When Wisconsin’s former governor Scott Walker set about to crack down on Medicaid fraud, it was an ambitious undertaking. Medicaid fraud costs the federal and state governments billions of dollars every year. While the intention was to curtail a level of fraud that takes away money from those in need, it may have caught a number of legitimate in-home health care providers in its net.
According to some sources, there have been home health care nurses and other providers who submitted paperwork with minor errors, as they described them, and were ordered to pay back a significant amount of money they received for services provided through the state’s Medicaid system.
Many of these in-home care providers do not earn a significant amount of money annually and, therefore, have struggled to make sense of these orders. In one case, Nurse Debra Zuhse-Green even considered selling her house and underwent a great deal of emotional stress, as she claims, because the state ordered her to repay $57,000 she earned while providing in-home health care services to clients over the course of several years.
As reported by The Cap Times in the blog, Critics call Wisconsin’s Medicaid fraud crackdown ‘bullying’, written by Helu Wang and Dee J. Hall:
“During his eight years in office, Republican Gov. Scott Walker has touted Wisconsin’s efforts to root out fraud, saying that as of 2017, the state had identified $150 million in Medicaid and FoodShare fraud and overpayments.
However, critics contend that the state has gone too far in some cases, seeking to take back huge sums of money from companies and individuals who provided health care services but had minor paperwork errors.
It is unclear whether the incoming Democratic administrations of Tony Evers, who defeated Walker in the November election, and Josh Kaul, who beat Republican Attorney General Brad Schimel, will continue the state’s aggressive tactics.”
It is certainly essential for state and federal governments to crack down on Medicare and Medicaid fraud, but when the system catches legitimate workers in its net, and it doesn’t provide for reasonable recourse, that can pose serious challenges.
It has the potential, at least in Wisconsin, for some nurses to avoid in-home care services, especially if they need to submit paperwork to Medicaid for reimbursement. A fear of an error in the reporting or on the paperwork that could lead to serious financial repercussions may leave some elderly and disabled individuals without proper care at home.
A simple mistake should not warrant a legitimate in-home health care provider to undergo financial or emotional stress or face the prospect of bankruptcy or losing their home.
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