Friday, March 30, 2012

Medicare Fraud

Mark Mandell

It takes nothing more than Googling the words “Medicare Fraud Strike Force” to realize our country has a growing problem; Medicare fraud.

Since their creation in early 2007, the Medicare Fraud Strike Force (MFSF) has placed charges on over 1,190 individuals who falsely billed the Medicare program for over $3.6 billion. MFSF operates in over nine districts, including Michigan where instances of Medicare fraud are far from rare.

In January, the U.S. Attorney’s Office filed a complaint against Universal Imaging, Inc., a Michigan company that fraudulently received over $1.56 million in Medicare kickbacks (accounting for over 90% of their business).

More recently in March, three Detroit-area clinic owners pleaded guilty to conspiracy to commit health care fraud. Estimates based off court documents suggest the three clinics billed Medicare for over $5.4 million during the course of their scheme. Each defendant faces a maximum penalty of 10 years in prison and a $250,000 fine.

With dollar amounts easily climbing into the millions and no end in sight, Medicare fraud certainly deserves our attention.

To learn more please visit:

http://www.justice.gov/opa/pr/2012/March/12-crm-323.html

http://www.justice.gov/usao/mie/news/2012/2012_01_06_universal_image.html

Veterans May See Increase in Mental Health Care Spending

Jim Fausone
Veterans Disability Lawyer


The proposed budget for the U.S. Department of Veterans Affairs 2013 fiscal year includes an increase in the funding for mental health care treatment of more than 5 percent.

This bump in funding represents an increase in the VA’s commitment to the mental health care of veterans as another one million active duty personnel join the ranks of veterans over the next five years.

The VA’s proposed $6.2 billion mental health care budget would help first with outreach and screenings since so many of the country’s veterans in need are suffering in silence. The money also would go toward programs that help reduce the stigma that can go along with mental health issues.

The mental health care budget also would support new technologies for self-assessment and post-traumatic stress disorder symptom management.

That’s only part of the VA’s massive $140 billion budget. Another part of the health care budget not included in the $6.2 billion set aside for mental health care is about $583 million in medical research appropriations. This money, along with $1.3 billion from other sources, goes to researching traumatic brain injury, PTSD and suicide prevention.

Thursday, March 29, 2012

PTSD & Prescription Drug Addiction

Jim Fausone
Veteran Disability Lawyer

With the Iraq and Afghanistan troops heading home, the challenges are considerable. VA, which does a great deal of medical research, recently issued a large scale report looking at mental health problems and drug prescription. Recent veterans with mental health diagnoses, particularly post-traumatic stress disorder, were significantly more likely to receive prescriptions for oxycodone, hydrocodone and other opioids than those with pain but no mental health issues. The veterans with mental health diagnoses who were prescribed the powerful, euphoria-causing and potentially addictive drugs had worse outcomes, with more overdoses, accidents and risky use patterns, the study found. VA needs to improve care of patients with "comorbid pain and PTSD because of the heightened risk of self-medication with opioids and substance abuse in veterans with PTSD, which may result in further declines in interpersonal and occupational functioning” according to Dr. Robert Kerns, the national director for pain management at the VA.

Family members should watch out for this troublesome combination of pain, PTSD and prescription opioids. This could become a quick slide down a very rough mountain.

http://www.stripes.com/news/va-study-ptsd-patients-more-often-prescribed-potent-opioids-1.170782

Wednesday, March 28, 2012

Personality Disorder Really?

Jim Fausone
Veterans Disability Lawyer

The military is about fitting in, not being different. Some men who join up just seem to take longer to fit in. The enlisted corp requires you to fit in fast or be labeled as unfit or something worse. You could get labeled with a personality-related diagnoses which are considered pre-existing conditions by the Department of Defense.

The data showed that 31,000 servicemembers were discharged from 2001 to 2010 because of personality disorders, a group of disorders in which a person’s behaviors and thoughts differ from their culture’s expectations, causing work and relationship problems. A recent GAO report indicates that DOD is slow to get it right about servicemen who do not fit in - do they have a pre-existing condition or a disability like PTSD or TBI. As the spotlight remains on the DOD to treat servicemen and women properly, we can only hope the 31,000 improperly discharged get the help to put their lives back in order.

http://www.stripes.com/news/veterans/veterans-study-thousands-wrongfully-discharged-for-personality-disorders-1.172678

Tuesday, March 20, 2012

VA Budget Includes Health Care Money for Women Veterans

Jim Fausone
Veterans Disability Lawyer


A specific line-item made its way into President Barack Obama’s 2013 fiscal year budget for the Department of Veterans Affairs that will devote funding to the gender-specific health care needs of women veterans.

The President’s $140 billion VA budget includes $403 million for women veterans’ health care needs and improving their access to services.

Research from the National Center for Biotechnology Information found that women veterans have different health care needs beyond the traditionally different health care needs of men and women. Combat conditions are different for women because they are often expected to take on different roles. Those conditions have a different effect on women because of an increased prevalence of certain conditions in women and gender-specific issues that only affect women.

Likewise, women veterans are going to have separate health care needs beyond those of civilian women. Women who enter the military tend to have specific socio-economic factors and life experiences. Additionally, exposure to certain chemical, environmental and stress will affect a woman veteran differently, according to the NCBI research.

The President’s budget includes $52.7 billion for medical care, which is a 4.1 percent increase over the previous year.

Thursday, March 15, 2012

American Legion Birthday

Jim Fausone
Veteran Disability Lawyer

Veteran Service Organizations (VSOs) plan an important role for veterans including re-integration, education of benefits, and camaraderie.

March 15 is the birthday of the American Legion. In 1919, the first American Legion caucus, held by members of the American Expeditionary Force, convened in Paris. March 15 is the date when the American Legion came to life. They did not form the organization out of self-interest. The bedrock of their existence would revolve around four pillars — a strong national defense, Americanism, support for veterans and mentoring our youth.

Today, the American Legion remains vital and as its Preamble to the Constitution of The American Legion states:

“For God and Country, We associate ourselves together for the
following purposes:

“To uphold and defend the Constitution of the United States of
America; to maintain law and order; to foster and perpetuate a
100 percent Americanism; to preserve the memories and incidents
of our associations in the Great Wars; to inculcate a sense of
individual obligation to the community, state and nation; to combat
the autocracy of both the classes and the masses; to make right
the master of might; to promote peace and good will on Earth;
to safeguard and transmit to posterity the principles of justice,
freedom and democracy; to consecrate and sanctify our comradeship
by our devotion to mutual helpfulness.”

Happy birthday Legionaries and keep up the good work.

Wednesday, March 14, 2012

Time to Stop Michigan Fraud

Jim Fausone

All you have to do is read the papers or online local news to realize that fraud, waste and abuse in government contracting and programs is running rampant. I will leave it to the psychiatrists to figure out why human nature leads people to take advantage of government programs. But the way to stop it is allow anyone to sue and recover from the wrong doer. This is one state's efforts.

An overhaul of the State of Washington’s Medicaid fraud recovery efforts to cut waste and recover taxpayer dollars was passed by the Legislature. Experts from the National Conference of State Legislatures estimate the cost of Medicaid fraud accounts for 3 and 10 percent of total Medicaid expenditures. Washington spent $8.5 billion on Medicaid last year only to recover less than $20 million in fraud. At its most optimistic, the state’s recovery rate tops out at less than 1 percent so more simply has to be done.

Michigan has a similar statute which is limited to Medicaid fraud. Let’s open it up and let citizens sue on all government programs. You can read more about Washington State's efforts at: http://www.maplevalleyreporter.com/news/142212725.html

Tuesday, March 13, 2012

Four U.S. Cities Getting New VA Hospitals Soon

Jim Fausone
Veterans Disability Lawyer


Four U.S. cities are in line to get shiny new VA Hospitals during the next few years including Denver, Las Vegas, Orlando and a hospital in New Orleans. The new VA hospital in the Big Easy will replace the one destroyed by Hurricane Katrina in 2005.

The Department of Veterans Affairs has earmarked about $792 million of the fiscal year 2012 budget toward the final stages of completion for the new hospitals. That is less than one half of a percent of the VA’s massive $140 billion budget.

The new VA Hospital in New Orleans is under construction in the mid-city area of town. Congress appropriated funds for a new VA hospital in New Orleans in 2006 after Hurricane Katrina destroyed the city’s former facility.

The replacement medical center in New Orleans is a 1.5 million square foot hospital with 120 inpatient beds and 60 beds for transitional care. The new VA hospital is being built to withstand hurricanes like the one that shut down its predecessor. It will be able to run for a week without resupply, it has a heliport and boat docks for evacuations and all mission-critical technologies are stored 20 feet above ground, according to the VA.

The new VA Southern Nevada Healthcare System in Las Vegas is scheduled to open this year. The Vegas VA hospital will have will have 201 beds in both inpatient and nursing home/extended care. It will be more than 1 million square feet on about 150 acres at 6900 N. Pecos Road in Las Vegas.

In Orlando, Florida, the new VA Medical Center will be co-located with the University of Central Florida College of Medicine, the Nemours Children’s Hospital, the Burnham Institute and the University of Florida College of Medicine in an area known as Medical City.

The 314-bed Orlando VA will have 1.2 million square feet and cost about $665 million. The beds will be split between inpatient services, community living center and domiciliary. The Orlando VA hospital is expected to open in 2012.

Finally, the new VA hospital development in Denver, known as Project Eagle, is a $580.2 million facility on the site of the former Fitzsimmons Army Medical Center. The 180-bed Denver VA Medical Center will include a 30-bed center for spinal cord injuries and disorders. Project Eagle is expected to finish in early 2015.

The next four cities on the VA’s list for new medical centers are Seattle, St. Louis, Dallas and Palo Alto, California, according to the VA’s 2013 fiscal year budget proposal.

All of these centers will be dedicated to the treatment and care of America’s 22 million veterans and more than a million new veterans expected to leave active duty during the next five years.

Thursday, March 8, 2012

VA Medical Care

Jim Fausone
Veteran Disability Lawyer

OEF/OIF combat Veterans can receive cost free VA medical care for any condition related to their service in the Iraq/Afghanistan theater for five years after the date of their discharge or release.

If you decide to use your VA Health Care Benefits:


  • Enroll in VA Healthcare (You'll need your DD214, Photo ID, medical records, and current prescriptions)

  • Schedule your first VA healthcare appointment for a baseline medical exam

  • Access your one time VA dental benefit (must be within 180 days of return from combat)

  • Meet with your VA OEF/OIF/OND Care Management Team for help navigating VA benefits, post deployment screenings and to learn more about your benefits and services

  • Register for TRICARE benefits, if eligible
Learn more at http://www.oefoif.va.gov/ or call 1-866-606-8216 (7am - 7pm CST M-F).

Tuesday, March 6, 2012

VA Budget Increased

Jim Fausone
Veterans Disability Lawyer

There will be about 1 million new veterans added to the 22 million American veterans as active-duty service members leave the military over the next five years.

This increase in veterans to serve means a larger budget for the Department of Veterans Affairs. President Barack Obama’s proposed budget includes $140.3 billion for the VA to cover the 2012 fiscal year beginning Oct. 1.

The budget proposal now must be approved by Congress. It is about a 10 percent increase over the last VA budget.

The requested budget includes $76 billion for mandatory spending, mostly for pensions and disability compensation. It also includes $64 billion in discretionary funds, most of which goes into medical care, according to the VA.

The VA’s budget supports a health care system with 8.8 million beneficiaries and programs servicing 12 million veterans, families and servicemembers. It also supports home loan guarantees, education benefits, the eighth largest program for life insurance in the country and America’s largest cemetery system.

The VA expects almost 6.5 million patients will use the agency for their health care next fiscal year. The President’s budget includes a medical care increase of about 4.1 percent over last year to $52.7 billion. These increases include upgrades in funding for mental health care and gender-specific health care for female veterans coming home from war, according to the VA.

The health care budget also includes $792 million to activate new health care facilities in Orlando, Florida, New Orleans, Denver and Las Vegas. Almost $400 million is flagged for continued construction on medical units in St. Louis, Dallas, Seattle and Palo Alto, California.

The proposed VA budget also includes funding for a new jobs program called the Veterans Jobs Corps. This new initiative is designed to leverage skills that veterans attained during military service for a variety of jobs in the United States. The Veterans Jobs Corps could put as many as 20,000 veterans to work here rebuilding or restoring public lands.

The President and Congress should be taking care of our Veterans who answer the country’s call to military service.

Monday, March 5, 2012

The VA should be for Veterans

Jim Fausone
Veterans Disability Lawyer

When you are really frustrated with the system, you think the VA hates veterans. Ok, not every employee at VA has such hate, but it sure feels that way to the veterans who get the runaround. We see it in the disability arena, but it is not exclusive as evidenced by an article about veteran business owners trying to get work from VA.

It is reported by some veterans the VA continues adversarial treatment of veterans instead of one of advocacy. This is baffling to many Veteran business owners who are trying to do business with the Department. "The VA, whose sole purpose for existence is to promote the welfare of Veterans, has flatly refused to honor a law known as Vets First which gives priority to Veteran owned business when the VA makes purchases. Even in the face of multiple rulings from the Government Accountability Office telling the VA its interpretation of the law is wrong the VA continues to subject Veterans to the humiliation of being placed behind non Veterans by the organization they rely on for support. What makes this issue such a flash point is the upcoming Veteran Owned Business Conference to be held in Detroit June 25th- 29th, 2012 by the VA. Many Veteran Business leaders call this the height of hypocrisy for the VA to promote this conference as the premiere event for the Veteran businesses when it disregards the very law meant to provide opportunities for Veterans to participate in the contracting process."

http://www.marketwatch.com/story/the-va-tells-veterans-to-get-in-the-back-of-the-line-when-it-comes-to-contracting-according-to-the-michigan-service-disabled-veteran-owned-business-roundtable-2012-03-01

Friday, March 2, 2012

VA Personal Benefits

Jim Fausone
Veteran Disability Lawyers

This is a great idea put forth by the VA. A book that explains your personal VA benefits.

The new booklet, called a Health Benefits Handbook, will provide a personalized listing of health benefits based on each Veteran’s specific eligibility. The handbook will also have contact information for their local VA medical facilities, appointment scheduling information, guidelines for communicating with their clinical team and, as applicable, information about copays.

Distribution of the handbooks began this month, with all 8.5 million Veterans enrolled in VA’s health care system scheduled to receive their handbooks by 2013. Veterans will receive updates to their handbook to reflect changes to their benefits or eligibility. The next time you are at a VA medical facility ask about the booklet.

http://www.va.gov/healthbenefits/