DiFi the Dino

Why the Democrats have to get rid of the Republicans in drag

© Bryan Zepp Jamieson
08/05/07

A friend of mine had hip surgery – a replacement – back in March, at the age of 54. She was an excellent candidate for rehab, of course. The surgery was a success, and she looked to be making a rapid and uneventful recovery. Instead, she fetched up in a convalescent place, and while she did receive care and eventually was able to go home, it was nothing like the sort of care that post-op patients usually got if they were lucky enough to be covered. In her case, she had Medi-Cal.

We couldn’t figure out why she had been turfed out to that dump in the first place. While her medical condition is intractable, she’s still young and capable of decent quality of life. There’s no reason she cannot continue living at home with her pets and a minimum of outside help. So it made sense to get her top level rehab, and thus improve her ability to live at home, both for her benefit and for the savings it would present to society.

But then today my wife spotted something in the Sacramento Bee. Seems that California’s whorish senior Senator had helped arrange for an auditing firm – not a medical group – to look over cases of people having surgeries such as hip replacements and the like, or who had suffered strokes, and who were slated to go to rehab. The outfit, PRG-Schultz International, got 25% of the savings for every medicare claim for rehab that it denied. Yes, you read that right; they got paid – lavishly – but only for claims they denied.

It probably comes as no surprise that PRG-Schultz International denied 97% of the claims they audited. Nice work if you can get it. And speaking of which, Feinstein’s hubby bought heavily into PRG-Schultz International stock shortly before Feinstein set this up.

The California Hospital Association, and Lois Capps, the Congresswoman from Santa Barbara, have each demanded full investigations into this arrangement, which the CHA says has resulted in thousands of patients being wrongly denied treatment that could have restored much of their lives and saved society billions of dollars, were this auditing firm not being paid to refuse them.

The involvement of an outfit like PRG-Schultz International in the process is questionable to begin with. That they got paid only if they refused the reimbursements of medicare is unconscionable, and further evidence of the utter moral and legal bankruptcy of America’s pathetic medical system.

Imagine that. They get paid, but only if they deny services. Who would have guessed they would be looking for any excuse – or no excuse at all – to deny services?

And of course, that’s exactly what they did. Of the 4,000-odd cases they oversaw, they rejected over 97%. It’s a wonder they approved as many as they did.

The House is now reviewing the contract to determine if it is being handled in a medically professional and ethical manner, and to determine if patients are being shorted. The Senate is considering taking the program, limited to Feinstein’s California, and making it national. Can you guess how Feinstein is gonna vote on that one?

Don’t expect much from the Senate. Senator Feinstein is overseeing it, and she already has a letter from PRG-Schultz assuring her that everything is in order – and they probably called to assure her that the stock prospectus was bright.

The sad thing is that our friend’s medical care is typical of what you expect in America today – grudging, inadequate, a burden on the undeserving rich. Who knows how many canapes Feinstein might have had to reduce for her next garden party had our friend received the type of care that in civilized countries would have been her birthright?

Even sadder is that, even with a level of corruption that would have been considered disgraceful in most civilized countries at any time after the 18th century, Feinstein isn’t bad compared to the general standards of the bought-out Congress. At least she hasn’t been accused of turning a blind eye to forced child labor and even child prostitution in American protectorates in return for petty bribes from Jack Abramoff – like John Doolittle and Tom DeLay have. Even though she’s a Democrat of sorts, it’s unlike that Putsch’s justice Department will raid her home(s) any time soon. Of course, the same people that own the administration are the same ones who see to it that her stock investments do well, so she won’t be convicted by the GOP and then possibly face trial.

But she has to play ball, being bought out like she is.

That’s why she broke ranks with her party on the Judiciary Committee and voted with the Republicans to send the nomination to the Fifth circuit of the dicey Leslie Southwick out to the full Senate.

That’s why she voted to support the extension on the ludicrously-misnamed FISA bill yesterday. One of 14 perfectly worthless Democrats who voted to expand the ability of the untrustworthy administration to wiretap and spy. This puts her as one with German legislators who voted for the Nuremberg Laws in order to expedite Chancellor Hitler’s ability to fight enemies, foreign and domestic.

The following day about 30 Dems broke rank in the House to support the same bill.

The party needs to get rid of the Feinsteins – the cowardly centrist, the bought out ones who have become convinced that serving the needs of the wealthiest 1% fulfills their obligations to the country, and the neo-fascists who think the mindless brutal authoritarianism of the GOP is just what the country needs.

The right wing chortles that “the Democrat Congress” is inept and unwilling to take any kind of stand, and of course, for 85% of the Democratic membership, that simply isn’t true. They ARE standing up for our rights, and to restore America to the decency and legitimacy that Putsch and his murderous clowns stole.

But the 15% that are DINOs, lackeys for the privileged, bought-out, and custard-heads prevent the country from throwing off the shackles of GOP rule.

The GOP stole three million votes in 2006. They have infiltrated nearly 10% of the positions the Democrats hold in congress.

And they are barely holding on.

Obviously, the country has seen enough of Putsch and his gang of vicious criminals.

And if the Democrats can’t bring the infiltrators and renegades to heel, they’ll find themselves facing a strong force from the left that will clean out the moderates along with the GOP rubbish next year.


No doubt that included our friend.
Hospital group wants auditor inspected
PRG-Schultz, which has ties to husband of Sen. Feinstein, wrongly rejects Medicare claims, association says.
By David Whitney - Bee Washington Bureau

Last Updated 12:13 am PDT Saturday, July 21, 2007
Story appeared in MAIN NEWS section, Page A3

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WASHINGTON -- The California Hospital Association has asked for an inspector general's investigation of PRG-Schultz International, an auditing company it said is wrongly denying thousands of Medicare reimbursements at rehabilitation hospitals.

According to government records, the claims rejections so far top $100 million statewide.

The hospital association said they threaten the care that will be available to patients recovering from common elderly problems like hip and knee replacement surgery, Parkinson's disease and strokes.

"Stroke is the single biggest category for patients going into acute rehabilitation hospitals," said Patricia Blaisdell, CHA vice president for medical rehabilitation services and continuing care.

The Centers for Medicare and Medicaid Services, an agency of the Department of Health and Human Services Division, said in a letter to Sen. Dianne Feinstein, D-Calif., last week that it has no concerns about the Atlanta-based contractor.

Leslie V. Norwalk, acting CMS administrator, said that after reviewing the hospital association's complaints and PRG-Schultz's work, the agency "concluded that it is acting in accordance with Medicare law and statutes." Feinstein asked for the review in May.

The controversy has been awkward for the senator because an investment company controlled by her husband, Richard Blum, is a major owner of PRG-Schultz. Blum Capital Partners hiked its investments in the financially shaky firm about the time the company was expecting profits to flow in from the California contract.

Blum's company now holds a seat on the PRG-Schultz board.

Feinstein's spokesman, Scott Gerber, said the senator had no comment on the CMS letter.

Shortly after Feinstein's letter to the CMS raising questions about the auditing work, 36 California House Republicans and Democrats joined in a similar letter.

The letter questioned whether a bounty of between 20 and 25 percent PRG-Schultz receives on every claim rejection was tilting its decisions to near-total rejection of rehabilitation hospital care.

"This action is unprecedented and (is) raising serious concerns about whether CMS has provided adequate safeguards to prevent recovery incentives from driving audit determinations," the letter said.

Rep. Lois Capps, D-Santa Barbara, a leading force behind the letter, had not yet received a response from the agency, said her press aide, Emily Kryder.

But Kryder said the CMS letter to Feinstein "has not alleviated Rep. Capps' concerns regarding this matter, and she will be working with her colleagues in the California delegation to determine how to move forward in addressing these concerns."

California is one of three states whose Medicare spending is being reviewed under a system called recovery auditing. The other two states are Florida and New York, where the contractors are nonprofit organizations.

Recovery auditing is premised on auditors keeping a percentage of whatever they collect. Its application to Medicare spending was included in a 2003 law as an experiment to create a program that would ferret out improper payments, and the program now has been made permanent and soon will expand to other states.

PRG-Schultz began reviewing California Medicare contracts in 2005 and, according to Norwalk's letter to Feinstein, it has looked at only 8 percent of claims submitted by inpatient rehabilitation hospitals so far.

There are 74 such hospitals in California, according to the hospital association. They typically take patients after they've been released from surgical and emergency-care hospitals in an effort to help them recover through intense physical therapy and other services.

PRG-Schultz targeted elderly patients recovering from joint-replacement surgery because a report by congressional auditors in 2005 found that "relatively few" such patients needed that level of rehabilitative service, Norwalk said.

"PRG concluded that although most of these beneficiaries need to receive rehabilitative services, they don't meet the Medicare criteria for receiving these services in inpatient settings," Norwalk said.