DOL Should Reexamine Cuts Affecting Sick Nuclear Workers

Updated 7 years ago by Terrie Barrie
DOL Should Reexamine Cuts Affecting Sick Nuclear Workers

The administrative costs for EEOICPA have always bothered me.  DOL published their budget justification to Congress for FY 2014 last week, and sure enough I found a few items that concern me.  They anticipate they will receive 12,480 claims next fiscal year.  This is a decrease of almost 9% from the 14,046 initial claims DEEOIC received for FY 2012.  So why is DEEOIC asking for a $3 million increase?  And why would they project that the benefits paid out will be almost 13% less in 2014 than was paid out in 2012 if there is a only a 9% decrease in new claims filed? Shouldn’t the decrease in benefits paid also be a 9% reduction?  How do they arrive at the additional 4% decrease?

Some might ask, what’s the big deal about a 4% difference?  I always try to put a human face to numbers that involve this program.  That 4% represents 125 workers or their survivors who could qualify for Part B lump sum benefits of $150,000.00 or 750 workers who could receive a 10% impairment rating for their condition.

Another area of this budget that I find very unsettling is DEEOIC’s apparent crack down on providing home health care for the approved claimants.  DEEOIC’s first concern is that, “Home health care costs have grown by 1,697 percent over the last seven years from…” (Page 18) 

Uh, do you think the rise in costs may be because these workers are sick and dying and need this medical benefit?

Their other concern is that these dying workers are receiving home health care for a year or two.  To me, that statistic reflects that the health care provided at home allowed these dying workers to spend another year watching the tulips bloom or celebrating another anniversary with their spouse.  What is wrong with that?  Many of these workers’ lives have been cut short because the government allowed them to be poisoned during the Cold War and refused to care for them until this program was enacted.  Many of these workers had no idea what the health effects were of the toxic soup they toiled in daily.  The very least the government can do is to provide them with the best care at the end of their life.

Ok, there was one company who defrauded DEEOIC for $3 million.  They were caught and rightfully punished.  I applaud the DOL Inspector General for pursuing this. I’m all for checks and balances for providers.  But, because of this one bad apple, is DEEOIC going on a witch hunt with other home health care providers? That is not fair.

I found two other types of fraud – and only two - from the Inspector General reports perpetrated on DEEOIC.  One was a privately held pharmaceutical company who, in 2007, was fined and placed on probation for “fraudulently marketing a prescription pain medication, OxyContin, as less addictive, less subject to abuse and less likely to cause withdrawal symptoms than other pain medications.”  The cost of this fraud was $42 million to DOL.  The other fraudulent case was an ACS employee was indicted for embezzling $260k from DEEOIC.  ACS is the medical bill paying contractor for DEEOIC.

I am glad these frauds were caught and punished.  However, in my research not once did I see DEEOIC state in their budget justification to Congress that they would evaluate all drug companies “to ensure appropriate prescribed care as well as to provide additional capacity to monitor for instances of fraud” or monitor ACS employees to make sure they were not embezzling. Why is this provision to monitor home health care providers specifically mentioned in the budget justification? 

There are hundreds of home health care companies in the country.  Are they assuming that every home health care provider is overbilling the government when caring for these dying nuclear weapons workers? Does DEEOIC plan to determine the level of care a dying worker needs by utilizing a medical consultant instead of relying on the worker’s personal physician?   Will DEEOIC strong arm the personal physician to reduce the level of care in order to save money?  What will be next?  DEEOIC will decide that cancer treatments are too expensive and institute an evaluation program for that benefit?

And why isn’t DEEOIC itself checking for potential waste of taxpayer dollars with their own contractors?  For example, DEEOIC contracted with Paragon Technical Services for over $12 million to manage the Site Exposure Matrix (SEM) database.  This contract is about 7 years old and the SEM is still not complete. DOE facilities are missing, workers who had the potential of being exposed to a certain toxic substance is missing and even some toxic substances themselves are missing from this database. 

But let’s take a look a little closer to DEEOIC’s management and the potential waste of a million dollars.  DEEOIC contracted with the Institute of Medicine to review SEM. IOM reported to DEEOIC on SEM’s deficiencies last month.  Instead of DEEOIC embracing IOM’s recommendations to improve SEM, DEEOIC basically said, “Thank you very much for your opinion.  We’ll consider it.”  A more detailed analysis can be found here

I hope Congress asks why DEEOIC needs $3 million more dollars when they are processing less claims.  I hope Congress asks DEEOIC if the reason for finally initiating, after 7 years, “the process of developing a new measure in FY 2013 to evaluate home health care cases to ensure appropriate prescribed care as well as to provide additional capacity to monitor for instances of fraud” has more to do with cutting benefits to the workers than it does for finding fraudulent billings. I hope Congress asks why DEEOIC did not catch the many problems with SEM.  And I hope that Congress asks why DEEOIC will only consider and not adopt IOM’s recommendations to improve SEM.

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