Posts Tagged ‘Medicaid’

Take Action – Missouri Legislature – Foster Care

Tuesday, January 31st, 2017

Periodically we let you know the progress of various proposed legislation making its way through the Missouri General Assembly and suggest ways for you to contribute your viewpoint to your state Representative and state Senator.

You can find your Representative and Senator, and their contact information, by entering your 9-digit zip code here.

This time, we’d like to discuss Senate Bill SB160, which Creates the Foster Care Bill of Rights, sponsored by Senator David Sater (R, District 29).

“This act establishes and enumerates the Foster Care Bill of Rights. The Children’s Division shall provide every school-aged foster child and his or her foster parent with an age-appropriate orientation and explanation of the bill of rights, as well as make them readily available and easily accessible online. Additionally, every Children’s Division office, residential care facility, child placing agency, or other agency involved in the care and placement of foster children shall post the bill of rights in the office, facility, or agency.”

This foster care bill of rights is primarily concerned with familial stability, which we think is a good thing. We would like to suggest an amendment aimed at reducing the amount of harmful psychotropic drugs regularly given to foster children in Missouri’s care.

Missouri Foster Care serves individuals age 0 to 21; not all states provide care to age 21. In FY2014 Missouri extended Medicaid benefits up to age 26 for individuals who have aged out of foster care. Medicaid pays for the psychotropic drugs given to foster children.

The high rates of psychotropic medication use in the Medicaid population, risks associated with these drugs, and research documenting inappropriate prescribing, have raised concerns, especially for children involved in the child welfare system.

Studies suggest that appropriate prescribing practices, that is, adhering to FDA-approved use and accepted clinical guidelines, may not always be followed for certain Medicaid populations such as the high-risk populations of children in foster care. In actual fact, multiple studies and reports have found that children in foster care are vulnerable to inappropriate or excessive medication use. Children in foster care are often prescribed more than one psychotropic medication at the same time. A review in Missouri once found some children in foster care prescribed five or more psychotropic drugs.

Psychotropic Drug Classes given to children in Missouri foster care (contact CCHR STL at CCHRSTL@CCHRSTL.ORG  for the complete report, or download it from cchrstl.org/foster.shtml):

ADHD
Antianxiety
AntidepressantAntipsychotic_Combo
Antidepressants_MAOIs
Antidepressants_SSRIsAndSimilar
Antidepressants_Tricyclics
Antipsychotics_FirstGeneration
Antipsychotics_SecondGeneration
Barbiturates
Bipolar Disorder
InsomniaNarcolepsySleepDisorders

Total foster care drug costs in Missouri have averaged roughly $16 Million per year, with a total for the five years 2010-2014 over $81 Million. All of these psychotropic drugs given to Missouri foster care children between the ages of 0 and 26 are harmful and can have serious side effects including violence and suicide.

The top costs are for ADHD drugs and Antipsychotics for all ages. ADHD drug costs appear to be increasing year over year. Babies less than a year old are more commonly given Barbiturates, one presumes as a remedy for insomnia. Barbiturates are highly dangerous because of the small difference between a
normal dose and an overdose.

For all these reasons, CCHR would like to see an amendment for SB160 to this effect:

Foster Children have the right:
(a) To be free of the administration of medication or chemical substances unless authorized by a physician,
(b) To be informed of the risks and benefits of psychotropic medication in an age appropriate manner,
(c) To tell their doctor that they disagree with any recommendation to prescribe psychotropic medication,
(d) To go to the judge with an advocate of their choice and state that they object to any recommendation to prescribe psychotropic medication,
(e) To refuse the administration of psychotropic or other medication unless immediately necessary for the preservation of life or the prevention of serious bodily harm,
(f) To refuse the off-label prescription of psychotropic drugs and at-risk polypharmacy,
(g) To have prescribing doctors disclose any financial ties they have to pharmaceutical companies in writing in an age appropriate manner.

Contact your Missouri state Representative and Senator, and let them know what you think about this. Such an amendment to the proposed legislation would certainly strengthen the rights of foster children and reduce the administration of psychiatric drugs, since they are all inherently damaging to young children and should not be held as standards of care.

For more information click here.

Human Rights Concerns with the Helping Families in Mental Health Crisis Act of 2015

Saturday, July 18th, 2015

Human Rights Concerns with the Helping Families in Mental Health Crisis Act of 2015

Congressional Rep. Tim Murphy (R., PA) originally introduced the Helping Families in Mental Health Crisis Act (H.R.3717) in 2013. Not to be outdone by H.R.6 the 21st Century Cures Act, he has reintroduced it to this year’s Congress as H.R.2646 the Helping Families in Mental Health Crisis Act of 2015.

Rep. Murphy is a psychologist, and a staunch supporter of “mental health care” as defined by the psychiatric and psychological industries; not to mention the pharmaceutical and insurance industries.

Official Title of the Act: “To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.”

The Act creates a new position in the Department of Health and Human Services – an official to be known as the Assistant Secretary for Mental Health and Substance Use Disorders. (As if we need another bureaucracy in the psych industry.)

The Act creates more funding for psych-based “treatments.”

The Act expands the bureaucracy surrounding “parity in mental health and substance use disorder benefits” under Medicare and Medicaid.

The Act provides for grants in early childhood intervention and treatment programs, and specialized preschool and elementary school programs.

The Act provides for grants in “Assisted Outpatient Treatment” programs.

The Act requires states to have a law that enforces court-ordered involuntary mental health treatment for the “mentally disabled” if the state want to receive certain federal funding.

The Act expands mental health training for primary care physicians.

This isn’t even half of the proposed legislation.

The Act spends lots more money on “suicide prevention” all up and down the entire educational chain, from elementary school through college.

The Act establishes an entirely new bureaucracy called the “Interagency Serious Mental Illness Coordinating Committee.”

Of course, the Act also expands the availability of and insurance coverage for psychiatric prescription drugs, as well as lifting limits on Medicare payments for inpatient psychiatric hospital services.

The Act expands the Community Mental Health Care programs.

The Act increases funding for the National Institute of Mental Health.

And even that’s not all the Act does to strengthen the already fraudulent and abusive psychiatric mental health industry.

CCHR Supporters should really consider contacting their Congressmen to express their opinions about this affront to rationality.

Let us know when you contact your Congressmen about this, and any response you may receive.

Feds Pay for Drug Fraud

Sunday, May 3rd, 2015

Feds Pay for Drug Fraud

92 Percent of Foster Care, Poor Kids Prescribed Antipsychotics Get Them for Unaccepted Uses
This Huffington Post article on April 30, 2015 exposes the fact that poor and foster care kids covered by Medicaid are being prescribed too many dangerous antipsychotic drugs at young ages for far too long — mostly without any medical justification at all.
“92 percent of all kids on Medicaid receiving antipsychotics don’t have any of the limited ‘medically accepted pediatric conditions’ supposedly justifying their use. These ‘accepted conditions’ include the authority to use antipsychotics even for autistic children as young as 5 for such dubious FDA-approved conditions as ‘irritability.'”

“Medicaid spends about $3.5 billion a year on antipsychotics for all ages, largely for unaccepted uses, with nearly 2 million kids prescribed them. Nationally, about 12 percent of all the nation’s 500,000 foster care children have received Medicaid-paid antipsychotics at some point, often because they haven’t been offered proven, “trauma-informed” intensive therapies, according to Kamala Allen, director of Child Health Quality for the Center for Health Care Strategies.”

“… it shouldn’t be surprising to learn that federal officials aren’t too keen on enforcing drugging protections for either nursing home residents (whose meds are usually paid by Medicare) or children on Medicaid. ‘The federal government has done absolutely nothing of significance to rein in overprescribing,’ says Bill Grimm, a senior counsel with the San Francisco-based National Center for Youth Law (NYCL) that has launched a PsychDrugs Action Campaign, now focused primarily on pending reform bills in the California legislature.”

“… just two months ago, a Philadelphia jury found that Janssen hid the breast-growth dangers of the drug Risperdal and owed $2.5 million to a 20-year-old autistic man who developed size 46 DD breasts as a teenager. ‘This was the first case related to the condition called gynecomastia that went to a jury, but thousands more lawsuits are lined up in Philadelphia, California, Missouri, and other locations,’ The Philadelphia Inquirer reported.”

“… what’s especially absurd … is the notion that federal officials think they’re not allowed to suggest to state Medicaid authorities to stop paying for the unaccepted uses of these and other drugs.”

“As Dr. David Rubin, the director of the Policy Lab at the Children’s Hospital of Philadelphia, told Mental Health Weekly, ‘The medications are being used particularly for disruptive behavior and to control the children.’ Yet nearly half of all kids getting the drugs aren’t getting other behavioral health services such as therapy, according to research by the Center for Health Care Strategies.”

“A shocking five-part series by The San Jose Mercury News, published last year, highlighted dangerous overprescribing that showed that thousands of foster care kids over a decade — nearly one in four foster teens — had been essentially ‘chemically restrained’ for their behavior with antipsychotics drugs that left many drooling, lethargic and obese.”

“Edward Opton, an attorney with the National Center for Youth Law’s PsychDrugs Action Campaign, has underscored why foster care kids are especially vulnerable. Even though they make up just 3 percent of all Medicaid children, they account for roughly 30 percent of all Medicaid behavioral spending for kids: ‘Foster children are a lucrative market for psychotropic drug sales. Unlike adults, they can’t say, “No, I won’t take any more of that drug,”‘ he wrote in a recent column on the Mad in America website.”

You should read the full Huffington Post article, it is most illuminating.

You should also contact your local, state and federal officials and ask them why this Medicaid fraud persists.

The Cloward-Piven Strategy

Wednesday, December 10th, 2014

The Cloward-Piven Strategy

The Cloward–Piven strategy is a political strategy outlined in 1966 by American sociologists and political activists Richard Cloward and Frances Fox Piven that called for overloading the U.S. public welfare system in order to precipitate a crisis that would lead to a replacement of the welfare system with a national system of a guaranteed annual income and thus “an end to poverty.”

[Cloward, Richard; Piven, Frances (May 2, 1966). “The Weight of the Poor: A Strategy to End Poverty”. (Originally published in The Nation)]

You heard that right. The idea is to drastically increase the ranks of people on government welfare, crash the welfare system and force it to be replaced by — another government welfare system for everyone.

As Cloward and Piven put it, the ultimate objective of this strategy is to wipe out poverty by establishing a guaranteed annual income. In order to precipitate this crisis, the poor must obtain more and more welfare benefits until the system is overloaded.

This is just another suppressive way of redistributing income through the federal government.

Another part of the strategy is that welfare advocacy “must be supplemented by organized demonstrations to create a climate of militancy that will overcome the invidious and immobilizing attitudes which many potential recipients hold toward being ‘on welfare.'”

In other words, let’s create a dangerous environment so that people lose their natural inclination to be self-sufficient and hook them on government welfare.

“To generate an expressly political movement, cadres of aggressive organizers would have to come from the civil rights movement and the churches, …” Are you starting to see a pattern here with recent riots and demonstrations, largely fomented by people sent in from outside the affected community?

They go on to say, “By crisis, we mean a publicly visible disruption in some institutional sphere. Crisis can occur spontaneously (e.g., riots) or as the intended result of tactics of demonstration and protest which either generate institutional disruption or bring unrecognized disruption to public attention.”

Are you getting it yet? Do we really need to name Ferguson? Roughly a quarter of those rioters arrested were not residents of Missouri. One report has it that, “The real story out of Ferguson is that a national network of agitators is ready, on a moment’s notice, to arrive on the scene to cause violence and mayhem.”

Do you know how much “mental health care” and psychiatric drugs are a part of this plot, given that these drugs incite violence and aggression as a “side effect?” Hint — the Missouri Department of Mental Health’s budget is over $1.8 billion per year. Medicaid claims for psychotropic drugs are well over 60 million per year, over 2 million claims per year in Missouri; Medicaid payments for psychotropic drugs are over $6 billion per year, and over $174 million per year in Missouri.

Missouri Medicaid (called MO HealthNet) covers 1 out of every 7 Missourians and 38% of Missouri’s children. Roughly 30% of Missouri’s total annual budget goes to Medicaid; but this only covers 50% of Medicaid spending — the other 50% comes from the federal government. 15% of the Medicaid budget goes to pharmacy services; 15% goes to mental health services. And of course the Affordable Care Act allows for the expansion of eligibility for Medicaid — a key part of Cloward-Piven, expanding access to welfare; although at this time Missouri has not yet expanded MO HealthNet eligibility.

Psychotropic drugs represent roughly 30% of all pharmaceutical spending, and the cost appears to increase roughly 20% per year.

The implementation of the Affordable Care Act is expected to add 2.7 percent, or $7.3 billion, to the level of Mental Health and Substance Abuse spending in 2020, as an expected 25 million people who were previously uninsured gain health insurance coverage.

Well, as we looked back on these statistics, we nearly fell off of our soapbox in shock. What to do? Contact your local, state and federal officials and express your alarm. Write a Letter to the Editor. Contact your employer, your school, your church, your family, friends, and associates. Show them a CCHR DVD documentary (we’ll mail you one if you promise to show it around.) Forward this newsletter and suggest they subscribe. Vote!

Find Out! Fight Back!

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.

U.S. Probes Psych Drugs on Kids

Sunday, September 8th, 2013

U.S. Probes Psych Drugs on Kids

The Wall Street Journal (WSJ) carried this report August 11, “U.S. Probes Use of Antipsychotic Drugs on Children,” sub-titled “Federal health officials are reviewing antipsychotic drug use on children in the Medicaid system.”

Concerned that psych drugs are being over-prescribed to very young children, the U.S. Department of Health and Human Services (DHHS) is reviewing antipsychotic use in the Medicaid system for children under 18 years old. These drugs include Abilify, which is widely prescribed to children for a range of behavioral symptoms. Other drugs in this category include Risperdal, Seroquel, and Zyprexa.

The DHHS has this to say specifically about this review: “We will determine the extent to which children ages 18 and younger had Medicaid claims for atypical antipsychotic drugs during the selected timeframe. On the basis of medical record reviews, we will also determine the extent to which the atypical antipsychotic drug claims were for off-label uses and for indications not listed in one or more of the approved drug compendia.”

Quotes from the WSJ article: “Medicaid spends more on antipsychotics than on any other class of drugs. Abilify, made by Otsuka Pharmaceutical Co., appears on lists of the top 10 drugs paid for by Medicaid in various states.”

“The number of people under age 20 receiving Medicaid-funded prescriptions for antipsychotic drugs tripled between 1999 and 2008.”

“Children on Medicaid are prescribed antipsychotics at four times the rate of privately insured children.”

“Of particular concern is use of the drugs on foster children in the Medicaid system.”

Contact Daniel R. Levinson, Inspector General, U.S. Department of Health and Human Services, at dan.levinson@oig.hhs.gov, and let him know what you think about the psychiatric drugging of children with harmful and addictive antipsychotics.

Abilify and other antipsychotic drugs have caused a potentially fatal condition called neuroleptic malignant syndrome. Patients who develop this may have high fevers, muscle rigidity, altered mental status, irregular pulse or blood pressure, rapid heart rate, excessive sweating, and heart arrhythmias (irregularities). Body temperature regulation—disruption of the body’s ability to reduce core body temperature—has been attributed to antipsychotic agents such as Abilify.

According to the U.S. consumer advocacy group Public Citizen after reviewing information about clinical trials of Abilify, “…nothing in these five trials can lead one to believe that aripiprazole (Abilify) is a meaningful advancement in the treatment of schizophrenia.”

Of course, we recognize that the real problem is that psychiatrists fraudulently diagnose life’s problems as an “illness”, and stigmatize unwanted behavior 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. All psychiatric treatments, not just psychiatric drugs, are dangerous.

It is vital that you, your family, your friends 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 here. Forward this newsletter to everyone you know and recommend that they watch this video.

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.

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.