
Lean, Mean, and Fighting Machines

Analysis | The Plot Against Louisiana
Koch Money
Yesterday, the conservative “think tank” the Pelican Institute released what it called “a study” about the potential economic impacts of four of the main proposals currently being discussed as a part of the upcoming second extraordinary session. It is the most absurd “economic study” you’ll likely ever encounter: a pathetically truncated four-paragraph-long talking points memo spread across four glossy pages and published by someone with the last version of Apple Numbers who apparently believed a color printer was an adequate substitute for legitimate analysis. It reads like Grover Norquist’s homework assignment from fifth grade, which was around the age he thought up the idea to one day demand all politicians sign his anti-tax purity pledge. According to the Pelican Institute’s report, each and every plan to solve the state’s $648 million fiscal cliff will reduce Louisiana’s Gross Domestic Product and result in thousands of job losses. There is essentially nothing Louisiana can possibly do in order to ensure the state has the resources and funding required to operate state government, nothing. (I’ll unpack the reasons why this argument is absurd later in this article). But first, in order to understand its context and appreciate its agenda, it’s important to know who, exactly, is behind the Pelican Institute. The organization first emerged ten years ago. “The Pelican Institute is a Louisiana-based think tank founded last year by native New Yorker and Tulane grad Kevin Kane,” I reported on CenLamar on August 1st, 2009. “Jeb Bruneau, son of former State Representative Peppi Bruneau, is its Vice President. (Peppi, as some may recall, was accused of timing his retirement announcement to maximally benefit Jeb’s campaign for the seat. Jeb lost anyway). Though it labels itself as ‘non-partisan,’ the Pelican Institute is undeniably bent toward conservative and libertarian political philosophies, with a concentration on limiting government.” Following the tragic death of its well-respected founder Kevin Kane in 2016, at the age of 50, the Pelican Institute struggled for a couple of years to regain its footing and reassert its role in policymaking. Today, they are associated with the national conservative advocacy organization, State Policy Network, which promotes libertarian and anti-tax legislation across the country and is financed by large corporations and a small roster of notable conservative political donors. The Pelican Institute is also affiliated with the Buckeye Institute of Ohio, a right-wing organization largely funded by the Koch Brothers and their donor fund, which provided the resources for their most recent “economic study.” In August of 2017, Daniel Erspamer, a Tulane graduate, became the Pelican Institute’s newest president. Erspamer’s previous job was with State Policy Network, where he had worked for slightly more than eight years as the organization’s Vice President for Strategic Partnerships. Prior to that, he spent a four-year stint with the Koch Brothers’ political advocacy organization, Americans for Prosperity. Erspamer’s first job out of college, in fact, was an assistantship with the Charles Koch Foundation. During the past year, and most notably in the past four months, Koch-affiliated organizations have set up shop in Louisiana and have attempted and often succeeded to assert an outsized influence in policymaking and the media coverage of the legislative session. Americans for Prosperity, for example, hired a state director, John Kay, who often uses his Twitter account to sharply and publicly excoriate anyone who deviates from his organization’s rigid anti-tax orthodoxy. (To Kay’s credit, though, he also latched onto state Sen. J.P. Morrell’s bill ending the practice of non-unanimous juries, which proved to be helpful). This very small cabal of political operatives has worked throughout the past several months to help conservatives in the state House and Senate develop a coherent communications strategy, designed to justify a type of reckless disregard for the existential crisis currently faced as a result of the looming fiscal cliff. It’s often worked, even though it requires utilizing a national network of phony news publications to amplify and lend credibility to their message. But really, this is just a small echo chamber of paid consultants. The study published yesterday by the Pelican Institute exemplifies this strategy better than almost anything else.A group of pelicans is called a “scoop,” and the waste from a scoop of pelicans is known, colloquially and obviously, as “poop.”
It is only fitting then to call the Pelican Institute’s most recent economic study a “scoop poop.” The report categorically misrepresents both the problem the state of Louisiana currently faces and the solutions that have, thus far, been proposed to fix that problem. It demands that readers maintain a willful suspension of disbelief over a series of obvious facts about recent history. Here’s how it describes its findings:As the state continues to shed jobs and population to neighboring states whose economies are growing, it’s important to take a deep look at the projected impact of new taxes. Today, the Pelican Institute, in partnership with the Buckeye Institute’s Economic Research Center, releases the results of a study projecting the economic impact of four difference revenue-raising proposals that have been discussed recently: increasing the state sales tax by a quarter-penny, increasing the state sales tax by a half-penny, compressing personal income tax brackets, and reducing individual income tax deductions. All four scenarios would result in job loss and a decline in the state’s gross domestic product (GDP), key measures of economic health.But the Pelican Institute doesn’t show its math, disclose its assumptions, or provide any insight whatsoever about its methodology. There’s nothing about this that even remotely resembles economic scholarship. Yet conservative operatives have shared the report as if it somehow proved something. Even The Business Report of Baton Rouge reported on the study as legitimate news and not merely a distracting, manipulative, and fundamentally flawed analysis from a partisan interest group. It appears no one there had actually read the study, because if they had, they would have noticed several massive red flags, details that most journalists would find deeply problematic. For one, the footnotes disclose a fact that should be considered automatically disqualifying: “Note,” it reads. “GDP (gross domestic product) and tax revenues in millions of 2009 (dollars).” In other words, the Pelican Institute is constructing its entire analysis based on numbers nearly a decade old, and it’s using those numbers to create “a macroeconomic general equilibrium model calibrated to Louisiana’s economy.” At least that is what it asserts: Again, there’s no information about its actual methodology. There’s another, perhaps more fundamental problem: The study claims that each proposal represents a tax increase, when, in fact, they will all actually decrease tax revenue from the previous year (and the state wouldn’t be “raising” or “increasing” sales taxes; it’d be reducing them from current rates), shrinking the size of government by nearly half a billion dollars.
- Raising the state sales tax by 0.25% would, within a year, lead to the net loss of 1,400 jobs and decrease the state’s GDP by $86 million, while raising $164 million in new tax revenue.
- Increasing the state sales tax by 0.5% would, within a year, lead to the net loss of 2,800 jobs and decrease the state’s GDP by $173 million, while raising $329 million in new tax revenue.
- Adjusting individual income tax brackets (reducing the top of the 4% tax bracket to $25,000) would, within a year, lead to the net loss of 2,600 jobs and decrease the state’s GDP by $191 million, while raising $190 million in new tax revenue.
- Reducing the amount allowable for individual income tax deductions due to excess federal itemized deductions would, within a year, lead to the net loss of 700 jobs and reduce the state’s GDP by $56 million, while raising $56 million in new tax revenue.
Cliff Diving
For those of you who are confused or overwhelmed or perhaps not closely following the telenovela of the Louisiana legislature, the underlying issues are actually less complicated than many people would have you believe. The Louisiana Budget Project, a nonprofit, nonpartisan organization, put together this easy-to-understand video tutorial: There are a few things necessary to clarify: While the total amount of the temporary revenue set to expire is slightly over $1 billion, the “fiscal cliff” is actually closer to $650 million; that’s the number it will require to ensure state government can continue to operate and meet its financial obligations. That number, only a few months ago, was much closer to $1 billion, and some Republicans argue that their intransigence during the first special session (they didn’t solve anything, but were all happy to collect their per diem checks) somehow saved Louisiana citizens a $400 million tax increase. That’s just fundamentally not true. First, the discussion is about replacing or renewing existing revenue, not increasing the overall tax burden. Their politicization of the fiscal cliff didn’t have anything to do with sparing people from a tax hike, which is fairly easy to prove. Second and most ironically, the only reason the fiscal cliff decreased by around $350 million in between February and today is because the Trump tax plan automatically triggered a provision in Louisiana state law that increased state income taxes in proportion to the reduction in federal rates. In other words, Republicans who suggest that they spared a massive, new tax increase are hoping the general public isn’t savvy enough to realize that their Republican colleagues in Congress and the White House did increase Louisiana state income taxes, which allowed the state to recover a portion of the expiring, temporary revenue.Jindalomics
Despite what the current governor’s political opponents may have you believe, we’re not in this predicament because John Bel Edwards is a “tax and spend liberal” who has massively grown the size of government. Louisiana is still dealing with the economic fallout from the previous administration, and that isn’t a convenient political blame game. It’s just the undeniable, factual reality. Jindal left the state saddled with anywhere between a $1.3 billion to $1.8 billion structural deficit shortfall, the direct consequence of nearly a decade’s worth of financial mismanagement and the use of one-time monies in order to avoid confronting the need for additional sources of revenue. During the Jindal administration, Louisiana’s credit rating was downgraded (Moody’s was the first to point out our structural deficit), and toward the end of his tenure, this became an existential crisis. Bobby Jindal was aided and abetted by the very same Republican members of the state legislature at the forefront of today’s debate, except, now, they assert any fault belongs to Democrats in the minority and to Gov. John Bel Edwards. Among other things, they willfully confuse the public about Medicaid expansion, wrongfully asserting the program has cost the state money out of its general fund. The math is clear: Louisiana nets around $300 million a year due to Medicaid expansion, a program that not a single Republican legislator has proposed to scrap and that all three of Gov. Edwards’ Republican opponents supported, and it hasn’t increased tax rates at all. The program is paid for through a 94% match from the federal government, and the state’s portion is covered through provider fees. (The notion that Louisiana could ever collect $500 million a year in beneficiary fraud, an absurd conspiracy theory cooked up in the waning hours of the regular session by Republican legislators who have failed to offer any meaningful plan to replace revenue, relies on a complete distortion of how Medicaid is funded. Even if there was massive beneficiary fraud- and there isn’t- that money wouldn’t go back to the state coffers, nor would it miraculously entitle Louisiana to even more federal funding). We are faced with the current situation because the only acceptable additional revenue source for Republicans was through a sales tax increase, a regressive taxation disproportionately affecting the poor and working class. As the video from the Louisiana Budget Project points out, our state income and corporate tax rates rank in the national average, but our combined state and local sales taxes are the very top in the nation. That’s a direct consequence of Republican leadership who refused to negotiate on anything except for increased sales taxes. As he stated at the time, the governor made those taxes temporary because he recognized the regressive nature of sales tax; this had always been intended to be a stop-gap measure, with the hope and expectation that Republicans in the legislature would act in good faith to find another solution this year. They haven’t. In fact, some of them are mendaciously peddling the talking point that Louisiana’s high sales tax rate was a priority for the Democratic governor.Nursing a Lie
There’s one other issue that has become front and center in the state’s ongoing debate about how to best resolve the fiscal cliff. From the very onset of this discussion, months ago, legislators had been warned that a failure to act would result in notices being sent out to people living in nursing homes and on a select number of programs that provide care for those with disabilities. Pursuant to federal guidelines, the state has a fiduciary duty to notify people within a certain period of time if there could be a change in their service care agreement under Medicaid. With a deadline looming, the governor’s office was compelled to send out those notifications- 37,000 in total, including 17,000 to individuals in nursing homes. Republican legislators immediately feigned outrage; they acted as if they were shocked by something they should have anticipated for months. And suddenly, for the first time in recent history, they became overnight advocates of government-subsidized health care. The truth is: For far too long, many of these legislators have operated without any understanding or recognition of the real-life consequences of their decisions or their failures to make decisions. They attempted to spread the message that the governor was engaging in scare tactics, and they reassured constituents that everything would eventually work itself out. LSU still has a football team, after all. When the Senate Finance Committee introduced and then adopted a budget resolution that restored funding for those 37,000 people, some state Republicans gleefully announced that they were right all along and used the opportunity to castigate the governor for ever sending out those scary eviction notices. But there’s one major problem with all of this: The Senate’s version of the budget actually revealed the only way to spare 37,000 people in nursing homes or on a waiver program for the disabled would be to effectively shut down the entire government. There’d be an across-the-board 24% cut in every department; district attorneys would be defunded, as would jails. TOPS would be gutted. There’d be massive layoffs, resulting in a huge spike in unemployment. We would have to completely end food subsidies for the poor. Our basic social safety network would be in tatters. That was the point of the Senate Finance’s decision: To underscore what was at stake. Some Republicans celebrated the pyrrhic victory of temporarily delaying the necessity of warning nursing home residents, because, pathetically, they thought they could use it as a talking point. We ran state government on the fumes generated by talking points for most of the past decade. It bankrupted us. Now maybe we should learn some simple economics and basic arithmetic.Senate to House: Enough “Petty Political Nonsense”
Dr. Tammy Savoie, Decorated Air Force Veteran, Will Challenge Steve Scalise

It’s Time
Town Criers and the Politicians Who Cry Wolf
Governing in the Age of Social Media
Websites like Facebook and Twitter, Justice Anthony Kennedy wrote last year in Packingham v. North Carolina, “can provide perhaps the most powerful mechanisms available to a private citizen to make his or her voice heard. They allow a person with an Internet connection to ‘become a town crier with a voice that resonates farther than it could from any soapbox.’” Kennedy may be exaggerating the democratizing effects of the internet. Let’s not kid ourselves. For the most part, the gatekeepers of our media are corporations led by a very small number of upwardly-mobile, highly-educated people; they’re still disproportionately white, disproportionately male, and almost exclusively from a huge city on either the East or the West Coast. But Kennedy isn’t entirely wrong about the ways in which social media, in particular, can amplify ordinary voices. More fundamentally, though, it has relocated the venues of government. Because the President of the United States dramatically changes domestic and foreign policy, even fires his own Secretary of State, via Twitter, he has forced us to completely redefine our understanding of when and how a government actor can take government action. And because he routinely blocks American citizens from reading or replying to his Twitter account, the legal and constitutional implications are no longer academic abstractions; they’re urgent. Although Donald Trump may represent the apotheosis of government in the current age of social media, he’s actually following the example of thousands of state and local elected officials all across the country, many of whom have exclusively relied on Twitter or Facebook to conduct virtual town halls, engage with their constituents, publish press releases from their office, and announce their support or opposition to proposed legislation or policies. A month after Kennedy wrote for the majority in Packingham, a case that did not inspire any dissent, Judge James C. Cacheris for the Eastern District of Virginia moved the goal posts even closer, ruling that when the Chair of the Loudoun County Board of Supervisors, Phyllis J. Randall, had banned a local critic named Brian Davison from her official public Facebook account for nearly a dozen hours, she was guilty of violating Davison’s First Amendment rights. Thus far, Judge Cacheris’ decision in Virginia provides the most significant court decision prohibiting government actors from blocking critics on their public social media accounts. Cacheris ruled the practice amounts to an unconstitutional restraint on free speech. Within the next year, the Supreme Court is likely to consider similar cases, and it’s all but certain the Court will agree to create a new framework and limitations on governing through Twitter. While the national focus has almost entirely been about the First Amendment, there is another issue that will eventually need to be addressed by lawmakers or the courts here in Louisiana. Unlike many other states, in Louisiana, a citizen’s access to public records is considered a “fundamental right.” “When an elected official uses his or her own social media to engage with the public in their capacity as a government actor, they may have a duty to comply with state public records laws,” Gary McGoffin, a Lafayette-based attorney, told me. McGoffin recently represented The Independent in a blockbuster public records case against Lafayette City Marshal Brian Pope. So, what happens when an elected official decides to delete criticism or ban critics from their public social media accounts?Criticism and Punishment

Conrad and His Colleagues

Appel claims he does not have a “recollection of specific instances” in which he blocked someone from Twitter, including his two colleagues. He points out that he regularly engages with people who disagree with him, even his most outspoken critics. “You can judge my motives best by (that) fact,” he says. “Wait, I have better proof than that. I don’t block you.” He is only slightly joking. “That’s not lost on me,” I tell him. Still, though, it’s not exactly reassuring.I would love to engage in this conversation with my colleague, Sen Appel. Unfortunately, I can’t do so because he still has me blocked on Twitter.
— Jay Luneau (@wjluneau) March 18, 2018
In this brave new world of “fake news” and “alternative facts,” the internet has actually made it easier than ever for an elected official to misrepresent basic truths and to crowd out criticism.
Because the law is still catching up with technology, there isn’t yet a “legal test” to determine when it’s proper for the government to censor or ban people from following public social media accounts, but a test is clearly needed. No one would fault Sen. Appel for removing threatening or criminally harassing responses or for deleting spam followers, for example. But who should determine what constitutes an “insult” worthy of censorship? And when does a social media account that a politician uses during their campaign become a public account once they win office? Donald Trump continues to argue, audaciously, that his Twitter account is a personal one, though Americans know it’s a now very obviously an instrument of the White House. In Louisiana, the government doesn’t hand out Twitter handles once you win an election. Most legislators, like Appel, repurpose their existing social media. That may create some confusion about their obligations under the law. As a default and unless it’s otherwise made abundantly clear, we should consider the public social media accounts of any elected official as an instrument of their office.Arguably, you can learn just as much about a politician from who they pay attention to as you can from who they purposely silence.
I doubt either state Sen. Morrell or state Sen. Luneau believe their colleague restrained their First Amendment rights, and I certainly don’t think that of anyone who has decided to block me online. But I recognize why it’s imminently reasonable that most people who find themselves blocked online by a government official understand it differently. For many, it may even seem like an act of public intimidation and oppression. Either way, it’s decidedly anti-democratic. It allows lawmakers to evade accountability from the media and critics and to cut off access from their constituents. That’s textbook viewpoint discrimination, which is unconstitutional. Recently, The Arizona Capitol Times filed a series of public records requests to determine which members of their legislature blocked people on social media and, more importantly, who they blocked. Not surprisingly, many of their requests went unanswered, and several lawmakers argued that their very public accounts were somehow private. They also discovered that several legislators banned their own colleagues. This should not be considered a partisan issue, because, as I can attest, it’s a practice employed by members of both political parties. We’re considering following The Arizona Capitol Times‘ example, even if it proves to be an exercise in futility.“We should know who our state legislators are telling to shut up,” journalism professor David Cuillier told the paper.
Landry and the “Rule” of Law

Budget Warfare Is Coming
The (False) Frontal Assault Against Louisiana’s Medicaid Recipients
Fake News and Dishonest Arithmetic
A week after The Bayou Brief reported that Louisiana State Sen. Sharon Hewitt (R- Slidell) had deceptively edited the video record of state legislative auditor Daryl Purpera’s public testimony to the Senate Finance Committee, removing a critical 12-seconds of footage and sharing the altered recording with her online followers, Hewitt continues to push a fake news story that Medicaid beneficiary fraud is “widespread” in Louisiana and costs the state nearly a half a billion dollars a year. Yesterday, she repeated her assertions in an article published by Watchdog.org, a well-known propaganda arm of the Franklin Center for Government Integrity, a far-right, anti-science organization funded by the petrochemical industry and loosely affiliated with the Koch brothers’ group Americans for Prosperity and the American Legislative Exchange Council (better known as ALEC). Hewitt promoted the paid content, which was written by John Haughey, a freelance blogger from Florida and long-time contributor to the publication Outdoor Life, on social media.And if you were to take the senator at her word, you’d probably think she had just ingeniously uncovered the panacea for all of the state’s budgetary woes.Disappointed that #lagov has chosen to threaten the security of 37,000 elderly & nursing home patients rather than actively investigating Medicaid fraud within the 1.6 M participants. #LaLege https://t.co/1uKtpuF8pY
— Sharon Hewitt (@sharonhewitt) May 8, 2018
All we need to do is “actively investigate” 1.6 million people (or nearly 35% of the entire state population) for suspected Medicaid fraud.
“Hewitt said the legislative auditor’s office estimates the state could save about $480 million in removing ineligible people from Medicaid’s rolls,” Haughey writes. “That would, essentially, restore the $431 million in LDH cuts in the proposed budget, which would mean an additional $1.6 billion or more in federal matching dollars.” It’s complete hogwash. As anyone with a working knowledge of Medicaid can tell you, Hewitt reveals a fundamental misapprehension of how federal matching dollars operate and interact with state discretionary spending. This has nothing to do with the fiscal cliff. Contrary to Sen. Hewitt’s assertions, Gov. John Bel Edward’s decision to avail the state access to federal funding for Medicaid expansion has been a wild success, creating more than 19,000 jobs, generating $178 million in state and local taxes, and resulting in a $3.5 billion economic impact, according to a recent, independent economic analysis conducted by three LSU professors. The program is also wildly popular, supported by 69% of all citizens. Only among Republicans is the program narrowly unpopular, dropping from 51% approval in 2017 to 47% during the first few months of 2018.
The Curious Case of Bruce Greenstein
In one of his very first actions as attorney general of Louisiana, Jeff Landry dropped the most significant criminal case against a state public official since the the FBI found $90,000 in cold cash in Congressman Bill Jefferson’s freezer. Bruce Greenstein, the former secretary of Louisiana’s Department of Health and Hospitals, had faced nine counts of criminal perjury for allegedly lying to members of the legislature about his efforts to improperly award a $200 million contract to his former employer, Client Network Services Incorporated (or CNSI). In 2014, after an exhaustive, eighteen-month-long inquiry, a grand jury decided to indict Greenstein, who was appointed to the position four years prior by then-Gov. Bobby Jindal. The contract in question, ironically enough, was about identifying Medicaid fraud and had been necessitated by changes enacted under the Affordable Care and Patient Provider Act (also known as Obamacare), which mandated states to suspend payments to “a provider when it determines that there is a credible allegation of fraud.” To be sure, there is absolutely no evidence nor was there ever any suggestion that CNSI itself engaged in anything illegal, and in fact, the company had subsequently sued the state of Louisiana for breach of contract. But there were thousands of text messages and hundreds of e-mails that had built a strong case against Greenstein. And Jeff Landry waited only three months after he took over as attorney general to drop that case. Today, Bruce Greenstein is serving as the Trump administration’s Chief Technology Officer for the Department of Health and Human Services. Given Landry’s newly-found interest in pursuing Medicaid fraud and the coordinated, hair-brained, propaganda campaign by his Republican colleagues in the state legislature to “actively investigate” 1.6 million Medicaid recipients for potential fraud, it’s worth remembering how easily and how quickly these same elected and appointed public officials had been willing to overlook and overturn a grand jury’s decision to criminally indict a man accused of repeatedly lying about how he facilitated a $200 million state Medicaid contract with his former colleagues. There’s another reason it’s important to remember the rise and fall and then the fall and rise of Bruce Greenstein: We are often willing to overlook abuses of corporate welfare but more than happy to stigmatize those most in need and most deserving of public support.
Medicaid fraud is almost exclusively committed by providers. Medicaid beneficiary fraud, therefore, is more accurately defined as eligibility error.
Unlike other government entitlements and earned benefits, Medicaid recipients do not receive a fungible product. Your Medicaid card cannot be used like a credit card or bartered away to someone else. “The Medicaid program makes zero payments directly to recipients. Zero,” Jen Steele, Louisiana’s Medicaid director, recently explained in a letter to The Advocate. Given the misinformation about beneficiary fraud being peddled by Republican state legislators, it’s a simple, incontrovertible fact about the program that is worth underlining in black ink: Providers are the only people who actually make money from Medicaid. Last year, Gov. Edwards created the Task Force on Coordination of Medicaid Fraud Detection and Prevention Initiatives, and charged members with five simple priorities, as outlined in the 2017 Regular Session (see Appendix A for Act 420 of the 2017 Legislative Session):1) To study and evaluate on an ongoing basis the laws, rules, policies, and processes by which the state implements Medicaid fraud detection and prevention efforts. 2) To identify and recommend opportunities for improving coordination of Medicaid fraud detection and prevention initiatives across state agencies and branches of state government. 3) To identify any systemic or system wide issues of concern within the Medicaid program with respect to fraud, waste, and abuse.The state’s Task Force was chaired by state legislative auditor Daryl Purpera and included ten other members: Sen. Fred Mills (R- Breaux Bridge), of the Louisiana State Senate; Rep. Tony Bacala (R- Prarieville) of the Louisiana House of Representatives; Matthew Block, the Executive Counsel for Office of the Gov. John Bel Edwards; Ellison Travis, the Director of the Medicaid Fraud Control Unit (MFCU) for the Office of Louisiana Attorney General Jeff Landry; Michael Boutte, the Medicaid Deputy Director over Health Plan Operations and Compliance for the Louisiana Department of Health; Tracy Richard, a Criminal Investigator for the Office of the Inspector General; Jarrod Coniglio, Program Integrity Section Chief for the Louisiana Department of Health; Luke Morris, Assistant Secretary of the Office of Legal Affairs, Louisiana Department of Revenue (LDR); Jen Steele, Medicaid Director for the Louisiana Department of Health, and Dr. Robert E. Barsley, Oral Health Resources, Community and Hospital Dentistry at the Louisiana State University School of Dentistry. Beginning in August 2017, the Task Force met once a month for five consecutive months. It was like the movie Groundhog’s Day, according to more than a couple of people who attended the meetings, a characterization that is corroborated by the written draft memos and the minutes of Task Force meetings, which were subsequently assembled and shared publicly by the state legislative auditor’s office.4) To develop recommendations for policies and procedures by which to facilitate and implement all of the following:
a. Random sampling of Medicaid cases to be selected for verification of enrollee eligibility.
b. Improvements in the Medicaid program integrity function of the Louisiana Department of Health (LDH).
c. Optimization of data mining among state-owned data sets for purposes of Medicaid fraud detection and prevention.
5) To make reports to the governor and legislature
A Solution in Search of a Problem
Apples to Oranges
At the same time, a comprehensive audit conducted by the Centers for Medicare and Medicaid Services (CMS) revealed that Louisiana is “both compliant with all federal fraud reporting requirements and has the proper procedures in place to detect and report fraud,” state Medicaid Director Steele subsequently explained in The Advocate. “The federal audit sets a high bar for its anti-fraud efforts, making it notable that Louisiana was one of only four states to pass this audit since 2014.” Steele was not exaggerating. The full report is available for download here. “In truth,” she wrote in March of 2018, “Louisiana is a national leader in Medicaid fraud prevention.” Yet a small contingency of lawmakers were determined to castigate tens of thousands of health care recipients as nothing more than criminals who had defrauded the government, even if those lawmakers had to rely on a flawed methodology to make their case. Luke Morris, the legal analyst for the Louisiana Department of Revenue, detailed his criticisms in a memorandum to the Task Force on Oct. 4th, 2017. “(The) LDR (Louisiana Department of Revenue), LDH (Louisiana Department of Health), and LLA (Louisiana Legislative Auditor) all agreed that the comparison of gross income and federal AGI (Adjusted Gross Income) would likely produce very few matches,” he reported. “This exercise is a quintessential apples to oranges approach for several reasons.” (emphasis added). Morris explained the significant differences between what applicants disclose on their Medicaid eligibility forms and the ways in which a person’s federal adjusted gross income is calculated and how deductions for things like “educator expenses, moving expenses, student loan deductions, and tuition and fees deductions” may be accounted for in a person’s federal AGI but are specifically “not accounted for in the reported gross income on the Medicaid application.” There are other significant discrepancies. “(T)he comparison of household size and exemptions would likely produce few matches,” Morris explains. “Household size includes all individuals living in one household. Exemptions include taxpayer, spouse, and dependents. An individual may live in the same household as another but may not be claimed on another’s tax return as a dependent based on the Internal Revenue Code.”Fuzzy Math and Alternative Facts

