10:04 AM, Apr 17, 2015 • By JERYL BIER
The system of federal and state "exchanges" or "marketplaces" that offer health insurance through the Affordable Care Act lean heavily on "navigators" to guide consumers in their choices. Organizations such as community health centers, legal aid societies, social service groups, church groups and even Planned Parenthood chapters have received grants in the past to serve in this capacity. Now the Department of Health and Human Services (HHS) has announced $201 million in grants to be made available for navigators over the next three years.
Until now, grants have been awarded on an annual basis. This time around, HHS is planning to change the "project period" from 12 to 36 months. Tricia Brooks of Georgetown University's Center for Children and Families is enthusiastic about this change. Writing at the Center on Health Insurance Reforms blog (CHIRblog), Brooks says:
But what really excited me about the notice – drumroll please – is that, in the supporting statement, CMS signaled its intent to provide three years of funding in the next round of navigator grants. Extending the length of the funding period is important to build stability in enrollment assistance programs. No longer will individual navigators have to put their resume on the street at the end of the grant year, just in case. Three-year funding periods will enable navigator entities to recruit and retain permanent, professional consumer assisters and assure high quality assistance for consumers.
Brooks also notes that HHS plans to substantially cut weekly and quarterly reporting requirements for navigators while increasing monthly requirements. She urges potential grantees to submit comments to HHS regarding these and other changes.
The grant announcement also provides details of what is expected of all marketplace navigators:
• Conducting public education activities to raise awareness about the Marketplace;
• Maintaining a physical presence in the Marketplace service area
• Facilitating selection of a QHP;
• Providing information in a manner that is culturally and linguistically appropriate to the population served by the Marketplace, including individuals with limited English proficiency and that is accessible to individuals with disabilities;
• Complying with applicable training and conflict of interest standards;
• Obtaining the authorization of applicants for coverage available through a Marketplace application prior to accessing their personally identifiable information;
Also listed are prohibited activities, largely aimed at limiting potential conflicts of interest:
• Charging any applicant for or enrollee in coverage available through the Marketplace for application or other assistance related to Navigator duties;
Compensating individual Navigators on a per-application, per-individual-assisted, or per enrollment basis;
• Providing certain kinds of gifts to any applicant or potential enrollee as an inducement for enrollment;
• Using Marketplace funds to purchase gifts or gift cards, or promotional items that market or promote the products or services of a third party, that would be provided to any applicant for or potential enrollee in coverage available through the Marketplace;
• Soliciting any consumer for application or enrollment assistance by going door-to-door or through other unsolicited means of direct contact, except in cases where the individual
has a pre-existing relationship with the individual Navigator or Navigator entity; and
• Initiating any telephone call to a consumer using an automatic telephone dialing system or an artificial or prerecorded voice, except in cases where the individual Navigator or Navigator entity has a relationship with the consumer.
HHS also stresses the training and certification needed for personnel to be qualified to serve as navigators:
Navigators must complete at least 20 hours of an HHS developed training program and pass an online exam to ensure appropriate understanding of relevant Marketplace-related information and must be federally certified before carrying out any consumer assistance functions.
In spite of the change to a three-year period, HHS notes that "all personnel serving as Navigators must obtain continuing education and be re-certified on at least an annual basis."
Fraudulent 2010 BP Gulf Oil Spill Claims6:10 PM, Feb 20, 2015 • By JERYL BIER
A former IRS tax examiner was indicted Friday along with three conspirators
11:33 AM, Dec 1, 2014 • By DANIEL HALPER
Scammers are taking advantage of President Obama's executive amnesty order. Which is why "advocates and immigration lawyers are doing whatever they can to raise awareness of what the policies mean so scammers don't cost those undocumented immigrants both money and their chances at reprieve," according to the liberal Huffington Post.
3:01 PM, Nov 21, 2014 • By JERYL BIER
In a 2011 blog post titled "There's a New Sheriff in Town," the White House announced that Vice President Joe Biden was spearheading a new "effort to root out wasteful spending at every agency and department in the Federal Government" called the
8:41 AM, Oct 28, 2014 • By DANIEL HALPER
The federal government is taking New York City to court. "Manhattan U.S. Attorney Files Healthcare Fraud Lawsuit Against Computer Sciences Corp. And The City Of New York For Orchestrating A Multimillion-Dollar Medicaid Billing Fraud Scheme," reads a headline from the Justice Department's press release.
9:08 AM, Sep 22, 2014 • By SCOTT SMITH
With the announcement in Kabul of a power-sharing government between the two presidential candidates, Ashraf Ghani and Abdullah Abdullah, the Afghan election comes closer to a resolution. What is missing, however, is an actual result. The “national unity government” was one part of a deal brokered by U.S. Secretary of State John Kerry back in July, when preliminary official results gave Ghani a massive victory, and Abdullah threatened to pull out of the process, claiming massive fraud had taken place. After two months of an audit overseen by the UN, when every ballot box was re-examined—something unprecedented in electoral history—a final result was reached. The result was given last week in secret to the candidates, but not to the public.
'A billion dollar government contract involving hundreds of local workers'...8:12 AM, May 13, 2014 • By DANIEL HALPER
An eye-opening report from KMOV about an Obamacare contractor using taxpayer dollars to pay their employees to spend all day doing nothing:
"A billion dollar government contract involving hundreds of local workers at an Obamacare processing center ... But now employees on the inside are stepping forward, asking, Is this why we're broke? Some of them claim to spend most of their day doing nothing," reports a local St. Louis reporter.
7:06 AM, Apr 15, 2014 • By JERYL BIER
Four years after Obamacare became law, the Department of Health and Human Services (HHS) is notifying Medicare providers and suppliers of new fingerprint-based background checks. Eventually, all individuals who hold a five percent or greater stake in a Medicare supplier or provider that is categorized as "high risk" will be subject to the requirement.
9:30 AM, Jan 11, 2014 • By IRWIN M. STELZER
Here we go again. JPMorgan Chase will pay $2.6 billion in fines and compensation for its inattention to numerous red flags warning that its important customer, one Bernie Madoff, was running a $65 billion Ponzi scheme.
Dec 30, 2013, Vol. 19, No. 16 • By THE SCRAPBOOK
Truth to tell, The Scrapbook has gotten as good a laugh as anyone out of the saga of John C. Beale, the retired Environmental Protection Agency official—Princeton grad, onetime deputy assistant administrator in the Office of Air and Radiation, congressionally certified expert on global warming—who has been sentenced to 32 months in prison for stealing nearly a million dollars from the federal government.
3:21 PM, Nov 12, 2013 • By JERYL BIER
The Treasury Inspector General for Tax Administration (TIGTA) reported last week that in 2011, the IRS paid out $3.6 billion in fraudulent refunds on tax returns filed by identity thieves. Even that amount was an improvement over the previous year when the total fraud was $5.2 billion. However, on Tuesday, TIGTA released a new report that found that though the IRS is making some progress against fraud, it is not using all available tools to prevent erroneous refunds and improper tax credits.
Plus, the law's privacy problems haven't disappeared.2:42 PM, Sep 12, 2013 • By MICHAEL WARREN
As the October 1 implementation of parts of Obamacare nears, House Republicans continue to pass legislation aimed at highlighting the health care law's flaws and weaknesses. On Thursday, the House passed a bill to reform an Obamacare verification process that would better stop fraudulent claims to health insurance subsidies. Politico reports: