West
Top Republican demands answers from Newsom, feds over wrongful Medicaid payments to California immigrants
EXCLUSIVE: The top Republican on the Senate Budget Committee is demanding answers from both the Newsom and Biden administrations regarding promised repayment of $52 million in “improperly claimed” Medicaid disbursements made via “MediCal” to certain immigrants.
Sen. Charles Grassley of Iowa sent letters to both California Gov. Gavin Newsom and Centers for Medicare & Medicaid Services (CMS) administrator Chiquita Brooks-LaSure, requesting updates on the Golden State’s promise to return to the feds $52 million in wrongful disbursements from payouts to “noncitizens with unsatisfactory immigration status[es].”
In response to a previous Fox News Digital inquiry on the matter, a representative for the California Department of Health Care Services (DHCS) acknowledged the findings of an inspector general’s report on the matter and pledged to repay the feds by June 30.
CALIFORNIA AGREES TO REPAY FEDS $52M IN IMPROPERLY-CLAIMED IMMIGRANT MEDICAID DISBURSEMENTS
California Gov. Gavin Newsom, left, and Sen. Charles Grassley, R-Iowa. (Getty Images)
“The investigation found that the state over-counted its reimbursable emergency care percentage by 8.49 percent, and had improperly claimed $52,652,698 from the start of October 2018 to the end of June 2019,” Grassley wrote to Newsom regarding Health and Human Services (HHS) Inspector General Christi Grimm’s probe.
“HHS OIG recommended that California refund the $52.7 million improperly claimed during that period and work with CMS to find any additional improperly claimed reimbursements for periods outside of the OIG audit.”
Grassley added that it appears California did not adjust its algorithm for determining Medicaid disbursements to such immigrants, after the inspector general’s report made the recommendation.
“As of today, [they] remain unimplemented. Each state must ensure that proper care is taken to protect the American taxpayer from fraud, waste, and abuse,” Grassley wrote.
19 STATE ATTORNEYS GENERAL CHALLENGE BLUE STATES’ RADICAL CLIMATE POLICIES IMPACTING OTHERS
Grassley followed up with a list of questions he wanted Newsom to answer by Sept. 5.
“Has California repaid any portion of the money it improperly received from the federal Medicaid program? If so, how much and when? If not, why not?” he wrote.
“What is California’s current methodology to quantify its portion of reimbursable income?”
Grassley also noted California’s annual budget is around $300 billion, therefore, questioning why the California DHCS is using a “manual process” to repay the feds rather than an immediate lump sum.
The May audit conducted by Grimm underlined that federal Medicaid benefits are usually limited only to citizens and “qualified” noncitizens. Examples of qualified noncitizens are refugees, people granted asylum or those lawfully admitted for permanent residence.
The audit covered more than $372 million in federal Medicaid reimbursements made on behalf of noncitizens during FY 2019.
The report, in part, blamed outdated algorithmic metrics on California’s end for the discrepancy in “improperly claimed” Medicaid reimbursements for the particular noncitizen class.
In comments to Fox News Digital, Grassley said economic conditions created by President Biden and Vice President Kamala Harris have led to households now “struggling, and having to stretch their dollars in every which way.”
“Meanwhile, California is providing federal health insurance to ineligible illegal immigrants using taxpayers’ hard-earned money,” he added.
The Centers for Medicare & Medicaid Services logo is seen displayed on a smartphone. (Getty Images)
“It’s a slap in the face, and we ought to know what CMS is doing to collect the improper reimbursements California confirmed it owed months ago.”
In his corresponding letter to Brooks-LaSure, Grassley noted the Social Security Act of 1935 requires the feds to reimburse states via her agency for a percentage of their Medicaid costs.
He said that, for “noncitizens with unsatisfactory immigration status,” only “emergency services” are typically covered after five years of coverage.
MediCal (the state’s equivalent to Medicaid) “uses state funds to provide full coverage for noncitizens with UIS by paying each managed care plan a monthly capitation,” Grassley said.
He similarly asked Brooks-LaSure whether California repaid their liability, and whether her agency has initiated any type of review to prevent this from happening in the future.
Meanwhile, illegal immigrants remain ineligible overall for federal coverage and disbursements under the Affordable Care Act, according to HealthCare.gov.
Fox News Digital reached out to CMS for an independent update on California’s agreed-upon repayment of the Medicaid remittances.
In a statement at the time, an official with California’s DHCS expressed plans to repay the requested amount by June 30.
“Additionally, DHCS has worked with the federal Centers for Medicare & Medicaid Services to develop and implement a more refined service identification methodology with updated payment and claiming processes,” the spokesperson said.
UPDATE: A spokesperson for the federal Center for Medicare & Medicaid Service said California has since returned the $52 million cited in the inspector general’s report.
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A San Francisco man convicted of sexually assaulting two of his relatives was sentenced to a lengthy prison term, prosecutors announced Tuesday.
The San Francisco District Attorney’s Office said in a press release that a judge sentenced Sergio Alvarado, 60, to a total of 25 years and four months in state prison following his convictions.
A jury found Alvarado guilty of three counts of forcible rape and one count of forcible oral copulation for crimes that happened in 2014. He was also convicted of attempted forcible oral copulation on a minor and assault in a 2019 case involving a different victim.
Prosecutors said Alvarado sexually assaulted the first victim repeatedly over a period of several months. Several years later, Alvarado assaulted the other victim, a 16-year-old relative, in his car after he offered to drive her to a job interview, the DA’s Office said.
“Family violence occurs within ongoing relationships that are expected to be protective, supportive, and nurturing,” said Assistant District Attorney Sheila Johnson in a prepared statement. “Mr. Alvarado’s exploitation of that trust caused two generations of women profound psychological trauma. Hopefully, seeing him brought to justice restores their sense of humanity and sends the message that violence of this kind will not be tolerated.”
Denver, CO
Denver police asking for help finding driver suspected in hit-and-run crash Monday morning
DENVER — The Denver Police Department (DPD) is looking for the driver in an alleged hit-and-run crash on Monday morning.
Around 7:15 a.m. Monday on westbound Interstate 70, just east of the Sheridan Boulevard exit, DPD said the driver of a newer Jeep Cherokee changed lanes into a motorcyclist in the far-left lane.
The motorcyclist suffered serious injuries as a result of this crash, according to DPD.
The driver of the Jeep Cherokee drove away from the scene of the crash without stopping or leaving any contact information, as is required by law. The vehicle was white or light colored with unknown license plates, DPD said.
Anyone with information about the driver, the suspected Jeep Cherokee involved or the crash itself is asked to call Metro Denver Crime Stoppers at 720-913-STOP (7867) or submit a tip online here. Tipsters can remain anonymous and are eligible for a $2,000 reward for any information that leads to an arrest.
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Driving down Lake City Way, there’s a warm light in the distance — a beacon calling you to a bar room full of beers and bands. The soft, yellow light that’s been glowing decades is the sign for the Shanty Tavern, though it’s known by another name to its owner.
“She is called Miss Shanty,” John Spaccarotelli tells KUOW. He’s owned the place and poured drinks for “umpteen years.”
More precisely, John Spaccarotelli has spent 64 years at this spot on the edge of the road in Lake City, running what’s referred to as the “last roadhouse” in Seattle.
This style of a neighborhood bar, equipped with a dance floor, used to be more common decades ago. John Spaccarotelli’s patrons and family see it as a vanishing piece of Seattle culture.
“There’s just something special about this place,” says Lisa Casal, who comes in for music regularly and enjoys a front row seat at the bar. “These places are disappearing — and it’s sad.”
For the last few years, John Spaccarotelli has only been opening the Shanty Tavern on Friday nights for beer and live music. His three daughters and his grandkids are here to help him out through the busy closing night.
Many of the business’s regulars live in Lake City and walk to the bar from their homes. Now they’re figuring what they’ll do with their Friday nights once the tavern’s doors close.
One regular, Eric Beam, has a “reserved” barstool at the far end of the bar, where he can always be found reading a thick book.
“I come here at the end of the week, sit here, and talk stories with John,” Beam says. “And I leave with a big smile on my face, feeling better. I’m really going to miss that.”
John Spaccarotelli doesn’t plan to sell the land or building, but the 94-year-old said retirement is calling.
“I’m just going to take it easy for a while,” he says.
The Shanty Tavern has been home to longtime regulars like Michael Wansley, better known around here as Wanz, who’s been coming since the 1990s.
“[I] come down here every Friday with a whole bunch of the neighborhood cats,” he says. “We hang out here, play pool, drink beer.”
On its last Friday night open, the Shanty Tavern is much busier than usual, Wansley says, because this is one of the last nights The Shanty Tavern is pouring beers.
People have come to pay their respects and give one last toast.
“I would toast the fact that the beer is always cold, the jokes are almost always dirty, and the asses are always smart,” Wansley says with a raised glass.
In the low, crowded barroom, the Rat City Brass Band wails in one corner. The dance floor is so packed, the floorboards bounce up and down.
John Noe books the bands here. And since the place is so busy on closing night, he’s helping pick up empty bottles, too.
“Twelve years doing this, so it’s the end of an era,” Noe says. “Kind of bittersweet tonight. You know, they’ve become a part of my family.”
It’s an emotional night for the entire Spaccarotelli family. John Spaccarotelli’s daughter, Dayna, has been working with him here for the past 18 years.
“Lot of tears will come later, [I’m] trying to hold it together right now,” Dayna Spaccarotelli says. “My whole life has been here.”
She grew up here with her two sisters. The three used to come in to “help” their dad.
“We’d dance to the jukebox. We’d play shuffleboard and pool. We’d throw darts,” Dayna Spaccarotelli says.
A lot of old regulars made the trip on Friday to say goodbye to the Spaccarotellis. The hardest part, Dayna Spaccarotelli says, is seeing all these old faces and sharing memories.
“I just keep telling myself to just get through tonight. Just get through tonight. It’ll be okay,” Dayna says. “It’s not going to be okay.”
John Spaccarotelli says he plans to spend more time with his family after his retirement. He also wants more time to do what he loves: dancing. He even met a potential new dance partner at the bar’s last call.
“She says she likes to dance,” he said. “Ao I’ll find out if she likes to dance that much with me.”
By around 1:15 a.m., the Shanty Tavern crowd has slimmed down, but the bar’s regulars, who don’t want the place to close yet, have stuck around.
Fulvio Longo, who has a favorite corner barstool, brought in some champagne and is singing goodbye songs with John Spaccarotelli.
Then comes the moment everyone’s been dreading:
“Last call! Last call!” John Spaccarotelli shouts out above the noise. “That’s it, everybody. Last call.”
John Spaccarotelli insists this isn’t goodbye, though.
He says he’ll host one more open house in January and then maybe rent the place out.
But no matter what, the glowing sign isn’t coming down, he says.
“Thank you for the good times with the people that I’ve met,” he says. “And hopefully I’ll meet someone on the street saying, ‘Hi, John.’”
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