Inspector General has identified $50 Billion of for-profit insurance company fraud in the Program. It could be just fine come January.
{{ Some are betting that the $450 billion Medicare Advantage industry could be ripe for regulatory easing.
In recent years, criticism of Medicare Advantage has grown, particularly among Democrats. Many accuse insurers of overbilling the government and denying care to seniors too frequently. Earlier this month, The Wall Street Journal reported that private insurers made hundreds of thousands of questionable diagnoses that triggered $50 billion in extra taxpayer-funded payments from 2018 through 2021. }}
Some years ago, gaming and defrauding Medicare was the core of Tenet Healthcare’s business model. The original scandal was some 20 years ago, but, today, when I looked for a link to that old case, I found flox of links to a new case of Medicare fraud by the “JCs” at Tenet.
Of course, now that SCOTUS has ruled that kickbacks are “gratuities”, not bribes, thus legal, Tenet will be free to engage in this behavior in the future.
There is a proposal to exempt tips from income tax. Tips are “gratuities”, so, maybe the idea is to exempt multi-million dollar kickbacks from tax liability?
Of course, a few years ago, the POTUS approved a DOL reg that allowed the “JCs” to take away from the tips the servers earned, and hand the money to the back room staff, rather than paying their full wages out of his own pocket. I rather suspect that the cut the “JCs” will take, is greater than the tax bite.
This is the DOL reg on tip pools. It covers the initial reg, from December 2020, and the revisions in September 2021, when a different crowd was in charge at the Labor Dept.
-apparently, the 2020 reg prohibited “JCs” taking employee’s tips for themselves, but did not provide any penalty for the “JCs” violating that provision. The 2021 revision established civil monetary penalties (CMP) for violating the prohibition on pocketing tips given to their employees.
-the 2021 revision established when minimum wage and overtime rules violations could result in a CMP for the “JC”.
The 2020 reg “burdened” the “JC” by requiring record keeping for the operation of the tip pool. I would suspect that, if tip income is tax exempt, this “burden” on the “JCs” would go away.