$446,000 Employee Fraud Scheme

     From a press release:

Martin Hernandez, 45, of Selma [CA], pleaded guilty on Monday to one count of wire fraud in connection with a scheme to fraudulently obtain unauthorized Social Security benefit payments, U.S. Attorney McGregor W. Scott announced.

According to court documents, Hernandez met Social Security benefit recipients through his employment at the Social Security Administration. Hernandez recruited certain recipients to receive fraudulent payments in addition to the benefits that they were entitled to receive. These recipients agreed to return a substantial amount of the money they received from the fraudulent payments back to Hernandez. Hernandez electronically initiated the payments from his workstation at the Social Security Administration offices where he worked. After Hernandez caused the beneficiaries to receive the fraudulent overpayments, he would instruct them to meet him in person to give him cash. During the course of the scheme, Hernandez caused the Social Security Administration to make unauthorized payments of over $446,000. ...

No, I Don't Know Why She Hasn't Been Approved But Even If She Is Approved, It Won't Be Enough To Live On

     From the Philadelphia Inquirer:

The pair are homeless. Currently, she sleeps in a bed at Chester County Hospital, while Don sleeps in the chair next to her. Medicaid covers hospital costs. They survive on $350 a month in food stamps, and whatever cash and gas money for Don’s father’s old car, a 2005 Nissan Altima, that friends, Chester County churches, and charitable strangers can give. ...

While Maureen has suffered through three years of chemotherapy, radiation, and other treatments, Don — who once earned $53,000 a year selling parts for BMWs — has been laid off twice, and now devotes his time to caring for his wife and looking for a part-time job.

The couple have applied for Supplemental Security Income (SSI) for Maureen, but have been denied by the federal government three times. SSI, which amounts to about $770 a month, is given to disabled and destitute people who can’t work. Despite a mythology that has grown around the program — that payments are easily obtained by cheating the system — approximately two-thirds of applicants are turned down, federal figures show. ...

Doctors have said Maureen might live a year or less, as cancer has ravaged one breast and lodged in the other. The disease has further metastasized to her lungs and her liver.

“This is a sad case, a sad case,” said Jan Leaf, executive director of the Lord’s Pantry of Downingtown food bank, which offers the Walls food, and has bought them a hot plate so Maureen can eat vegetables. "To see people who worked all their lives, just to end up in this situation ... .

COLA Announcement Coming On October 10

     The big announcement of Social Security's Cost Of Living Adjustment (COLA) is coming up on October 10. Expect it to be 1.5% or 1.6%.

Tide Has Turned

     The Wall Street Journal says that policy debates about Social Security have shifted from cutting benefits to raising benefits. Looking back, it’s hard to understand we’ve spent so many years listening to talking heads telling us we have to cut benefits. That’s never been what people wanted.

     I remember years ago reading this imagined exchange between a Republican member of Congress and a Democratic member:

Republican: All you do is tax and spend.
Democrat: And elect and elect

Did They Get Their Money's Worth?

     I don't think I've seen this before. Social Security has posted the amount it spent on consultative medical examinations of disability claimants in Fiscal Year 2018: $353,390,976.61.

Tense Negotiations Over Union Contract

     From Federal News Network:

After more than a year of tense negotiations, the Social Security Administration and the American Federation of Government Employees have finally reached an agreement on a new, six-year contract.

The new collective bargaining agreement, which SSA management and AFGE representatives signed late last week, settles months of disagreements between the two parties and offers both some stability days before the injunction on the president’s May 2018 executive orders was lifted. ...

The Federal Mediation and Conciliation Service (FMCS) in September brought AFGE representatives and SSA management together to begin discussing how the two parties would move forward after a June decision from the Federal Service Impasses Panel.

In total, the impasse panel ruled on four provisions for management, six with slight modifications for management, one provision for AFGE and another for the union with slight modifications. ...

SSA wanted to allow five days for negotiations with the union. AFGE proposed four weeks, the union said.

Both parties struggled to agree on a bargaining process — specifically how long they could negotiate and what specifically they should negotiate over.

In the end, the union faced a decision: drop all ongoing litigation related to the SSA bargaining agreement, which included two court cases and nine grievances, and negotiate with the agency — or have the impasses panel rule on the remaining articles of the existing AFGE contract. SSA, meanwhile, said it would begin to implement the provisions of the president’s workforce executive orders under the second option. ...

“We had two options available to us. Neither option was particularly good,” Rich Couture, president of AFGE Council 215, which represents employees at SSA’s Office of Hearings and Appeals, said in an interview. “One was a choice between a certain annihilation of representation at SSA, as well as long-held employee rights and benefits and privileges, versus a chance at continued survival.” ...

The new agreement gives a bank of 125,000 hours of official time — half of the official time bank AFGE representatives had under the previous contract but 75,000 more hours than what the impasses panel granted in its recent decision. ...

The agreement allows 20 union representatives to use no more than 840 hours of official time a year, meaning those employees could spend about 40% of their time on union activities and the remaining 60% of their time performing the functions for which they were initially hired.

All other union representatives have a limit of 400 hours of official time a year, meaning these employees can spend as much as 19% of their time on union activities. Both of these scenarios give AFGE representatives more official time to work with than what’s described in the president’s executive orders. ...

“The fight is not over, but at least we will have some time and resources to conduct a fight,” AFGE wrote in a summary of its new contract to its members. “There will no longer be any union officials who on 100% official time, 75% official time or even 50% official time. Every union official will be doing production work and we will be feeling, first hand, the same pains and abuses that every other worker feels.” ...

“The commissioner had stated to us that he wanted to have a strong and positive relationship with the unions at SSA, that he wanted to improve working conditions for employees,” Couture said. “Everybody is pretty well aware that SSA’s Federal Employee Viewpoint Survey scores for the last few years are pretty poor. Also, the commissioner wanted to really bring in employee ideas and engage employees in labor in finding ways to address, tackle and solve a lot of SSA’s service delivery issues.” ...

Maintaining the status quo with telework was one of the top priorities for the union, Couture said, but it was one of the few areas where AFGE and SSA couldn’t compromise. ...

The union said it’s concerned SSA component leaders may make their own changes now to existing telework policies. ...

Seizing Social Security Checks To Pay A Hospital Bill

     From a San Antonio television station:

Texas passed laws this year to protect patients from surprise medical bills. But some hospitals can still hit you with huge charges, take money from your paycheck, even confiscate your tax refund. News 4 Trouble Shooter Jaie Avila shows us how it's devastating some local families.

Government-owned hospitals like Brooke Army Medical Center can save your life in an emergency. But they are not part of any insurance network and will not negotiate charges with them. If your insurance doesn't pay the bill in-full the government goes after you.

Back in 2015 Frank Hooker suffered a fall that fractured his skull and caused bleeding in his brain. He was flown to Brooke Army Medical Center for several days of treatment.
“To this day I don't know why the bill wasn't paid because he had really good insurance," said Frank’s daughter Jana Gentry. ...

Frank worked for the City of Devine for decades, but now suffers from Alzheimer's and his wife recently passed away. His daughter Jana says she had no idea there was an unpaid hospital bill for $60,000 until January of this year.

“I got a letter from the Department of the Treasury saying if it wasn't paid in-full they were going to take it out of his social security," Jana recalls.

And that's what they did....

So, we contacted Humana, and BAMC, on Frank's behalf.

Brooke Army Medical Center says after hearing from us they immediately called Jana.

“We provided a copy of the bill to her for her records. As a courtesy to Ms. Gentry, we rebilled her father's insurance carrier," BAMC officials said in an email.

Humana also told us it would look into Frank's bill, adding: "We work diligently and with our members to research and resolve their personal situations."

A few days went by and then, Humana called Frank's daughter Jana with fantastic news: it is covering the hospital bill. ...

We've heard from numerous other families who are struggling to pay off large bills because their insurance companies will not cover charges from BAMC. We've asked to interview someone with Brooke Army Medical Center and the Treasury Department about their collection methods, We hope to bring that to you soon.

      No, I don't know why why Brooke Army Medical Center would have been treating a civilian. (I've actually had a client who had a heart attack while visiting a relative who was an inpatient at a VA hospital. The visitor was admitted to the VA hospital even though he wasn't a vet. That's not the situation here, however. I remember that there was an insurance problem in that case but it was only because the situation came up so seldom that the VA hospital had trouble producing a bill.) I do know that if this had been a hospital owned by anyone other than the federal government that they could not have taken his Social Security check.

Year In Prison For Striking Guard

     From WCPO in Cincinnati:

A Milford man will spend a year in prison for punching a Social Security Administration guard in the face.

U.S. District Judge Michael R. Barrett sentenced 35-year-old Daniel Toops Thursday for the assault that happened on April 11 at the Batavia Social Security office.

According to court documents, Toops was dissatisfied with information he was given after speaking with an official at the social security office. Toops started to leave the building and shouted expletives that included threats to the office and the workers.

Court documents said Toops was then approached by a security guard. There was an altercation, and Toops punched the security guard in the face. ...