by Corinne Murdock | Oct 5, 2022 | News
By Corinne Murdock |
Last Thursday, the Arizona Auditor issued a report finding that the state’s Medicaid agency, the Arizona Health Care Cost Containment System (AHCCCS), failed to fulfill four major aspects of its services, including a year delay on average to investigate over half of fraud or abuse incidents.
AHCCCS provides health care coverage to over 2.4 million Arizonans: about 33 percent of the population.
In all, the audit report determined that AHCCCS also failed to: review health plans every three years as required, make correct eligibility determinations, ensure that health plans oversaw providers in two key areas, and establish oversight processes for its Housing Program and Administrator.
In order to remedy these issues, Auditor General Lindsey Perry issued 22 distinct recommendations. AHCCCS agreed to implement all 22 of Perry’s recommendations without contest.
AHCCCS explained that no federal or state regulations mandated the completion of preliminary investigations within 3 months, like Perry recommended, but agreed it was best practice and would adopt that protocol. Likewise, AHCCCS explained it would adopt a self-auditing process to review eligibility determinations, despite there not being any federal or state regulations for such quality assurance reviews.
AHCCCS also noted that its lack of eligibility reviews was due to understaffing caused by the COVID-19 pandemic.
The audit may also result in a change to state law. AHCCCS noted that it wasn’t able to create a monthly report as required by statute. This report — which was to be sent to the governor, the house speaker, and the senate president — was meant to include Title XIX and non-Title XIX categories that outlined the persons served, the units of service, and the amount of funding provided for client services and the amount provided for regional behavioral health authority administration and case management expenses.
In addition to the negative findings of the audit report, AHCCCS is facing a lawsuit filed by several federally-qualified health centers. The community health centers claim that AHCCCS is wrong to deny reimbursements for dentists, podiatrists, optometrists, and chiropractors. Earlier this month, the Ninth Circuit Court of Appeals reversed a decision dismissing the lawsuit.
Arizona Alliance for Community Health Centers sued AHCCCS, joined by Canyonlands Healthcare, Chiricahua Community Health Centers, Desert Senita Community Health Center, Mariposa Community Health Center, Marana Health Center, Mountain Park Health Center, Native Health, North Country Healthcare, Sun Life Family Health Center, Sunset Community Health Center, and United Community Health Center-Maria Auxiliadora.
Corinne Murdock is a reporter for AZ Free News. Follow her latest on Twitter, or email tips to corinne@azfreenews.com.
by Dr. Thomas Patterson | Oct 1, 2022 | Opinion
By Dr. Thomas Patterson |
Suddenly America is facing a severe structural labor shortage. We all feel it, whether we’re trying for reservations at a restaurant that has reduced hours, seeking handyman help, or just trying to get somebody to answer the dang phone.
Nurses and teachers are in short supply. Employers report at least two job openings for each job seeker. Beyond personal inconvenience, when workers produce fewer services and goods for dollars to chase, prices go up and inflation results.
You can partly blame it on COVID. Politicians shut down much of the economy, then shoved trillions of dollars in “COVID relief funds” to those forced not to work.
Unfortunately, the spigot was never fully closed, and many Americans found that sleeping in agreed with them. Europe, Canada, and Japan all rebounded while the U.S. was left with about one million fewer workers.
Adding to the problem, the youth anti-work movement continues to grow. Work is for suckers and victims. Social media outlets praise workers for quitting their jobs. Others are lionized for being “quiet quitters,” idlers who do the least work possible while still collecting a paycheck.
The inspiration for the anti-work cult traces back to the Marxist anti-capitalist movement, a long-time foe of the American work tradition. Their thesis is that capitalist employment is exploitive and therefore, not working is virtuous.
It coincidentally turns out that, for many Americans, government policy has significantly disincentivized work. And for these people, working harder is no longer the way to get ahead.
Writing in the Wall Street Journal, Phil Gramm and John Early explain how this effect is commonly underestimated because of the way income is reported by the federal government. The Census Bureau, inexplicably, does not treat most transfer payments as income.
That’s important because government transfer payments to the bottom 20% of households, income-wise, ballooned by 269% between 1967 and 2017 while the middle 20% realized only a 154% increase in their after tax income.
The results were staggering. In 2017, the bottom 20% of households had $6,941 in “income” and only 36% of working age people actually worked. However, after the transfer payments and taxes are included, as they should be, their total income was $48,806.
The second to the bottom quintile had 85% employment and an average total income of $50,492, actually less than a $2,000 difference from the lowest group. The middle quintile was 92% employed and earned $66,453, but after taxes and transfers that shrank to $61,350, merely 26% more than the bottom quintile.
But wait, there’s more. Family units are smaller in the lowest quintile than the others. Per capita, the adjusted net income was actually $33,653 in the lowest quintile, $29,497 in the next lowest, and $32,754 in the middle.
Sorry for all the numbers, but they tell an important story. For 60% of Americans, working much harder and even earning more money produced a negligible net benefit. Means-tested government programs were just as lucrative. It’s not hard to understand why the percentage of working age people in the lowest quintile who were employed fell from 68% in 1967 to 36% in 2017.
Policymakers seem to believe that incentives don’t matter, but they do. People who choose not to work and live off the labor of others earn some understandable resentment, but they’re not acting irrationally under the circumstance. The heart of the problem is their enablers in Big Government who, for their own political purposes, created this perverse system.
It’s often forgotten that in the 1990s, governments established work requirements for many means-tested benefits. “Workfare” was a generational policy success. In spite of hysterical warnings that “children would starve in the streets,” poverty rates dropped as employment increased.
Unfortunately, the advocates for workfare declared victory and moved on. But welfare bureaucrats stayed put, patiently reestablishing their vision of welfare without requirements. So now poverty is supported rather than reduced. And Arizona was among the states that quietly removed the work requirements for Medicaid and other welfare programs.
But government handouts that replace labor don’t work. They erode self-reliance, worker pride, and self-sufficiency. They threaten our shared prosperity. And most of all, they undermine American values.
Dr. Thomas Patterson, former Chairman of the Goldwater Institute, is a retired emergency physician. He served as an Arizona State senator for 10 years in the 1990s, and as Majority Leader from 93-96. He is the author of Arizona’s original charter schools bill.
