Business & Economy
Baucus, Grassley Uncover Gaming of the Medicare System by For-PROFIT Home Health Companies PDF Print E-mail
News Releases - Business & Economy
Written by Grassley Press   
Monday, 03 October 2011 14:11
Finance Senators Release Report Showing Companies Intentionally Increased Frequency of Home Health Visits to Manipulate Reimbursement Rates

Washington, DC – Senate Finance Committee Chairman Max Baucus (D-Mont.) and senior Finance Committee Member Chuck Grassley (R-Iowa) today released a Finance Committee staff report showing tactics used by major for-profit home health companies to game Medicare.  The result has been waste of taxpayer dollars and the delivery of what could be medically-unnecessary patient care to increase the companies’ profits.  Baucus and Grassley initiated the investigation into the improper practices as part of the Committee’s oversight role of the Medicare and Medicaid programs and the Senators’ ongoing commitment to protect patients and taxpayer dollars from waste, fraud and abuse.

“The gaming of Medicare represents serious abuse of the home health program,” said Baucus.  “Elderly patients in the Medicare system should not be used as pawns to increase a company’s profits. Especially in these tough economic times, taxpayers simply cannot afford for their dollars to be wasted on unnecessary care.  We are going to continue to crack down on these companies to ensure taxpayer dollars are used efficiently and Medicare patients are protected.”

“The reimbursement policy encourages gaming, and gaming is what’s occurred.   Companies are doing everything they can to make as much money as possible, whether the patients need the care or not.  The federal government needs to fix the policy that lets Medicare money flow down the drain.  This can’t wait until tomorrow.  It should have been done yesterday.  The longer this kind of policy continues, the more Medicare’s budget balloons, and the bigger the burden on taxpayers,” Grassley said.

In May 2010, Baucus and Grassley began their investigation into home health therapy practices at Amedisys, LHC Group, Gentiva, and Almost Family in response to a media report that these home health companies took advantage of the Medicare therapy payment system by providing medically-unnecessary patient care.

The Committee staff report released today examines documents provided by the companies which show how therapists were encouraged to target the most profitable number of therapy visits, even when patient need may not have required such visits.  In addition, therapy visit records for each company showed concentrated numbers of therapy visits at or just above the point at which a “bonus” payment was triggered by the Medicare program.

Internal documents from three of the four companies, Amedisys, LHC Group and Gentiva, provided evidence of top-down strategies to game Medicare.  Highlights from the report include:

  • Managers encouraged therapists to meet a 10-visit target that would have increased their payments from Medicare.
  • An “A-Team” tasked with developing programs to target the most profitable Medicare therapy treatment patterns.
  • Therapists and regional managers that were pressured to follow new clinical guidelines developed to maximize Medicare reimbursements.
  • Top managers instructed employees to increase the number of therapy visits provided in order to increase case mix and revenue.
  • A competitive ranking system for management aimed at driving therapy visit patterns toward profitable levels.
  • Evidence that management discussed increasing therapy visits and expanding specialty programs to increase revenue.

The Medicare Part A program pays out an estimated $19 billion yearly for home health care.  Fraud, waste and abuse in the health care system cost Americans an estimated $60 billion a year, approximately three percent of total health care spending.

Baucus and Grassley have led numerous major investigations of the health care industry to protect consumers and taxpayer dollars.  Earlier this year, when their investigation found that the drug company Sanofi interfered in the approval of generic alternatives to its blood-thinner drug Lovenox, the Finance leaders called on the Food and Drug Administration (FDA) to help guarantee consumers have access to affordable generic medications.  Last December, Baucus and Grassley released a report detailing the relationship between Abbott labs and a Maryland doctor who allegedly implanted nearly 600 unnecessary cardiac stents into his patients, costing the federal government as much as $3.8 million in overpayments.  The specific stent case highlighted in the Senators’ report is indicative of a widespread, national problem of unnecessary stenting.  The Senators also spearheaded a two year inquiry which revealed undisclosed side effects of the diabetes drug Avandia.  This resulted in the FDA restricting use of the drug, ensuring that patients and doctors have the information they need to make safe, informed decisions about their medication.

The Committee’s full report is available here.


Morthland's Gas Tax Report Released PDF Print E-mail
News Releases - Business & Economy
Written by Rich Morthland   
Monday, 03 October 2011 14:08

Moline, IL...State Representative Rich Morthland's (R-Cordova) House Resolution 328 directed the Illinois Commission on Government Forecasting and Accountability to conduct an objective, non-political examination of the State's policy of charging "ad valorem" Illinois sales taxes on motor fuel. This report revealed various factors contributing to the price of gas sold in Illinois.

"Our gasoline sales tax of 6.25% makes Illinois the 3rd highest total tax on fuel in the nation," Morthland said. "This tax has a compounding effect as it increases when gas prices increase. This contributes to flight to Iowa and other states that don't have such a punitive tax structure." Morthland continued, "When we buy our gas in Iowa, it's not uncommon to pick a few groceries or other items there." 

The COGFA report speculates that this tax structure has a negative on business in Illinois.

"It's nice to have the income, but it's not necessarily a good dollar in if it's hurting our state and derailing Illinois jobs by pushing sales across state borders," Morthland said. "I am working on a form of tax relief for border communities in Illinois to restore our competitive edge."


Iowa Farm Bureau Study Estimates Missouri River Flooding at $207 Million in Crop and Economic Losses PDF Print E-mail
News Releases - Business & Economy
Written by Iowa Farm Bureau   
Monday, 03 October 2011 14:06


WEST DES MOINES, IOWA – Oct. 3, 2011 – This year’s devastating flooding on the Missouri River caused an estimated $207 million in lost crop sales and related economic activity in six western Iowa counties that border the river, according to a new study commissioned by the Iowa Farm Bureau Federation (IFBF).

The flooding began in late June when the U.S. Army Corps of Engineers opened up a series of dams in the Dakotas to release water caused by heavy snows and record rains. Farmers are finally seeing the floodwaters recede and assessing the damage which includes severely damaged roads and the destruction of several hundred thousand acres of corn and soybean fields.

The study focused on Fremont, Pottawattamie, Mills, Woodbury, Harrison and Monona counties and analyzed the direct and indirect economic impacts from crop losses from flooded fields, said Dave Miller, IFBF director of research and commodity services. The study also factored in the impact of lost wages as the income of the lost crops won’t circulate in the western Iowa communities.

“This study shows the repercussions of the lost cropland and economic activity in these counties,” added Miller. “On a business level, farmers won’t be purchasing machines or inputs such as fertilizer for land. But there is also a household effect with reduced expenditures in those counties.”

For the farmers in the six-county region, the flooding cost $46.1 million in net income compared to pre-flood estimates.  That total included losses on flooded acres that can’t be harvested, as well as yield losses from affected crops that were within a mile of the flooded area. The study also factored in the cost of seed, fertilizer and other inputs that farmers had already invested in their 2011 corn and soybeans before the fields were damaged or wiped out by flooding.

The study also accounted for potential crop insurance indemnity payments that farmers will receive because their crops were destroyed, as well as payments from the U.S. Department of Agriculture’s Supplemental Revenue Assistance payments (SURE) program, which provides financial assistance for crop production and or quality losses due to a natural disaster.

Fremont County suffered the highest losses, at an estimated $52.2 million; with $43.9 million in direct crop income loss and $8.3 million indirect losses from the damaged fields. Harrison County suffered $36.7 million in crop and other economic losses, and Monona County lost $32.3 million.

Losses in the remaining Missouri River counties were: Pottawattamie at $31.2 million; Mills at $22.2 million and Woodbury at $14.7 million.

Miller emphasized that the study measured losses of economic activity from lost crop sales and didn’t factor in losses to personal property, or the steep cost of rebuilding roads, levees and other infrastructure damaged or destroyed by the months of flooding.

“This is really just the tip of the iceberg on economic losses from the flooding,” Miller said. “But we hope this study will provide valuable information to help farmers, community leaders and lawmakers as they rebuild the region and push for policies to prevent or minimize flooding in the future.”


Q & A on Chinese Currency and U.S. Exports with U.S. Senator Chuck Grassley PDF Print E-mail
News Releases - Business & Economy
Written by Sen Charles Grassley   
Monday, 03 October 2011 13:01

Q:        What’s the effect on Americans when China undervalues its currency?

A:        China’s policy of intervening in its currency markets to limit or halt the appreciation of its currency, the yuan, against the U.S. dollar or other currencies has the effect of keeping Chinese exports cheap and imports expensive, putting some U.S. businesses at a disadvantage.  That has a negative effect on U.S. jobs.  It’s also an unfair and unlawful trade advantage for China to subsidize its exports.  New market opportunities are needed for job creation here at home, and market-based currency policy is an important factor in free and fair trade relationships.  Iowa has long been an exporting state, with good-paying jobs related to exports in manufacturing and agriculture.  One in every three tractors made in John Deere’s plant in Waterloo is sold to customers overseas.  One in every three acres planted on Iowa farmland heads to the international marketplace.  Ag exports account for one-quarter of farm cash receipts in Iowa.  U.S. exporters deserve a level playing field with China’s exporters.

Q:        What can be done?

A:        By law, the Treasury Department is required to name any country it suspects of manipulating the value of its currency to gain an unfair advantage in international trade.  Unfortunately, for too long, presidential administrations of both parties haven’t done what the law allows.  The current debate in Congress over China’s currency policy draws from more than five years of legislative proposals that would induce China, and other countries manipulating their currencies, to reform its currency policy or to address the effects of that policy on the U.S. economy.  I’ve introduced bipartisan legislation in the past, and this fall there is a proposal with bipartisan support to increase U.S. oversight of currency manipulation.  The measure would trigger meaningful consequences for countries that fail to adopt appropriate policies to eliminate currency misalignment and make sure U.S. trade laws may be used to counter the economic harm to U.S. manufacturers caused by currency manipulation, in accordance with international trade laws.

The executive branch also can and should prepare a case against China’s currency manipulation in the World Trade Organization, the 153-member organization (made up mostly of sovereign nations) that governs international trade.  The framework for World Trade Organization policies is based on the principles of non-discrimination, reciprocity, binding and enforceable commitments, transparency, and safety valves.  In joining the World Trade Organization ten years ago, China committed to adhering to the trade rules of the global marketplace.  If China is not willing to live up to its obligations, the behavior should be challenged under the international rule of law.


September 30, 2011

Road to Recovery by U.S. Senator Chuck Grassley PDF Print E-mail
News Releases - Business & Economy
Written by Sen Chuck Grassley   
Monday, 03 October 2011 08:50

As Americans stare down a road of economic uncertainty, the White House has issued yet another spending plan that it says will put Americans back to work.  Shoveling more tax dollars out the door can’t make up for the President’s first stimulus plan that turned out not to be so shovel-ready after all.

Adding insult to injury, the President is pitching to pay for his $447 billion plan by raising taxes.  He says it’s a matter of fairness.  Fair to whom?  Raising taxes on small business owners will not help create jobs.  Instead of rewarding risk and ambition, the President’s so-called Buffett Rule would siphon away job-creating capital and investment for Main Street and send it to Washington to spend.

Considering Washington’s poor track record for prudent fiscal stewardship, it doesn’t make sense to believe that raising taxes on the wealthy will solve Washington’s deficit disorder.

Just consider a recent audit by the internal watchdog at the U.S. Justice Department.  The analysis revealed extravagant spending on the taxpayer’s dime, including conference fees charging $16 per muffin and $8.24 per cup of coffee.  Has the federal bureaucracy even heard of sticker shock?  The taxpaying public deserves better.  The audit exposes yet another example of the type of excessive, wasteful spending that tells taxpayers Washington just doesn’t get it.  In fact, spending by the Justice Department on conferences has increased from $48 million in 2008, to $73 million in 2009 and $92 million in 2010.

And yet the President is trying to score political points with what he’s calling the Buffett Rule, named after the billionaire investor who likes to say he doesn’t pay enough taxes.  First, let’s be clear on one point.  No one is stopping Warren Buffett from sharing more of his income with Uncle Sam.  But it’s irresponsible and disingenuous for the President to portray the Buffett Rule as the solution to the federal government’s enormous budget shortfall.  In fact, the Buffett Rule is just another, more complicated version of the Alternative Minimum Tax, or AMT.  The AMT, originally intended to tax a small number of rich individuals who didn’t pay any federal tax, now hits millions of middle-class families.  Those wealthy who don’t want to pay any tax will always have an army of lawyers and accountants to help them.  An additional AMT isn’t going to change that.

What’s more, penalizing risk-takers and job creators will not help grow the economy. Strangling small businesses with red tape doesn’t help create jobs.  We need public policy to promote wealth creation, not to stifle ambition.

As policymakers, analysts and investors try to find a pulse in the U.S. economy, American households are hesitant to spend and businesses are bracing for slower growth.  With 25 million Americans looking for work, job creation is priority number one. Consumer confidence won’t recover without paychecks.

Partisanship and poll-driven ideology such as the Buffett Rule need to take a back seat. Instead, Washington needs to let America’s entrepreneurs; innovators and risk takers get America back on the road to economic recovery.

Congress gave the green light to ramp up America’s entrepreneurial spirit with passage of the America Invents Act.  As a sponsor of the bipartisan patent reform legislation signed into law in September, I worked to protect inventors’ rights and shift innovation and investment in our economy into the fast lane.

The new law gives fast-track approval process to start-ups, cutting an average wait time. When entrepreneurs need critical investment to get their business off the ground and running, patent ownership can mean the make-or-break difference.

Getting ideas, inventions and goods to the market sooner will help foster economic growth and employment on Main Street USA.  The America Invents Act addresses the backlog at the U.S. Patent and Trademark Office and recognizes the outdated patent review system slows innovation with costly litigation and delays.

The newly updated patent laws will give America’s scientists, researchers and engineers an edge in the global marketplace.  Public policies that clear the way for American businesses to compete and give consumers what they want will help put America on the path towards long-term prosperity.  Washington needs to steer clear of regulatory roadblocks and burdensome taxes that would send the U.S. economy in the wrong direction.

Let’s be clear.  The Buffett Rule would not help the U.S. avoid a double-dip recession or encourage employers to put Help Wanted signs in their storefronts on Main Street.

Tuesday, September 27, 2011

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