Posts Tagged ‘Fraud’

PowerShares Dynamic Pharmaceuticals

Wednesday, April 16th, 2014

PowerShares Dynamic Pharmaceuticals (PJP)

PJP

This graph shows the price per share over the last few years for an investment fund based on the common stocks of 30 U.S. pharmaceuticals companies. (Top 10 holdings: Johnson & Johnson, Pfizer, Merck, Amgen, Eli Lilly, Bristol-Myers Squibb, Biogen, Gilead Sciences, Depomed, Questcor.) There is over $1 billion invested in this fund.

No, this is not a recommendation to run to your broker and buy these shares; although if you’d like to sell your shares we would not object. We might, however, whisper “blood money” under our breath.

In all seriousness, many people are making huge amounts of money off the pharmaceutical industry. As it was explained to me once by the CEO of a large company in the insurance industry, “We make our money on the misfortunes of others.”

Actually, this would not be such a major issue if it were not for the corrupt alliance between the psychiatric and pharmaceutical industries.

experimental stage With 30 million Americans having taken antidepressants for a “chemical imbalance” that psychiatrists admit is a pharmaceutical marketing campaign, not scientific fact, it is no wonder that the conflict of interest between psychiatry and Big Pharma perpetuates.

The American Psychiatric Association is steeped in a conflict of
interest with the pharmaceutical industry. After all, it has made at least $40 million just in sales of its Diagnostic and Statistical Manual of Mental Disorders (DSM), often called Diagnosis as a Source of Money, the billing bible that psychiatrists use for insurance reimbursement for “treatment” which is most often psychotropic drugs.

The campaign to “Stop the Stigma” of “Mental Illness” was launched by the Pharmaceutical Industry. With a seemingly altruistic agenda, the fact is the campaign to end the “stigma” of mental illness is one driven and funded by those who benefit from more and more people being labeled mentally ill — pharma, psychiatry and pharmaceutical front groups. The “Founding Sponsors” of the National Alliance on Mental Illness (NAMI) campaign to stop the “stigma” were Abbott Labs, Bristol-Myers Squibb, Eli Lilly, Janssen, Pfizer, Novartis, SmithKline Beecham and Wyeth-Ayerst Labs.

Controversy swelled around the fifth edition of the DSM, known as DSM-5. One study suggested that the 900-page bible of mental health published in May 2013 is rife with financial conflicts of interest. Nearly 70 percent of DSM-5 task force members reported financial relationships with pharmaceutical companies — up from 57 percent for the previous edition.

St. Louis has not been immune to the fallout from psychiatric drugs. On January 15, 2013, 34-year-old Sean Johnson walked onto the Stevens Institute of Business & Arts campus and shot the school’s financial aid director once in the chest, then shot himself in the torso. Johnson had been taking prescribed drugs for an undisclosed mental illness.

Remember that the real problem is that psychiatrists fraudulently diagnose life’s problems as an “illness”, and stigmatize unwanted behavior or study problems as “diseases.” Psychiatry’s stigmatizing labels, programs and treatments are harmful junk science; their diagnoses of “mental disorders” are a hoax — unscientific, fraudulent and harmful.

It is vital that you, your family and associates watch the video documentary “Making A Killing – The Untold Story of Psychotropic Drugging”. Containing more than 175 interviews with lawyers, mental health experts, the families of psychiatric abuse victims and the survivors themselves, this riveting documentary rips the mask off psychotropic drugging and exposes a brutal but well-entrenched money-making machine. The facts are hard to believe, but fatal to ignore. Watch the video online by clicking here.

File a Complaint about psychiatric Abuse Today

Wednesday, March 12th, 2014

File a Complaint about psychiatric Abuse Today

We are delighted to inform you that if you have experienced abuse by a psychiatrist, you can now file a complaint in any state in a few minutes.

With thanks to PsychSearch.net, this complaint form,

http://www.psychsearch.net/complaints/

is now available. It will help you send a complaint to the proper authorities in any state in the U.S.

Vulnerable people who have sought help from psychiatrists and psychologists have been falsely diagnosed and forced to undergo unwanted and often harmful psychiatric methods.

The real problem is that psychiatrists fraudulently diagnose life’s problems as an “illness” and stigmatize unwanted behavior or study problems as “diseases.”

In case there is any doubt, here are some examples of what constitutes psychiatric fraud or abuse:

False diagnosis of mental illness, rape, sexual assault, physical abuse, mis-diagnosis, harmful and unnecessary drugging, involuntary commitment, electroshock therapy, psychosurgery, harmful restraints, threatened with committal or punishment for refusal of treatment, coerced into hospitalization or treatment, neglect, insurance fraud (fraudulent billings to an insurance company, Medicare or Medicaid — such as submitting a bill when no service was performed.)

Psychiatric curricula and tests in our schools destroy morality and values as evidenced by the rising incidents of crime, drug abuse, and suicide among children and adolescents. The bottom line is that all psychiatric “treatments” are harmful and can cause crime.

Here are the currently defined categories of fraud and abuse on the PsychSearch.net Complaint Form:

  • Coerced into “Treatment”
  • Confidentiality Break
  • Crime
  • Drug Trafficking
  • Falsified medical records
  • Financial Irregularity
  • Forced Drugging
  • Fraud (Financial, insurance or otherwise)
  • Harmful Drug Effects
  • Harmful Effects of Electroconvulsive Therapy, (ECT)
  • Harmful Effects of Lobotomy
  • Inappropriate prescribing for non-medical reasons
  • Involuntary Commitment
  • No Biological Test for “Mental Illness”
  • No Informed Consent
  • No Testing for Underlying Physical Condition
  • Physical Illness Misdiagnosed as “Mental Illness”
  • Questionable Billing
  • Restraints
  • Sexual Misconduct
  • Shock Treatment
  • Threats
  • Told I have a “chemical imbalance”
  • Unethical Conduct
  • Unprofessional conduct
  • Use of Force
  • Something else that didn’t seem quite right

To help you formulate your thoughts for filing a complaint, you can download the CCHR psychiatric Abuse Questionnaire by clicking here.

Please let us know when you file a complaint. Feel free to forward this information to someone you think might have a desire to file a complaint.

Find Out! Fight Back!

Fake Article in Psych Research Journal

Monday, November 11th, 2013

Fake Article in Psych Research Journal

A Norwegian study that claims to have observed significant brain changes in mental patients who switched from so-called “first generation” antipsychotic drugs to second generation varieties has been retracted from the peer-reviewed journal BMC Research Notes. As announced by Retraction Watch, the foiled paper was pulled after it was discovered that researchers had literally switched their data sets and come to completely opposite and false conclusions.

Sources:
Natural News
Retraction Watch
BMC Research Notes (BioMed Central Ltd)

This is the official retraction statement for the article, “Does changing from a first generation antipsychotic (perphenazin) to a second generation antipsychotic (risperidone) alter brain activation and motor activity? A case report:

“The authors have retracted this article as the fMRI data presented in the case report are incorrect. The activation data reported for session 1 are the activation data for session 2 and vice versa. As a result the discussion and conclusions of the case report are based on the wrong set of data and are no longer valid. The authors apologise for the error.”

Here are some more references about fake psychiatric research:

Has psychiatry been corrupted beyond repair?

Psychiatry’s New Schizophrenia test – more fake science

The DSM fraud

Nosology

Sunday, September 29th, 2013

Nosology

While not directly related to Schnozology, Nosology is still an interesting term.

Nosology: The branch of medicine concerned with the classification of diseases. [from Greek nosos disease + Greek logos word]

We caught the term being used in the July 2013 issue of Reason magazine, in an article by Gary Greenberg, a practicing psychotherapist, titled “Overselling Psychiatry;” here is the quote: “Doubts like Frances’, on the part of both respected professionals and confused laypersons, are inevitable given the way the APA conducts nosology, the science of disease classification.”

Here are some additional quotes from this article to give the context:

“Allen Frances, former head of the Duke University School of Medicine’s psychiatry department … was chair of the APA task force for DSM-IV … [and] has been warning everyone who will listen that the newest DSM revision [DSM-5] will turn even more of human suffering into mental illness and thus into grist for the pharmaceutical mill.”

The DSM, of course, is the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the fifth edition (DSM-5) having been released this past May. Despite a growing consensus of people who see the DSM for what it is — a purely subjective work of no scientific substance or authority — it is still accepted in the legal system as being a scientific work that catalogs descriptions of mental symptoms as if they were real medical diseases.

“…many critics have pointed out that these disease categories do not exist in nature…”

In 1984 the results of a survey of 20,000 Americans indicated that, “In any given year, more than 20 percent of Americans qualified for a DSM-III diagnosis.”

Extrapolating this result to say that 20 percent of the population is mentally ill, as is the current marketing cry of the mental health industry, is the height of fraudulent statistical hubris, as the DSM itself has no basis in fact.

“… doctors using DSM checklists were all too likely to find disease everywhere they looked. There was no governor in the mechanism, no way to say this person was sick and that one was simply unhappy…”

“‘The tendency [is] always strong,’ John Stuart Mill wrote in 1869, ‘to believe that whatever receives a name must be an entity or being, having an independent existence of its own.’ … this tendency had led all the stakeholders in nosology — scientists, regulators, editors, doctors, drug companies, and, of course, patients — to take the labels not as arbitrary descriptions but as the names of actual diseases.”

The moral of this tale, to spell it out, is that psychiatric labels are junk science; psychiatry is junk science; psycho-pharmaceuticals are junk science.

See a competent, non-psychiatric health professional for your troubles. Insist on full disclosure of lab tests, diagnoses, drug actions and drug side effects, and exercise your fully informed consent before accepting treatment.

While we do not provide medical advice, we do provide educational materials so that you can Find Out yourself about these things. Select a downloadable booklet from www.CCHRSTL.org that catches your interest and let us know what you think about it. Forward this newsletter to everyone you know and recommend they subscribe.

Psychiatric Medicaid Fraud

Monday, September 23rd, 2013

Psychiatric Medicaid Fraud

In an August 28, 2013 decision by the United States Court of Appeals for the Seventh Circuit, the appeals judge held that psychiatrists commit Medicaid fraud when they submit Medicaid claims for off-label prescriptions for psychiatric drugs to children for uses that are not approved by the FDA or supported by certain specific pharmaceutical references.

In the words of the court, “…the federal government generally will not pay for medications prescribed for purposes not approved by the FDA or ‘supported’ by any of several pharmaceutical reference books (called ‘compendia’). …Medicaid can only provide reimbursement for ‘covered outpatient drugs.’ …Covered drugs do not include any drugs ‘used for a medical indication which is not a medically accepted indication.’ …’medically accepted indication’ is a statutorily defined term that refers to a prescription purpose approved by the Food, Drug, and Cosmetic Act…or ‘supported by’…the American Hospital Formulary Service Drug Information, the United States Pharmacopeia Drug Information…and the DRUGDEX Information System.”

Basically, the appeals court reinforced the common-sense position that Medicaid fraud occurs when a doctor submits a Medicaid claim for a prescription written for off-label use, as many psychiatric drugs are prescribed.

The original lawsuit, ex rel Watson v. King-Vassel, was brought under PsychRights’ Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth by Dr. Toby Watson, a Wisconsin psychologist, to support the Law Project for Psychiatric Rights‘ effort to try and stop the tremendous harm caused by off-label psychiatric drug prescriptions to poor children on Medicaid for uses that have no recognized scientific support.

Starting on January 1, 2014, all low-income, non-elderly and non-disabled individuals will be eligible for Medicaid, courtesy of the Affordable Care Act. The Federal Government will provide 100% of the cost of newly eligible people between 2014 and 2016, 95% of the costs in 2017, 94% of the costs in 2018, 93% of the costs in 2019, and 90 percent matching for subsequent years. The bottom line — expanding Medicaid in this manner will also expand Medicaid fraud. Ensuring that psychiatric drugs are available for all citizens, access to Community Mental Health Centers is being emphasized.

Need we say that all psychiatric drugs are harmful? Find out why!

Report Medicaid fraud in Missouri to Missouri Medicaid Fraud & Compliance.

Your Federal Government at Work

Saturday, August 24th, 2013

Your Federal Government at Work

Last June the President hosted the National Conference on Mental Health to talk about how to raise awareness of mental health issues and make it easier for everyone to get the mental health care “they need.”

The President’s Fiscal Year 2014 Budget proposal includes large amounts of taxpayer money helping teachers recognize signs of “mental illness” in their students and referring them to “mental health care;” supporting state-based mental health programs aimed young people ages 16-to-25; and training 5,000 additional mental health professionals with an emphasis on treating these students and young adults.

The goal is to have more Americans seek mental health treatment, and make sure that their insurance pays for it.

The Affordable Care Act is a major player in this big brother view of mental heath care, expanding mental health benefits and federal insurance parity protections for more than 60 million Americans. There are 314 million Americans, so this expansion is aimed at roughly 20% of the entire U.S. population. The Affordable Care Act requires new health plans to cover depression screenings for adults and behavioral assessments for children, and soon insurance companies will no longer be able to deny health care coverage to anyone because of a pre-existing mental health condition.

Are you looking forward to this? Are you not excited about the government guaranteeing “treatment” for all the fraudulent mental disorders in the new DSM-5? Get ready to sign up, because the Whitehouse knows what’s good for you!

The only thing is, they are not talking about the rampant fraud and abuse in the mental health care industry, and the very real damage that psychiatric drugs and treatments cause. They are not funding any efforts to curb the fraud and abuse. They are certainly not suggesting that psychiatry itself is a fraudulent and abusive practice.

What can you do about it? As a non-political organization, we are not suggesting political action. But we are suggesting that you Find Out and Fight Back in a manner consistent with your own views in the matter. Occasionally we might make some particular suggestions about what you can do.

Speaking of which, here are some suggestions.

FIND OUT

Review the material on the various CCHR websites and in the various CCHR publications and documentaries. You can start here: www.CCHRSTL.org.

If you have not seen any of the CCHR documentaries, watch them now. You can request a free information kit here.

Satisfy yourself that psychiatry and the current mental health care industry in America does not have your best interests at heart.

Sure, people can have mental trauma, and they need effective care. However, psychiatry is harmful junk science; your family and friends deserve better. Find out about the alternatives to harmful psychiatric treatments.

Ask yourself how many people you know who are taking psychiatric drugs, and if you really think this is OK.

FIGHT BACK

Support CCHR by becoming a member of CCHR St. Louis and request a DVD documentary. Show the documentary to your family, friends and associates; to your school groups and church groups; to your legislators; to your attorney and your insurance provider. You get the idea. Tell us what you did.

Give a CCHR documentary or booklet to someone.

Contact your local, state and federal officials, and let them know what you think about the fraud and abuse in the mental health industry. Write Letters to the Editor of your local news media.

Forward this newsletter to everyone you know and recommend they subscribe.

Volunteer some time to help CCHR fight back. Donate some funds to help CCHR fight back.

Execute a Living Will — a Letter of Protection Against Unwanted Psychiatric Incarceration and/or Treatment.

Report all instances of complaints and adverse psychotropic drug reactions to your national drug regulatory agency. In the U.S. this is at www.fda.gov/medwatch.

There are many other ways to help. The alternative may be a United States where everyone is taking psychiatric drugs on government orders.

Missouri State Department of Mental Health

Sunday, June 23rd, 2013

Missouri State Department of Mental Health

The budget keeps getting bigger, but the cures stay at zero

Reports show that:

* 10% to 25% of mental health practitioners sexually abuse patients.
* Psychiatry has the worst fraud track record of all medical disciplines.
* An estimated $20-$40 billion is defrauded in the mental health industry in any given year.

Download and read the full report “Massive Fraud — Psychiatry’s Corrupt Industry.”

Missouri Department of Mental Health 2013 budget — over $1.6 billion; and this does not include mental health services provided by other state departments such as Health and Senior Services, Elementary and Secondary Education, Corrections, and Social Services.

Over 100 million people worldwide are taking psychiatric drugs right now.

Psychiatric drugs do not improve academic performance. The National Institutes of Health reports “there is little improvement in academic achievement or social skills” by children taking stimulant drugs.

Every 75 seconds another citizen is incarcerated by psychiatry.

The top five psychiatric drugs combined gross more money than the gross national product of each of over half the countries on Earth.

Every Missouri citizen gives the Department of Mental Health $267 per year to abuse their neighbors.

The largest and fastest growing source of funds for the Missouri Department of Mental Health is the U.S. federal government, amounting to nearly $900 million this year.

20 million children worldwide take psychiatric drugs daily, 9 million of those in the U.S. These drugs potentially cause violent behavior, psychosis, hallucinations, strokes, heart attacks, obesity, life-threatening diabetes and even suicide.

Giving more tax dollars to the Department of Mental Health merely perpetuates the cycle of state tax largesse. Curtailing and cutting the budget will force the Department of Mental Health to reduce their costs, thereby forcing useless and unnecessary state institutions either to improve their services or close shop.

Increasing the Department of Mental Health’s budget covers expensive and debatable psychiatric drugs as necessary medical costs. Many international warnings have been issued on the harmful side effects of various psychiatric drugs, which include suicide, violence, addiction, liver damage, and heart attacks.

The Department of Mental Health is also an easy place to cut spending in the long, difficult effort to save our health-care system, as the citizens of this state have long used the Department of Mental health as an emergency health care provider. The unprecedented use of Missouri’s Mental Health psychiatric facilities as emergency health care has hidden a long overlooked problem that the state’s poorer citizens are enduring.

The Department of Mental Health’s motto should be “We care for those who cannot care for themselves”; not “We want to care for all.”

Contact your local, state and federal officials and representatives and let them know what you think about the insane bloat of budgets for psychiatric mental health care that promote fraud and patient abuse.

Feel free to forward this newsletter to others and recommend that they subscribe.

Medicare

Wednesday, May 1st, 2013

Medicare

Continuing our discussion of psychiatric fraud (see our recent newsletter on Medicaid), we highly recommend an excellent article on Medicare and Medicaid fraud by Chris Parker in the St. Louis Riverfront Times (RFT) (“Thieves’ Bazaar: Hospitals, doctors and dealers have made Medicare the nation’s sweetest crime”, 4/25/2013).

Medicare is a federal government health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant).

Following are some quotes and paraphrases from the RFT article.

“Think of the Medicare program as a bank that never bothered to buy a safe. Everyone from HMOs to drug dealers have been caught robbing it time and time again, stealing the kind of money that makes the sequester look like pocket change.”

Since 2007 the federal Health Care Fraud Prevention and Enforcement Action Team (HEAT) has charged 1,480 defendants with $4.8 billion in fraud.

In 2011 Mohammad Khan, administrator of Houston Riverside General Hospital, confessed to federal fraud investigators for enriching the hospital through a kickback scheme, paying “recruiters” $300 a head to bring Medicare patients to Riverside’s six psychiatric clinics.

“They arrived by the van-load for daily therapy sessions they rarely qualified for or received. Medicare picked up the $116 million tab.”

“Kahn ratted out CEO Earnest Gibson III as his co-conspirator. The feds also nabbed Gibson’s 35-year-old son, Earnest IV. He ran one of the psychiatric clinics and was charged with billing nearly $700,000 for care that ‘was not medically necessary and, in some cases, not provided,’ according to prosecutors.”

“Investigators discovered that, since 2005, the hospital had been swindling the feds to the tune of $22 million a year. Kahn pleaded guilty. The two Gibsons and five others await trial on charges of fraud, conspiracy and money laundering.”

Cuban expat Armando Gonzalez started several outpatient psychiatric clinics in Miami with a scheme similar to Riverside’s. “Gonzalez paid assisted-living facilities kickbacks to bus in residents suffering from retardation and dementia. The clinics would then bill Medicare for services the ‘patients’ weren’t eligible for or didn’t receive. By the time the feds started sniffing around in 2008, Gonzalez had already made off with $28 million…He closed shop in Miami, only to reopen in North Carolina. When he was finally arrested last year, Gonzalez was planning to expand into Tennessee.”

In 2010 Frank Walther of the Medicare fraud task force helped take down American Therapeutic, the highest-billing mental-health center in the country. “The company was cycling addicts, alcoholics and Alzheimer patients through its six clinics. Patients’ diagnoses were changed so they would qualify for expensive group therapy.”

In 2011 “Minnesota was pumping up its Medicaid reimbursements to cover losses in a state program that Medicaid doesn’t reach.”

Then there’s the Las Vegas Cocktail, mixing Xanax, Soma and Vicodin for a powerful opiate high. Michigan’s Monroe Pain Center, near the Toledo, Ohio, border, went from seeing 40 patients a day to as many as 250, prescribing 5 million doses of narcotics over two years, defrauding Medicare out of $5.7 million.

New York state centers for people with mental issues were charging the feds $5,000 per day per patient while Arizona only charges $200 a day. New York’s estimated overcharges: $15 billion.


Oh, my! Who’s paying for all this fraud? Medicare and Medicaid are government programs, financed by your tax dollars (and the federal debt.) Can anyone guess why health care costs are so high and continuing to rise?

What shall we do? What do you think? Has your own health insurance cost increased recently? Shall we just let this fraud continue?

These are not purely rhetorical questions. They do have some answers.

You are one of the answers. Contact your local, state and federal officials and representatives; let them know what you think about this situation. Suggest that they find out about all the money wasted on fraudulent and abusive psychiatric mental health care, and recommend that they reduce or eliminate the use of harmful, coercive and abusive psychiatric treatments and psychiatric drugs in favor of non-psychiatric alternatives, so that people with mental trauma can actually be helped rather than harmed.

Forward this newsletter to your family, friends and associates and tell them to subscribe.

More information about psychiatric fraud can be found by clicking here.

By the way, report Medicare fraud here.

Exchange

Sunday, April 21st, 2013

Exchange

Many readers of this newsletter have provided support for CCHR St. Louis, either as volunteer helpers or as monetary donors; many have not. We wanted to provide a way for all our readers to easily exchange for receiving the benefits of this newsletter.

Exchange: Trading something of value in return for something of similar value.

For example, permitting someone to receive something of value without their valuable contribution in return, or permitting someone to give something of no value while receiving something of value, are alike encouraging criminal behavior.

We delight in providing readers this newsletter; and although we certainly would not discourage volunteer help or monetary donations, an exchange that would significantly help us, which is of great value to us, would be your forwarding this newsletter to your family, friends, and associates — and asking them if they might like to subscribe. We would not even discourage you from recommending a subscription to this newsletter, should you find it of value. It is easy to subscribe, and easy to unsubscribe.

Send them here to subscribe: www.cchrstl.org/subscribe.shtml

Of course, the concept of exchange also applies very much to the mission and purpose of CCHR. The psychiatric industry is totally out of exchange with the rest of human society. They are selling something harmful and calling it helpful. This is criminal fraud.

Fraud: A deception deliberately practiced in order to secure unfair or unlawful gain; deliberately misrepresenting something to secure profit; dishonest dealings, cheating or trickery; selling something harmful but calling it helpful.

The United States loses approximately $100 billion to health care fraud each year; up to $40 billion of this is due to fraudulent practices in the mental health industry.

The mental health monopoly has practically zero accountability and zero liability for its failures.

Psychiatric drugs don’t cure anyone and they don’t prevent disease.

Despite more than a decade of healthcare fraud investigations and convictions in the U.S. alone, psychiatrists and psychologists have not reformed the fraudulent practices that are rife within its ranks.

Psychiatry’s predatory and profit-driven practices are international in scope and fraudulent to the core.

With mental health care insurance coverage being mandated in the U.S., fraud levels escalate.

Community Mental Health Centers have led to massive increases in government spending and fraud, with no commensurate results.

Drug abuse and drug fraud are commonplace in the psychiatric system.

Studies in numerous countries reveal that between 10% and 25% of psychiatrists and psychologists admit to sexually abusing their patients.

One of psychiatry’s most successful means of defrauding those who pay for psychiatric treatment is through the use of its unscientific Diagnostic and Statistical Manual of Mental Disorders (DSM).

Mentally troubled persons living in residential psychiatric facilities are easy targets for exploitation: fraud, assault and sexual or financial abuse.

The primary purpose of mental health treatment must be the therapeutic care and treatment of individuals who are suffering emotional disturbance. It must never be the financial or personal gain of the practitioner. Those suffering are inevitably vulnerable and impressionable. Proper treatment therefore demands the highest level of trustworthiness and integrity in the practitioner.

What should be done about fraud in the mental health industry?

This is another area where you can contribute and make a valuable exchange for receiving this newsletter. Contact your local, state and federal officials and representatives and let them know what you think about fraud and abuse in the mental health industry; let them know that psychiatry is a criminal exchange; demand they Do Something About It!

A good start would be to demand that the DSM should be removed from use in all government agencies, departments and other bodies including criminal, educational and justice systems. None of these so-called “mental disorders” should be eligible for insurance coverage because they have no scientific, physical validation. Provide funding and insurance coverage only for proven, workable treatments that verifiably and dramatically improve or cure mental health problems.

Medicaid

Thursday, April 18th, 2013

Medicaid

It’s in the news today, constantly. What is it, and what should we know about it? What’s all this talk about expanding state Medicaid?

Medicaid is a state and federal partnership providing health coverage for people who qualify. Across the U.S. over 62 million people are enrolled in Medicaid, with a total federal plus state budget of $400 billion per year.

The Center for Medicaid and CHIP Services (CMCS) is one of six Centers within the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services (HHS). CMCS serves as the focal point for all national program policies and operations related to Medicaid and the Children’s Health Insurance Program (CHIP).

If you don’t have and are unable to afford health insurance, you and your family may qualify for free or low-cost health insurance coverage through Medicaid.

Each state operates its own Medicaid program that provides health coverage for lower-income people, families and children, the elderly, and people with disabilities. The eligibility rules for Medicaid are different for each state.

Enacted in 1965 through amendments to the Social Security Act, Medicaid is a health and long-term care coverage program that is jointly financed by states and the federal government. Each state establishes and administers its own Medicaid program and determines the type, amount, duration, and scope of services covered within broad federal guidelines. States must cover certain mandatory benefits and may choose to provide other optional benefits.

Federal law also requires states to cover certain mandatory eligibility groups, including qualified parents, children, and pregnant women with low income, as well as older adults and people with disabilities with low income. States have the flexibility to cover other optional eligibility groups and set eligibility criteria within the federal standards.

The Affordable Care Act of 2010 creates a new national Medicaid minimum eligibility level that covers most Americans with household income up to 133 percent of the federal poverty level. This new eligibility requirement is effective January 1, 2014, but individual states may choose to expand their Medicaid coverage before this date. For a household of one person, 133% of the current federal poverty level is an annual income of $15,282 (and add $5,347 for each additional person.)

Medicaid is the single largest payer for mental health services in the United States. Examples of provided mental health services include screening, counseling, therapy, medication management, psychiatric services, licensed clinical social work services, peer supports, and substance abuse treatment.

There is a large and active Medicaid fraud culture, both provider and participant fraud, that wastes billions of dollars per year. For example, estimates range between $2 billion and $4 billion in fraudulent psychiatric drug claims per year nationally. Medicaid spends roughly $25 billion per year on prescription drugs.

Some of the more common provider fraud includes: billing for services when no service was provided; billing for a more expensive treatment or service than was actually provided; billing for unnecessary services; billing for the same service multiple times; receipt of kickbacks; excessive compensation for medical directorships or consultancies; physicians referring patients to obtain services from a Medicaid provider whom the physician or physician’s immediate family member has a financial relationship.

Some of the more common participant fraud includes: signing documentation indicating services were provided when not provided; selling prescription medications obtained through the Medicaid program; forging prescriptions to obtain medications; allowing someone other than the card holder to use a Medicaid card; falsifying information to qualify for Medicaid services.

Of course, CCHR supporters will understand that all psychiatric treatments and drugs are harmful and fraudulently prescribed.

Medicaid is an enormous and complex bureaucracy, making it extremely difficult to distill meaningful statistics across all 50 states and the federal government. Diligent research is required to isolate relevant information.

In Missouri, the Medicaid program is known as MO HealthNet. Of the 6 million people in Missouri, over 1 million are Medicaid recipients. Each year, Missouri Medicaid spends over $8 billion to provide health services. Roughly $6 billion is provided by the federal government, and Missouri contributes another $2 billion per year. $600 million goes toward prescription drugs; $43 million goes toward long term mental health care facilities; roughly $500 million goes toward all mental health services, not including drugs.

Missouri offers home- and community-based programs for developmentally disabled adults and children, provided by the Department of Health and Senior Services or the Department of Mental Health. There have been double-digit increases in yearly Medicaid drug spending since 1995. Psychiatric drugs are among Medicaid’s most costly and commonly prescribed drugs. One-third of seniors and people with disabilities enrolled in Missouri’s Medicaid program are prescribed psychotropic drugs.

What do we think about all this? We don’t necessarily think that Medicaid is a bad idea. We do think that expanding Medicaid without also expanding fraud control is a mistake. We think that expanding Medicaid without reducing or eliminating the use of psychiatric treatments and psychiatric drugs is a mistake. We think there are enough non-psychiatric alternatives so that people with mental trauma can actually be helped rather than harmed.

Write your state legislators and let them know what you think about this. More information about psychiatric fraud can be found by clicking here.

By the way, report Medicaid fraud in Missouri to Missouri Medicaid Fraud & Compliance.