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DOA, OGB backtrack on medical/pharmaceutical plans in face of litigation threat; to refund $4.5M to OGB members

Posted in Attorney General, Courts, DOA, Finances, Governor's Office, Health Care, Lawsuits, Legislature, Legislators, OGB, Office of Group Benefits, RFP, Request for Proposals on November 5, 2014| 11 Comments »

You have to love the Division of Administration (DOA) and the Office of Group Benefits (OGB). Their concern for the 230,000 state employees, retirees and dependents is surpassed only by their arrogance.

Saying “We heard the financial concerns of our members and Legislators,” Commissioner of Administration Kristy Nichols made the self-serving announcement that OGB has decided to delay the effective date of changes arbitrarily (and illegally) implemented to medical and pharmacy plans from Aug. 1 to Sept. 30. OGB RELEASE

Here is the information provided on the OGB web site: https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A4D344D6A45794E533551524559334E6A4D32

Never mind that State Rep. John Bel Edwards (D-Amite) told Nichols and OGB CEO Susan West back on Sept. 25 that they were flirting with major litigation and the threat of having to refund millions of dollars to OGB members who were hit with benefits changes which were illegal until such time as a rule could be adopted. Here is the link to video clips of that hearing: http://youtu.be/ct652tBa8Mc.

Except for Edwards who said the move was illegal. He requested and obtained an Attorney General’s opinion that agreed with him.

            Nichols, as is her custom, was not going to promulgate rules at all in implementing the new rates members would have to pay for prescriptions even though the law requires advertisement and public hearings on such changes. Instead, the administration, facing a shrinking OGB reserve fund because of its repeated premium cuts, plunged ahead, the law and state employees be damned.

The premiums were reduced so that the state would enjoy a similar reduction in the 75 percent of premiums it is required to pay for health coverage of OGB members. Gov. Bobby Jindal and Nichols cut the rates by nearly 9 percent despite a report from Buck Consultants which stated flatly that it never made such actuarial advice.

Pursuant to testimony given in the Sept. 25 hearing by the Joint Legislative Committee on the Budget (JLCB) in which Kristy said Buck Consultants had recommended a premium reduction, Edwards requested a copy of the actuarial recommendations.

            “I still have not received any actuarial recommendations for the 2013 and 2014 premium reductions at OGB,” Edwards said Tuesday. “Nor have they told me that such recommendations do not exist. Clearly, they do not.”

The OGB web site does contain a request for proposals (RFP) for an actuarial that is dated Sept. 26: https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A4D774E4445794D793551524559334E444531

The Baton Rouge Advocate said the refunds the state must now make to OGB members who were overcharged in the form of out-of-pocket expenses will come to nearly $4.5 million and is expected to be refunded within 60 days.

http://theadvocate.com/news/10718472-123/group-benefits-change-announced

Getting the refunds for the overcharges won’t be a walk in the park if past experience with the OGB pharmaceutical benefits administrator is any indication. “Members who incurred increased pharmacy costs between Aug. 1 and Sept. 29 based on exclusions must submit an appeals form to MedImpact,” said the news release from OGB, adding that Blue Cross and Blue Shield of Louisiana (BCBS) will reprocess claims for members who incurred increased medical costs through their providers during that time period. There is an appeals form for MedImpact on the OGB web page, but it appears to apply only to prescriptions that were rejected or denied by pharmacies in August and September: https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A4D344D6A45794E693551524559334E6A4D33

“If members incurred costs that were not submitted through a provider, they must submit an appeal request form to Blue Cross and Blue Shield,” the release said. “The forms can be found on the OGB website at www.groupbenefits.org.”

Edwards said the burden should not be placed on state employees and retirees to file appeals on overpayments. “Group Benefits has the claims information and they should be required to make the determination of who is owed what and it should be Group Benefits that takes the initiative on this,” he said.

Of course, by placing the onus on employees and retirees, DOA is counting on members being unfamiliar with the process or uninformed about the refund program altogether. If they do not file appeals for refunds, no refund will be made and the state will not have to repay victims of the overcharges. “That’s why Group Benefits should be the one responsible for seeing to it that everyone who was overcharged because of its illegal actions in implementing the changes in the first place should get those overcharges refunded,” Edwards said. “The members should not be held responsible for the illegal actions of Group Benefits and DOA.”

Here are links to the after-the-fact DOA Emergency Rule declaration: http://www.doa.louisiana.gov/doa/Presentations/Emergency_Rules_-_Office_of_Group_Benefits_9-30-2014.pdf and DOA’s Notice of Intent: http://www.doa.louisiana.gov/doa/Presentations/Ordinary_Rule_-_Office_of_Group_Benefits_10-01-2014.pdf

The clumsy attempt at circumventing the law is just another in a long line of embarrassing episodes perpetrated by the Jindal administration as the governor pays less and less attention to the home front in his quest for the Republican presidential nomination, leaving the job of running the state to appointees equally unqualified as he to run so much as a snow cone stand.

Nichols typically ignored the threat of litigation in making the announcement just as the administration ignored the law in implementing the changes, even disagreeing in that Sept. 25 hearing on the necessity of publishing the proposed changes and conducting public hearings.

And West even attempted to justify the changes by pointing out to retirees and active members that she must pay the same premiums as they. She apparently failed to consider the fact that most state employees and certainly most retirees do not make her $170,000 per year salary.

The Retired State Employees Association (RSEA) threatened a lawsuit, challenging the administration’s contention that it could use the emergency rule (employed repeatedly by the administration during Jindal’s nearly seven years in office) to make changes in the medical and pharmacy plans.

Nichols was not even around for the conclusion of that Sept. 25 JLCB meeting, having stepped out of the committee room ostensibly to take an “important” phone call. In reality, it turned out she stepped out permanently to take her daughter to a boy band concert in New Orleans where she watched from the comfort of the governor’s luxury box at the Smoothie King Arena (see the snow cone stand reference above).

“Let’s hope that the legislature will continue to exercise oversight on this issue to drive more changes in the plans whereby the out-of-pocket cost increases of OGB members are reduced and (so that) the state will share in the cost of restoring the system’s soundness,” Edwards said in a prepared statement.

 

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When a legislator (or a governor) doesn’t like the message, the obvious solution is to pull Inspector General’s funding

Posted in Attorney General, Budget, Corruption, Ethics, Fraud, Governor's Office, Legislature, Legislators, Politicians, State Fire Marshal, State Police, Transparency on November 4, 2014| 2 Comments »

What kind of person, serving as a municipal fire chief, would purchase ribbons and decorations of previous conflicts from a military surplus store and pen them on his own uniform?

Apparently the kind of person that Deputy Secretary of the Department of Public Safety (DPS) and Gov. Bobby Jindal would want to protect even to the point of prevailing upon an ally in the legislature to file an amendment to abolish the very agency conducting an investigation of that and other offenses.

At the same time State Fire Marshal Butch Browning was being reinstated in May of 2012 by his boss, Mike Edmonson who serves as both State Police Superintendent and Deputy Secretary of DPS, State Rep. Joe Harrison (R-Napoleonville) was introducing an amendment to House Bill 1, the state’s operating budget, to pull the $1.7 million funding for the Office of Inspector General (OIG) in the middle of OIG’s investigation of allegations of payroll fraud and a sloppy inspection of a carnival ride in Greensburg only seven hours before teenage siblings were injured by the ride.

The timing of the amendment was enough to make you toss your lunch of stone cold ethics and hot back room politics.

Browning “retired” on April 18 in the middle of that investigation but returned just 12 days later, on April 30, with an $8,000-per-year increase in pay after being “cleared” by Edmonson of any wrongdoing—six months before an investigative report by OIG was even issued.

But if Jindal and his co-conspirators intended to thwart the investigation by abolishing the agency led by Stephen Street, those efforts wilted in a backlash of public support for the office immediately ensued which caused the legislature—and Jindal—to back down from the effort despite a favorable 11-5 vote on Harrison’s amendment by the House Appropriations Committee.

Remember, this is the same governor who two years later would attempt to sneak through another amendment granting Edmonson a lucrative $55,000-a-year increase in retirement benefits only to have that plan crash and burn when LouisianaVoice learned of the implications of the amendment by State Sen. Neil Riser (R-Columbia).

OIG serves as white-collar watchdog and as an internal affairs division within state government but Harrison, in offering his amendment, argued that OIG’s functions overlapped those of State Police and the Attorney General’s Office.

As we have already seen, State Police, under the direction of Edmonson, gave Browning high marks in exonerating him from any wrongdoing and as we have also seen in other matters, the Attorney General’s Office is more than a little reluctant to involve itself in the investigation of any state agency—except of course in a situation such as that of former Department of Health and Hospitals Secretary Bruce Greenstein where the feds are already actively investigating a questionable contract with Greenstein’s former employer.

In that case, Attorney General intervention made good press.

In fact, since the 1974 State Constitution was adopted over the objections of then-Attorney General Billy Guste, the Attorney General’s duties are primarily restricted to defending state agencies, not investigating them and can generally enter a local matter at the express invitation of the local district attorney. In fact, the Attorney General has even begged off certain investigative matters, citing a potential conflict of interest should his office be called to defend or represent the agency.

Hammond attorney and state government watchdog C.B. Forgotston, former chief counsel for the House Appropriations Committee disagreed with Harrison’s contention that the OIG is “pretty much redundant.”

Forgotston said the office might be redundant “if any other agency in the state was stopping waste and fraud within the executive branch. Nobody at the state level is pursuing corruption in Louisiana,” he said.

Street said he linked his office’s funding to the amount of money it uncovers through wrongdoing by state officials and contractors. OIG’s annual report in 2012 showed the office had uncovered $3.2 million in fraud and waste the previous fiscal year, nearly double the office’s $1.7 million budget appropriation.

The reaction to Harrison’s bill and to Jindal’s transparent ploy was immediate.

“Is it a bargain to spend $1 to root out nearly $2 in fraud in Louisiana?” the Lake Charles American Press asked in a May 15, 2012, editorial. http://www.americanpress.com/AP-Editorial-5-16-12

“Apparently, some members of the state Legislature don’t think so,” the editorial said, adding that Harrison had admitted that he did not agree with the OIG’s investigation of Browning. He said there should have been no investigation in the first place but Street said his office had received a complaint (from the New Orleans Metropolitan Crime Commission) about how Browning was doing his job and so he launched an investigation. “I was told if you do this (job) right, you’ll eventually have people trying to shut you down,” Street was quoted by the paper as saying.

The editorial disagreed with Harrison’s claim that State Police and the Attorney General’s Office could take up the slack. “The attorney general in Louisiana is too much of a political species to launch investigations into wrongdoing by other politicians or political agencies,” it said in something of an understatement. “An office that ferrets out nearly $2 in fraud for every $1 it costs is too valuable to Louisiana to eliminate.”

The non-partisan Public Affairs Research Council (PAR) agreed. “The state needs a self-motivated watchdog agency to stop waste, mismanagement, abuse and fraud in executive-branch government,” it said in a May 7, 2012, news release. http://www.parlouisiana.com/explore.cfm/parpublications/commentariesandletters/100092

“Stephen Street… is a former criminal staff lawyer with the Third Circuit Court of Appeal, a former public defender and a former Section Chief with the state Attorney General’s Insurance Fraud Support Unit who handled white-collar prosecutions. He has extensive experience teaching courses on white-collar crime investigation,” the PAR release said.

“A sudden halt in funding of the Inspector General would terminate ongoing investigations and send a message nationwide that Louisiana government is open for corrupt or wasteful business. Lawmakers who oppose continued funding of the office while also criticizing particular ongoing investigations are running the risk of deeply politicizing the state’s law enforcement systems. If these efforts at shutting down the Inspector General’s office are successful, their effect will be to strongly encourage further political interference in the law enforcement profession throughout the state,” the release said.

James Gill, then a columnist for the New Orleans Times-Picayune, wasn’t nearly as charitable. As only he can, Gill noted that Edmonson had exonerated and reinstated Browning even before Street’s investigation was complete. Then came Gill’s zinger: “Perhaps Edmonson forgot that he had claimed Browning’s resignation had nothing to do with the allegations against him.” http://www.nola.com/opinions/index.ssf/2012/05/battle_over_funding_for_louisi.html

Gill quoted Harrison as claiming that he had thought for two years that Louisiana did not need an inspector general. “Anyone but a politician would be carted off to the funny farm for saying that,” he wrote, adding that despite Harrison’s claim that his amendment had nothing to do with Browning, he launched into “a passionate denunciation of the inspector general’s office over its treatment of browning.” Gill quoted Harrison as saying no good investigator “would bring it (the investigation) to this point without verifying information.”

“Even a politician deserves a trip to the funny farm for spouting such nonsense,” said Gill at his derisive best.

But even more to the point, Gill observed that “Since Browning has already been returned to duty, it may not matter much what conclusions the inspector general reaches.”

May not indeed. This administration is, after all, the gold standard of ethics.

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Rep. Jim Fannin may have inadvertently blown Jindal’s budget surplus claim in brief exchange at LRTA meeting

Posted in Auditor, Budget, DOA, Ethics, Governor's Office, Legislature, Legislators on October 28, 2014| 9 Comments »

State Rep. Jim Fannin (D/R-Jonesboro) may have inadvertently exposed the Jindal administration’s $178 million “surplus” for the fraud it is in a brief conversation with one of our readers from north Louisiana who knew the right questions to ask, LouisianaVoice has learned.

Fannin, Chairman of the House Appropriations Committee, delivered a “State of the State” address at the Fall Meeting of the Louisiana Retired Teachers Association in Baton Rouge on Monday and afterwards was confronted by retired teacher Kay Riser Prince of Ruston.

Rubbing her forefinger and thumb together, Riser asked Fannin, “Is Jindal’s new-found money real—that is, can the light bill be paid with it, or is all on paper?”

“I don’t know,” answered Fannin initially before he finally said it is money that was assigned to various agencies but not spent.

“When I taught at (Louisiana) Tech,” Riser responded, “we were told that if we did not spend money that had been allocated by June 30, it went back to the state.”

Fannin then admitted to Prince that was where Jindal’s “discovery” of some $320 million originated.

Prince was able to obtain an answer to a question no one else has been able to get—probably because Fannin was sent a list of funds Jindal had supposedly “swept” from some 17 agencies to arrive at his bogus surplus and when asked point blank, he acknowledged that the surplus was, at best an illusion, an accounting sleight of hand.

So now it would appear that the surplus so proudly proclaimed by Jindal is not cash after all, but an accounting entry and any available cash at the time of the under-budget expenditures (reportedly dating all the way back to 1997) has long since reverted back into the General Fund and has been spent.

In fact, if the state kept books like a business, this shell game might well have affected the retained earnings of owners’ equity and may have even resulted in Enron-like indictments.

In standard business practice, such funds would have been included as a carry-forward asset but never as revenue leading to a subsequent accounting period budget surplus. You can ask Enron’s now defunct accounting firm, Arthur Andersen, about that.

But Gov. Bobby Jindal and Commissioner of Administration Kristy Nichols have each seen their shadows and have retreated back into the fantasy world in which they now reside—but not before Nichols fired off a broadside at State Treasurer John Kennedy for not knowing of the existence of a nonexistent bucket of cash lying around for all these years—and they’re not scheduled to emerge until the Legislative Auditor’s report sometime in late December.

By that time, of course, Jindal will be in Iowa or traipsing around in the snows of New Hampshire in search of caucus and primary votes he hopes will catapult him into semi-serious contention for the Republican presidential nomination—an exercise our crystal ball tells us will give him the distinction of having less a chance at the nomination—or even of being picked for VP— than Alf Landon had of beating FDR in 1936 or of Barry Goldwater upsetting LBJ in ’64. Meanwhile, the looming legislative session will be but a mere distraction, and Louisiana’s financial troubles will start to become a fading bad dream for him and a mess to be sorted out by his successor.

 

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October fundraiser enters final week; your contribution will help us write and publish book about Jindal administration

Posted in ATC, Budget, Civil Service, Commissions, Contract, Contracts, Corruption, Courts, DHH, DOA, Economy, Ethics, Governor's Office, Grant, Grants, Health Care, Higher Education, Legislature, Legislators, OGB, Office of Group Benefits, Privatization, Public Records, Retirement, Revenue, State Agencies, State Fire Marshal, State Police, Teague, Transparency on October 26, 2014| 4 Comments »

Our October fund raiser enters its final five days and we still need assistance to help us offset the cost of pursuing legal action against an administration that prefers to conduct its business behind closed doors and out of sight of the people to whom they are supposed to answer.

We also are launching an ambitious project that will involve considerable time and expense. If Gov. Bobby Jindal does seek higher office as it becomes more and more apparent that he will, the people of America need to know the real story of what he has done to our state and its people. Voters in the other 49 states need to know not Jindal’s version of his accomplishments as governor, but the truth about:

  • What has occurred with CNSI and Bruce Greenstein;
  • How Jindal squandered the Office of Group Benefits $500 million reserve fund;
  • The lies the administration told us two years ago about how state employee benefits would not be affected by privatization;
  • The lies about how Buck Consultants advised the administration to cut health care premiums when the company’s July report said just the opposite;
  • How Jindal attempted unsuccessfully to gut state employee retirement benefits;
  • How Jindal attempted to sneak a significant retirement benefit into law for the Superintendent of State Police;
  • How Jindal appointees throughout state government have abused the power entrusted to them;
  • How Jindal has attempted a giveaway plan for state hospitals that has yet to be approved by the federal Center for Medicare & Medicaid Services (CMS);
  • How regulations have been skirted so that Jindal could reward supporters with favorable purchases and contracts;
  • How Jindal fired employees and demoted legislators for the simple transgression of disagreeing with him;
  • How Jindal has refused Medicaid expansion that has cost hundreds of thousands of Louisiana’s poor the opportunity to obtain medical care;
  • How Jindal has gutted appropriations to higher education in Louisiana, forcing tuition increases detrimental to students;
  • How Jindal has attempted to systematically destroy public education in Louisiana;
  • How Jindal has refused federal grants that could have gone far in developing internet services for rural areas and high speed rail service between Baton Rouge and New Orleans;
  • How Jindal has rewarded major contributors with appointments to key boards and commissions;
  • How Jindal attempted to use the court system to persecute an agency head who refused to knuckle under to illegal demands from the governor’s office;
  • How Jindal has manipulated the state budget each year he has been in office in a desperate effort to smooth over deficit after deficit;
  • And most of all, how Jindal literally abandoned the state while still governor so that he could pursue his quixotic dream of becoming president.

To this end, LouisianaVoice Editor Tom Aswell will be spending the next several months researching and writing a book chronicling the Jindal administration. Should Jindal become a presidential contender or even if he is selected as another candidate’s vice presidential running mate, such a book could have a national impact and even affect the outcome of the 2016 presidential election.

This project is going to take time and involve considerable expense as we compile our research and prepare the book for publication in time for the 2016 election.

To accomplish this, we need your help.

If you are not seeing the “Donate” button, it may be because you are receiving our posts via email subscription. To contribute by credit card, please click on this link to go to our actual web page and look for the yellow Donate button: https://louisianavoice.com/

If you prefer not to conduct an internet transaction, you may mail a check to:

Capital News Service/LouisianaVoice

P.O. Box 922

Denham Springs, Louisiana 70727-0922

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It was Kleckley, not Fannin, who rejected Armes proxy

Posted in Budget, DOA, Governor's Office, House, Senate, Legislature, Legislators, Revenue on October 20, 2014| 4 Comments »

CORRECTION:

We were in error when we reported on Saturday that Rep. Jim Fannin (D/R-Jonesboro), chairman of the Joint Legislative Committee on the Budget (JLCB) refused a request by Rep. James Armes (D-Leesville) that Rep. Kenny Havard (R-Jackson) be allowed to serve as his proxy at last Friday’s JLCB meeting in Baton Rouge.

LouisianaVoice was unable to contact any of the principals involved over the weekend but we spoke with Armes on Monday and he informed us that it was not Fannin, but House Speaker Chuck Kleckley (R-Lake Charles) who declined, or simply failed to act on, Armes’ request.

More accurately, it appears now that Kleckley may have indicated he would consent to Armes’ request but either had a change of heart or simply did not follow up. “When I spoke with the speaker, he told me he would take care of it,” Armes said today. “I was unavailable and unable to attend, so I called him (Kleckley) and asked that Rep. Havard be allowed to serve as my proxy. Normally when a member cannot attend, we will try to get someone from the Baton Rouge area to attend and Rep. Havard is only a few miles outside Baton Rouge.

While it may not have been Fannin who dropped the ball on approving a proxy for Armes, it was Fannin who informed committee members after they had convened that the issue of the $178.5 million budget surplus claimed by the administration would not be taken up pending a report by the Legislative Auditor’s office. That report is expected sometime in December. Meanwhile, the state is in budgetary limbo over whether there is a surplus as claimed by Commissioner of Administration Kristy Nichols or a $141 million deficit as claimed by State Treasurer John Kennedy.

The administration’s sudden “discovery” of $360 million (accumulated since 2002), which it says brought the state out of a $141 million hole to a surplus of $178.5 million has drawn fire from two former commissioners of administration, Raymond Laborde of Marksville and his niece, Stephanie Laborde of Baton Rouge. Raymond Laborde was commissioner during former Gov. Edwin Edwards’ third term of office and Stephanie Laborde (at the time Stephanie Alexander) served during Edwards’ fourth and final term. Both, along with Kennedy, indicated it was highly improbable that that much money could have remained hidden for so long a time.

One source has put the amount closer to $500 million but added that the money has already been spent. If so, that would put the deficit closer to $300 million than the $141 million initially claimed by Kennedy.

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