Proving vulnerability to fraud is pretty simple. Check your email.
Our inboxes overflow with offers from alleged African royalty or Saudi Arabian petroleum magnates who proclaim that merely by providing your checking account and routing numbers, untold riches soon will be yours.
Cyberhackers burrow into protected networks to steal Social Security or credit card numbers. Pyramid and Ponzi schemes are still plentiful, even post-Bernard Madoff. Late-night TV hucksters peddle the key to wealth in five easy payments.
Just by waking in the morning, we’ve become vulnerable to fraud. It could happen anywhere, anytime, to anyone.
So touting, as conservative activist James O’Keefe did in Maine this week, that MaineCare is vulnerable to fraud is the equivalent of proving nothing at all.
Earlier this year, an Irish-accented lad from O’Keefe’s group, Project Veritas, entered the Biddeford office of the Department of Health and Human Services and videotaped his bewildering bid to receive MaineCare.
Under the unlikely name Ted Cannadeigh, the pseudo-applicant presented himself as likely the world’s dumbest and most reckless fisherman/marijuana smuggler, whose parents had fallen on hard times and left him to run the fishing boat business.
His vessel is named the Bob Marley (not the Upta Camp variety). His business card says he’s engaged in “pharmaceutical imports” and is emblazoned with a cannabis leaf. For a person engaged in an alleged illicit trade, subtlety is not Cannadeigh’s strong suit.
Good thing for him it’s all fiction. Otherwise he’d be receiving all the free health care he could handle in the penitentiary.
The video’s release was meant to instill doubts about the effectiveness of MaineCare and the honesty of the workers who administer it. It seems to me the video proves inept, evasive Irish fisherman/drug smugglers will be questioned thoroughly.
This should be a vote of confidence in the system.
To his credit, Gov. Paul LePage reacted with a swift and measured response to the video, acknowledging it raises concerns, but does not conclude there was fraud or wrongdoing on the part of the DHHS worker.
He’s right.
LePage is no fan of Medicaid; reforming the program was a signature platform of his campaign and one of his earliest policy goals as governor. He easily could have used this video to take a swing at an unpopular agency and program. That he didn’t is commendable. It would have been overreaction to a publicity stunt that generated some heat, but no light, about the management of Medicaid.
It also distracts from the real problem of MaineCare fraud and abuse, which is neither rumored, nor hinted, nor presumed. It is unquestionably true, and it doesn’t take an undercover video sting by an alleged dope smuggler with a business card to realize it.
Look at recent headlines: A woman from Harrison, Dawn Solomon, was sentenced in May for stealing $4 million from the program through her Norway business, starting in 2006. She intentionally over-billed for services; it earned her 42 months in prison.
No brazen deep-cover investigation unveiled this crime — it was an audit.
Even the current speaker of the House, Robert Nutting, has been the subject of a MaineCare investigation, when it was found the pharmacy he owned in Oakland over-billed for certain products from 1997-2003. He lost his business, True’s, because of it.
All welfare programs are victimized by fraud. For example, a Winslow woman was just convicted of playing pregnant for 40 consecutive months to collect food stamps.
Aren’t stories like these all the evidence necessary to prove that fraud exists?
So when former-lawmaker-turned-conservative-activist Carol Weston says the video is “explosive evidence of the potential for fraud within Maine’s Medicaid system,” she’s not only hyperbolic, she’s also wrong. We all know the fraud is there.
This is why the video only serves to prove what’s been known for years: The system is vulnerable to those who would try to exploit it.
As revelations go, it’s right up there with the sun rising in the east and setting in the west.
And problems with MaineCare specifically — let’s not even talk about its billing fiasco — have been apparent for many years.
O’Keefe’s video operation seems tantamount to yelling “Fire!” in front of a burning theater. Thanks, we know.
Now, put down the matches.
Anthony Ronzio is editor and publisher of the Kennebec Journal and Morning Sentinel. Email to [email protected].
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