.

Inmates’ Receipt of Unemployment Bennies Costing State Big Bucks

MacIver News Service | September 14, 2011

[Madison, Wisconsin] Hundreds of individuals in Wisconsin’s county jails and prison system are illegally receiving unemployment benefits, the MacIver News Service has learned.

In March, the Department of Workforce Development (DWD), started to cross match their data with the Department of Health Services to combat inmate fraud in unemployment insurance claims. As of September 2, the number of over-payments to 236 inmates was $325,416.

According to an official in the Department of Workforce Development about 75-135 jailed individuals receive unemployment insurance on a monthly basis.

DWD Deputy Administrator Andrea Reid deemed about half of these claims to be fraudulent. The other half would be people who are booked over-night or jailed on a short-term basis who therefore are still eligible to file and receive payment for unemployment claims.

“The typical scenario for inmate fraud is the spouse, the girlfriend, the mom, actually reporting for that claimant,” said Reid.

The MacIver News Service recently reported on the Governor’s Commission on Waste, Fraud and Abuse, where a new system to combat UIf fraud was discussed.

Unemployment benefit fraud in Wisconsin has skyrocketed over the past few years.  Between 2008 and 2010, the amount of fraudulent payments shot up from $21 million to $78 million. The number of cases increased 130 percent. The amount of overpayments over $1000 that were intentionally concealed went from $9.25 million in 2007 to $40.5 million in 2010, a 338 percent increase.

Even with the cases of fraud increasing, few people have been successfully prosecuted for it.  In order to face punitive action, a person must have fraudulently received more than $5,000 in benefits and committed 5 acts of concealment. In 2010, 2,169 people met those requirements, yet only 31 of them were prosecuted. That resulted in 11 convictions.

Recently, the Wisconsin legislature passed a one-week waiting period before would-be recipients can receive UI benefits. This move, criticized my many legislative Democrats as cruel, is expected to save the state up to $50 million a year as the extra time will allow the state to investigate the validity of claims.

“The one week waiting period was a 55 million dollar highway robbery of workers without any recommendation from the advisory council,” said Senator Bob Jauch (D-Poplar) during legislative debate on the waiting period.

Jauch and many of his fellow Democrats were upset that the legislature was acting upon an unemployment-related policy item without the direction of the Unemployment Insurance Advisory Council. But Republicans, including DWD brass, argued the move was an integral component of their plan to root out fraud.

“[The waiting period] actually ends up saving us about $50 million a year, because if you look at the first week when a termination or a resignation occurs, it gives the department the opportunity to evaluate what is that particular employee owed, if anything,” DWD Secretary Scott Baumbach to the MacIver News Service this summer. “It cuts down on over payments.  It cuts down on fraud.”

The DWD says it plans on soon running cross matches with with the Department of Justice (DOJ) as well as Department of Health Services.  According the Reid, the cross match with DOJ, “will be much more timely and should reduce over-payment amounts.”

Because of the surge in unemployment claims made by its residents in 2009 and 2010, Wisconsin owes the federal government more than $1.3 billion. Plus interest.

If the amounts in Wisconsin’s Unemployment Reserve account in the U.S. Treasury are not sufficient to cover anticipated unemployment payments, the state can borrow funds from the federal government. In February 2009, it went insolvent. At the end of the first quarter of the year, the balance of the loan was at its peak ($1.6 Billion). At that time Wisconsin had the 11th highest loan of any state, and the 4th highest in the nation as a percent of total wages.

Wisconsin Continues Fight Against Welfare Fraud

MacIver News Service | September 11, 2011

[Madison, Wisc...] Fraud continues to be discovered within the controversial child care program known as Wisconsin Shares.

A total of $305,619 in overpayments to suspended providers were newly reported to lawmakers last month, bringing the cumulative total overpayments to suspended child care providers in the program to more than $8.1 million.

The program, aimed to help low-income families pay for child care, continues to be riddled with waste, fraud and abuse according to the latest report from the Department of Children and Families. In July, the Department of Children and Families spent $205,200 on fraud prevention and investigation, and had $44,300 in expenses related to recovering overpayments due to error or fraud.

As a result of those $249,500 in expenditures, DCF recovered $249,689 in overpayments and/or restitution in July ($57,210 in child care overpayments to individuals and $192,479 in overpayments to child care providers).

The Department has been required to provide the legislature’s Joint Committee on Finance with monthly reports since mid 2009 after widespread reports of abuse within the program.

During July, seven more child care providers were suspended from participating in the Wisconsin Shares program.

GOP Senators Drop Waiting Period for Benefits, Could Cost State $50 Million

MacIver News Service | July 19, 2011

[Madison, Wisc...] A Senate amendment passed Tuesday afternoon could eliminate a proposed one-week waiting period on unemployment benefits, which could cost the state in excess of $50 million a year from unemployment benefit fraud and lost administrative savings.

The bill before the Senate Tuesday would allow the state to accept federal funds to extend unemployment benefits to recipients for another 13 weeks.  That extension would be funded mostly by the federal government, but would also require a contribution from Wisconsin employers. It would not, however, add to the loan balance with the feds.The Senate approved the extension Tuesday by a vote of 30-3, with Republican Senators Grothman (West Bend), Lazich (New Berlin) and Zipperer (Pewaukee) voting no after the body added an amendment removing a required one-week delay in receiving benefits.

The amendment undid a change in state law that was included in the just-passed state budget.  That amendment could cost between 41 and 56 million dollars, annually. The Assembly had been expected to approve the plan on Wednesday. Governor Scott Walker had indicated he was prepared to sign the original proposal, which was recommended by the Unemployment Insurance Advisory Council earlier this year.

“The extended benefits will help the worker out.  The one-week waiting period actually helps the department out,” Secretary Scott Baumbach, Department of Workforce Development, told the MacIver News Service earlier.  “It actually ends up saving us about $50 million a year, because if you look at the first week when a termination or a resignation occurs, it gives the department the opportunity to evaluate what is that particular employee owed, if anything.  It cuts down on over payments.  It cuts down on fraud.”

During the floor debate, Democrats criticized the waiting period.

“The one week waiting period was a 55 million dollar highway robbery of workers without any recommendation from the advisory council,” said Senator Bob Jauch (D-Poplar).

However, Baumbach explained to the MacIver News Service, “It doesn’t mean that the employee loses a week.  It actually shifts to the back end.”

Andrew Welhouse, Senate Majority Leader Fitzgerald’s spokesman, said even though the amendment was approved by the Senate, it is not yet set in stone.
“It was put in because our senators are trying to work together to get to the right answer to help people who are out of work and struggling,” Welhouse said.  “There are still a lot of discussions back and forth between the Assembly, the Governor’s Office, and the Senate about this specific issue.”

Senator Rich Zipperer, (R – Pewaukee) objected to the change, saying “this will increase the cost of the bill without any plan to pay for it.  We are trying to restrain spending and pass balanced budgets in Wisconsin and this change goes in the other direction.”

The Department of Workforce Development hoped the $50 million could be used toward paying back the $1.3 billion the state burrowed from the federal government for unemployment benefits.  As MNS reported earlier, Wisconsin’s unemployment reserve fund has been insolvent for over two years.

Fraud Within Wisconsin’s Taxpayer-Subsidized Day Care Program Continues

MacIver News Service | November 17, 2010

[Madison, Wisc...] Another month brings more news of continued fraud within the controversial child care program known as Wisconsin Shares.

$526,039 in overpayments to suspended providers were newly reported this month, bringing the cumulative total overpayments to suspended child care providers in the program to more than $5.8 million.

The program, aimed to help low-income families pay for child care, continues to be rife with waste, fraud and abuse according to the latest report from the Department of Children and Families.

In October, the Department of Children and Families spent $295,200 on fraud prevention and investigation, and had $42,100 in expenses related to recovering overpayments due to error or fraud.

As a result of those expenditures, DCF recovered $142,087 in overpayments and/or restitution in September  ($47,843 in child care overpayments to individuals and $94,244 in overpayments to child care providers).

Eleven more child care providers were suspended from participating in Wisconsin Shares in September, bringing the total number of suspended providers to nearly 200.

The Department has been required to provide the legislature’s Joint Committee on Finance with monthly reports since mid 2009 after widespread reports of abuse within the program.

New Month, More Fraud Found in Wisconsin Shares Program

MacIver News Service | October 18, 2010

[Madison, Wisc...] Another month brings more news of continued fraud within the controversial child care program known as Wisconsin Shares.

The program, aimed to help low-income families pay for child care, continues to be subjected to waste, fraud and abuse according to the latest report from the Department of Children and Families.

The Department has been required to provide the legislature’s Joint Committee on Finance with monthly reports since mid 2009 after widespread reports of abuse within the program.

In September, the Department of Children and Families spent $229,700 on fraud prevention and investigation, and had $35,900 in expenses related to recovering overpayments due to error or fraud.

As a result of those expenditures, DCF recovered $175,899 in overpayments and/or restitution in September  ($38,161 in child care overpayments to individuals and $137,737 in overpayments to child care providers).

$559,099 in overpayments to suspended providers were newly reported this month, bringing the cumulative total overpayments to suspended child care providers in the program to more than $5.2 million.

Ten more child care providers were suspended from participating in Wisconsin Shares in September, bringing the total number of suspended providers to nearly 170.

Feds and Locals Disagree on FoodShare Fraud in Wisconsin

The same week Wisconsin Lawmakers expressed concern over fraud in the state’s FoodShare Program, the U.S. Department of Agriculture announced Wisconsin’s program is one of the most accurate in the country and will be rewarded with an extra $3 million.

“We have worked very hard in Wisconsin to make sure the right people have the right benefits at the right time. And we are proud to be a national leader on an important issue for the health and well being of people across Wisconsin. These bonus awards prove that our hard work is paying off and that hundreds-of-thousands of people in Wisconsin are getting the food benefits they’re entitled to,” said Tom Vilsack, USDA Secretary.

However, recent investigations by Racine County and the Racine Journal-Times reveal the right people are not getting the right benefits at the right time.

“County officials announced in May that they had uncovered massive fraud in the state’s FoodShare program, which provides families in need with debit-like cards that allow them to purchase food,” reported the Racine Journal Times earlier this week.

“FoodShare cards are being sold, and anyone can use the card as long as they have a pin number,” Racine County Human Services Fraud Supervisor Susan Keown told the paper. That transaction is also enabled by federal rules that state people do not have to show identification to use the cards.

This problem has not escaped Wisconsin lawmakers. At a Joint Finance Committee meeting on Wednesday, members discussed possible steps the state could take to stop FoodShare fraud.

“The effort here is to get food to folks who are really struggling, but there are individuals taking advantage of this program,” said Senator John Lehman, D-Racine.

“We have seen that efforts throughout the state have really been lax with people who are committing this kind of fraud. We know that in other states like Michigan, they have thousands of people who are prosecuted for Foodshare fraud. I think in Wisconsin I think it was 60,” said Representative Robin Vos, R-Racine.

A recent audit that uncovered massive fraud in the state’s child daycare programs has prompted the Legislative Council to conduct a study of public assistance program integrity.

Senator Bob Jauch, D-Poplar, has been named the chair of that committee. His office did not return a message from the MacIver News Service whether FoodShare would be included in that study.

At the Joint Finance Committee meeting, Senator Lehman said, “We’re making every effort to get FoodShare included in the subject of that study committee. I believe that’s going to happen. But whatever we can do here in Madison to help out the reporting and the prosecution of any kind of fraud just gets more food and more resources to people who really need it.”

Representative Vos added it is important “that we don’t wait until February to start going after people that commit fraud.”

However, the Legislative Council said the study’s first meeting won’t happen until August or September. It will meet once or twice a month for the rest of the year. The committee will try to have recommendations ready for the next legislature at the start of the new session in January.

  • Print
  • Email This Post Email This Post
  • Share

Recent Posts


MacIver on facebook @MacIverWisc on twitter MacIver Youtube channel subscribe