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Contributor
Ray
Haynes
Mr.
Haynes is an Assembly member representing Riverside and
Temecula.
He serves on the Appropriations and Budget Committees. [go to
Assembly Member Haynes
website at California Assembly][go to Haynes index]
 Welfare Fraud
Fraud
Legislative
oversight fantasies...
[Ray
Haynes] 3/31/04
I have been losing my hair since I joined the Legislature.
It is not because of age; it is because of frustration. The more
I hear about government, the more frustrated I get, and the more
hair I lose.
Let me give you an example.
In the last
several weeks, the Legislature, for the first time in the 12
years
I have been a part of this process, has begun “budget
oversight” hearings. This week’s hearing was on the
Medi-Cal fraud and investigations unit.
Now—let me make this clear. We are not looking into “beneficiary” fraud,
the fraud where someone gets free medical services from the government
for which they don’t qualify. In some cases, the state
doesn’t even check to see if you are poor before they pay
for your doctor. And—if you crossed our borders illegally—well
heck, we just pay for everything.
But, the
legislature doesn’t want to look at that kind
of fraud. It only wants to investigate “provider” fraud—when
a doctor bills for services he or she doesn’t perform.
Or, when someone who is not a doctor tries to bill the state
for medical services. The fraud unit has 395 budgeted positions,
at a cost of about $10 million per year to stop this kind of
fraud, and the Legislature finally decided to look and see if
this unit was doing its job.
This unit
claims that it saved us $371 million last year for all the
bad guys
it caught, and that $316 million worth of fraud
will be avoided this year, just because they are on the job catching
the crooks. Except that a recent audit found that these estimates
are “unreliable and may overestimate savings.” It
turns out that their “savings” are calculated by
counting all of the billings of any one they catch as savings.
What that means is—if you billed $5 million last year,
and they catch you cheating on $10,000 in billing, they count
the entire $5 million as savings, even if the other $4,990,000
was legitimate. As for the “cost avoidance,” that
estimate is just plain blue sky.
The state
has expanded this division 240% in the last 3 years, but only
collected
back about $3 million from those who ripped
off the state. Nobody knows if this “anti-fraud” program
is working at all, yet the department has come in asking for
61 new positions next year. And they did it with a straight face,
saying they are fighting fraud. Well—maybe they are and
maybe they’re not—no one knows for sure, and the
State Auditor has a lot of questions concerning their performance.
What is frustrating is that I asked these same questions 3
years ago (the same ones that the State Auditor just asked),
when the Legislature started expanding the program, and I was
told not to worry my pretty little head about it, they knew what
they were doing.
Except they
didn’t.
Now we are trying to concentrate on stopping welfare fraud,
and the same people who were in charge
of screwing up the program in the first place are in charge of
fixing it.
Lots of
people at Enron went to jail for fraud for selling less blue
sky than
these bureaucrats. How can we expect to stop
fraud when the people we are hiring to catch the perpetrators
are themselves engaging in a massive fraud to get your tax dollars,
and the majority Democrats didn’t care (until this year)
whether these bureaucrats were doing their job or not.
I regret
that I have only one head of hair to give for this state. At
this rate,
it isn’t going to be enough. CRO
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