Like a growing number of disabled Americans on Medicaid, Keith Foreman, a 57-year-old in Metropolis, Ill., qualified for a personal caregiver to help him with daily activities like dressing, shaving, and preparing meals.

Foreman, who prosecutors say suffers from a spinal injury, hired his girlfriend, Sheila McDonald, for the job. In 2011, McDonald received almost $5,000 from Medicaid for six months of care she provided to Foreman.

These personal care services, which are available in all 50 states, are designed to help the sick, elderly, and disabled remain in their homes — and out of expensive nursing facilities. But Foreman was not living at home. During the days marked on McDonald’s timesheets, Foreman was housed in the Massac County jail in Illinois, serving time for forging a stolen debit card signature at a local liquor store.

Like Foreman and McDonald, who both pleaded guilty to charges of making false statements, unscrupulous beneficiaries and home health workers are increasingly targeting personal care services programs for illegal money-making schemes, according to a new federal report. Investigators say lax requirements ...

The nation’s top health information technology official has launched an internal review to determine if electronic health records are prompting some doctors and hospitals to overbill Medicare.

Dr. Farzad Mostashari, the Obama administration’s National Coordinator for Health Information Technology, said in an interview Monday afternoon that his policy-setting committee of experts would examine the issue and make recommendations on how to address it. 

It is the second government action in the wake of the Center for Public Integrity’s“Cracking the Codes” series, which found that thousands of medical professionals have steadily billed higher rates for treating seniors on Medicare over the last decade — adding $11 billion or more to their fees.

The Center’s year-long investigation, published in September, suggested that Medicare billing errors and abuses are worsening as doctors and hospitals switch to electronic health records. A similar report was subsequently published by theNew York Times.

Mostashari said he wants to find out if the digital systems are triggering higher billing codes by allowing doctors to cut and paste records from prior encounters with a patient, a practice known as “cloning.” Many experts say that this process can raise the size of a patient’s bill, even though it reflects little in the way of added or necessary medical service.

“If we are just copying the same information over and over, that’s not good medicine,” Mostashari said. “I’ve asked the policy committee to provide guidance on that.”

Mostshari also said that ...

Last Wednesday night the terms “middle-income” and “middle-class” were mentioned 34 times over the course of the first 90-minute so-called presidential “debate.”The phrases rolled jauntily off the tongues of both candidates as they attempted to make impassioned appeals to what is often seen as the most important voting bloc.

Applying a term without first defining it, however, is the hallmark of ideology. Marx’s “Sie wissen das nicht, aber sie tun es” (“they do not know it, but they are doing it”) expression from Das Capital represents the most incisive definition of ideology to date. Ideology in its most elemental form entails unwittingly maintaining the taken-for-granted categorical presuppositions and omissions around which we choose to organize the world. And our collective presumption of “middle-classness” is one such ideological ruse.

Unfortunately, we Americans know troublingly little about income distribution and our relative position in it. We all seem to think we’re part of the ubiquitous “middle class” because, well, we’ve rarely bothered to hazard a definition. For instance, according to an April 2007 poll by CBS News only 2 percent of the 994 adults surveyed said they were "upper class.” 7 percent said they were "lower class.” 

Class, of course, is as much a cultural concept as it is an economic one.  There needn’t necessarily be any natural correlation between cultural habits and remuneration, and as such the relationship between class and income is often mystified. For example, the perceived high cultural class standing of, say, an adjunct professor, doesn’t necessary reflect her low income or job ...

The Heritage Foundation today spread a falsehood about a change the Obama administration is instituting in the 1996 welfare reform law that has rapidly spread through the right-wing blogosphere. Letting Heritage and the right wing get away with this lie would do serious harm to people trying to pull themselves out of poverty.

Heritage headlined its Morning Bell email, "Obama's Imperial Presidency Guts Welfare Reform." Actually, if President Obama got all imperial on us and actually gutted welfare reform, that might not be such a bad thing, given how the law has actually failed in many respects to help people in poverty to get the economic support they need.

But what the Obama administration is actually doing through a memorandum issued Thursday by the Department of Health and Human Services is allowing states to test more effective ways to move people who are in the welfare program, Temporary Assistance for Needy Families, into the workforce and into economic independence—actually a bedrock conservative principle.

"This is not a back-door way to get out of the work requirement," said Elizabeth Lower-Basch, a senior policy analyst at the Center for Law and Social Policy. Instead, the explicitly states that the agency "is interested in more efficient or effective means to promote employment entry, retention, advancement, or access to jobs that offer opportunities for earnings and advancement that will allow participants to avoid dependence on government benefits."

"There was a growing consensus that the current work requirements ...

Last Thursday the Supreme Court upheld President Obama’s signature domestic policy –the Affordable Health Care Act –by arguing that its individual mandate falls under Congress’s jurisdiction to levy taxes. Chief Justice Roberts wrote in his majority opinion that the Affordable Care Act’s mandate to purchase health insurance may “reasonably be characterized as a tax [and because] the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.” 

Meanwhile, the Obama administration has long asserted that the mandate—the bill’s fulcrum, really—is necessary to ensure that other provisions of the law function smoothly. That is, supporters view the mandate as essential to market based reform; without it, they argue, many healthy people would remain without insurance coverage, premiums for individuals and employers would accelerate, and insurance markets could become unstable. When the uninsured who can afford premiums do become ill, unaffordable health care costs are often absorbed by the rest of the population.

Unfortunately, the penalty-tax that the individual mandate imposes will soon constitute one of the most regressive taxes in the United States. (The terms “penalty” and “tax” here are effectively fungible. Whatever the nomenclature, it’s the functional equivalent of a tax.) The penalty-tax structure authorized by this law inherently disadvantages low income earners who, in effect, pay proportionally more on fewer dollars. Taxes imposed here are uncannily akin to the regression rates of sales and social security taxes. Take a look at the scatter chart below:

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Census data shows nearly one in two Americans live in poverty and now the Congressional Budget Office warns things could soon get worse if President Obama and Congress remain at an impasse over the 2013 fiscal budget. House Republicans are calling for cuts to food aid, healthcare and social services while protecting funds for the Pentagon. We discuss poverty with Peter Edelman, who resigned as assistant secretary at the Department of Health and Human Services over then-President Bill Clinton's signing of the 1996 welfare reform law that threw millions off the rolls. "Basically right now welfare is gone," Edelman says. "We have six million people in this country whose only income is food stamps -- that's an income at a third of the poverty line. ... Nineteen states serve less than 10 percent of their poor children. It's a terrible hole in the safety net. Welfare has basically disappeared in large parts of this country." Now a professor at Georgetown University Law Center, Edelman has written a new book, "So Rich, So Poor: Why It's So Hard to End Poverty in America." "I'm very much in support of Occupy," he adds. "The idea ... of the 1 percent and the 99 percent ... all fits together -- we really should be all one country."

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