By J. Lyn Carl, GalleryWatch.com
Austin, TX –
With opponents citing the stigma and the psychological impact associated with the fingerprinting or biometric scanning involving teenagers, Sen. Jane Nelson (R-Lewisville) hit a stump with her SB 47 on the Senate floor today. Her bill addresses efforts to reduce Medicaid fraud among providers and recipients by requiring recipients to prove their identity through biometric identification.
Aimed at reducing Medicaid fraud, the pilot program seemed innocuous enough. Who wouldn't want to reduce fraud, save the state a few bucks? The identification program would ensure that the person who seeks services from a provider is actually the person who qualified for the services and to whom a benefits card was issued. The legislation would require children under age 15 who are Medicaid recipients to participate in the pilot program.
Enter Sen. Royce West (D-Dallas), who offered his concerns regarding the psychological impact such identification measures might have on teenagers, particularly if a retina or iris scan or fingerprinting were to be used for identification. He questioned whether these young people should be exposed to this type of identification measure just to "satisfy ourselves that fraud is being perpetrated on the state of Texas."
Sen. Steve Ogden (R-Bryan) questioned West regarding an amendment which, among other things, changed the age of those young people who would be required to participate in the pilot program from 15 to 18.
Ogden noted that in the criminal justice system, DNA testing is sought, which he called much more reliable than other testing. He said, however, that when it comes to reducing fraud, there seemed to be some concerns that identification methods were "too aggressive on that."
The "degree of aggressiveness" is what is in question, responded West.
The Bryan Republican argued that biometric identifiers are "less invasive, less intrusive, more reliable and easier to do," and that the technology is there to make it an even simpler process. "Just because you're asking for identification through new technology, is that a bad thing or a presumption of their guilt?"
West again argued that he was in favor or ruling out as much fraud as possible, but questioned the level of aggressiveness and the amount of indignity involved through the proposed identification proposals.
When Ogden said he did not look at is as an indignity, West fired back, "You don't have to go through it." Ogden called West's concerns "misplaced."
West noted that there was compromise involved to get the bill moving from the committee to the floor and that he had worked with Nelson on his amendment. Nelson said the amendment did, indeed, represent a conversation she had with West regarding his concerns. She pointed out that there are already such pilot programs in six Texas counties that have had "very good results," and then noted that the amendment offered by West was acceptable to her as the author of the bill.
Sen. Gonzalo Barrientos (D-Austin) questioned Nelson regarding the other pilot programs, which Nelson said had identified $105 million in fraud. "It uncovered a portion of the fraud that is taking place," she said, "but certainly not all of the fraud that is taking place."
Asked how many persons were convicted and sentenced related to the fraud, Nelson responded, "I don't know. I hope every one of them."
"How many were ill, in pain and trying to get Medicaid service - and how many were providers?" questioned Barrientos.
"I bet not many of those providers were ill or in pain," said Nelson.
Barrientos thus zeroed in on his point, that a great majority of the money lost due to fraud was perpetrated by the providers, "not the poor people who were trying to get treated."
"I think we can do better," said the Austin Democrat. "I know your heart and mind are in the right place, but we can do better."
After West's amendment failed, he told Nelson he thought "we had an agreement on the amendment."
"Senator, I voted for the amendment," responded Nelson. "I said it was acceptable."
West countered saying he would not have voted for a suspension of the rules to hear the bill on the Senate floor if he had known the amendment would fail.
Nelson reiterated how the proposed pilot program came about, saying even before the 78th Legislature when the state was facing a $10 billion budget deficit and looking for ways to save the state money, one of the "obvious" ways was to identify fraud and abuse that was taking place. HB 2292 implemented a pilot program that was aimed at detecting fraud and abuse "through this imaging process." She said the concerns created by the possibility of an iris scan or facial scan were "not our intent."
She said she tried to make it very clear that the only identification means being promoted in the bill is "fingerprinting."
West went back to his failed amendment. "I thought the first amendment was acceptable," he said to Nelson.
"Just because I say the amendment was acceptable to the author doesn't mean 31 others (senators) will vote for it," she responded. "I can't deliver you 31 votes."
With Nelson retaliating by seeking West's support for moving the bill on through the Senate floor actions, the Dallas Democrat said he could not commit on how he will vote until he can sit down and further discuss the bill and a possible amendment with Nelson. She said she would move passage to engrossment of the bill and then hold the bill after that.
Barrientos then rose again, saying it appeared that actions aimed at "getting sleazy, sneaky people who take money from Texas," are now "shades of (the book) 1984, George Orwell, Big Brother..." He noted that while the identification process may not cause pain or inconvenience, many of these people who are Medicaid recipients already have been the "butt of embarrassment, emotional feelings and distress."
"They are human beings," he said. "They are people."
West added that a forced identification program for these young aid recipients was trying to balance the need of "rooting out fraud" with balancing the "delicate psyche" of 15-17-year-olds, who because of peer pressure hate to admit they are recipients of some such services. This identification process, he argued, would "further humiliate them" by requiring them to engage in a fingerprinting process.
"This is not about the stigma of identification of people on state aid benefits," countered Sen. Kyle Janek (R-Houston). He said it is instead more about the provider and making sure the "person we're helping is the person who is eligible."
Nelson closed by saying that if a 16-year-old is committing fraud, "Shouldn't we hold them accountable? We hold them accountable for other crimes. If we are going to provide services to as many people as we possibly can who need our help, isn't it incumbent on us to seek out fraud that may take place?"
She said Barrientos made an excellent case for her bill through his remarks. She said of the $105 million in Medicaid fraud identified in other pilot programs, most of it is by providers. "I want to nail them and this bill is the only way I can come up with that will do that efficiently and effectively." Nelson added that the technology is available now and the state needs to take advantage of it to help identify fraud and abuse "that we both want to identify and eliminate."
Nelson held off on seeking passage to third reading of her bill, but it is set on the Senate Intent Calendar again for Wednesday, with West no doubt working on another possible amendment or some kind of compromise with Nelson.