Date: 2024-05-15 Page is: DBtxt003.php txt00016478
Rule of Law -v- Accountability
The Affordable Care Act was a sweeping statute ...
The Affordable Care Act was a sweeping statute ... Unintended Consequences ... Oops: Billion Dollar Fraud Case Could Be Dismissed Because Trump Hates Obama
Peter Burgess
Call it unintended consequences, call it acting without thinking, call it pure unadulterated stupidity. We all know that the “administration” has decided to go all in and argue the position of “Judge” what’s-his-name in Texas that says the ACA should be entirely enjoined. The whole thing. All of it. Every letter.
Put a pin in that.
We have had columns this week talking about how the ACA is so much a part of the plumbing of the health care system of this country now. They talk about the premium system, the delivery systems, guaranteed issue, all those fancy bells and whistles.
Put a pin in that, too.
Just recently in Florida (of course), there was a HUGE Medicare/Medicaid fraud trial. How huge? Rick Scott huge. Over a Billion dollars. So, according to Think Progress and the Miami Herald,
The billion-dollar fraud case involves Philip Esformes, who ran a chain of skilled-nursing and assisted living facilities in Miami-Dade. Esformes’ business was apparently quite lucrative — as the Miami Herald noted, the health executive raked “in millions from his healthcare business, gobbling up pricey real estate and darting around the country in chartered jets,” until his arrest in 2016.
[Prosecutors claim that the]health care executive paid kickbacks to health providers “in exchange for medically unnecessary referrals” to Esformes’ facilities. Esformes and co-conspirators then allegedly submitted “false and fraudulent claims to Medicare and Medicaid in an approximate amount of $1 billion for services that were medically unnecessary, never provided, and procured through the payment of kickbacks and bribes.” All of Esformes’ co-conspirators plead guilty, according to the Miami Herald.
That’s the trial part. Here’s where the ACA comes in. On Wednesday, Esformes’ lawyers filed a motion to dismiss, or alternatively, a motion to declare a mistrial.
Why?
“Because the Justice Department has admitted that the health care offenses at issue in this trial are unconstitutional.”
Let me repeat that.
“Because the Justice Department has admitted that the health care offenses at issue in this trial are unconstitutional.”
Basically the argument boils down to this:
The problem arises because O’Connor did not simply strike down the core provisions of the Affordable Care Act. He declared that every single provision of the law is invalid, including relatively minor provisions amending the statutes governing Medicare fraud and kickbacks paid to health providers. Though Esformes alleged actions may also be illegal under the unamended versions of those statutes, Esformes was charged under the amended versions.
According to Esformes’ motion, “every health care statute cited in the Indictment has been identified as among those ruled unconstitutional” by Judge O’Connor.
“the Due Process Clause will not permit the Justice Department to prosecute the Defendant based upon alleged violations of statutes and regulations that they have independently deemed and declared to be unconstitutional.”
So now, the DoJ lawyers are in a bind. They either have to contradict their bosses and say “No no, the provisions ARE constitutional”, as if that’s going to happen, or go along with Dear Leader and cross their fingers and see what happens. In which case Double Jeopardy applies and Esformes gets away with a billion dollars or taxpayer money.
And as fraud cases are ones where the defendants can afford lawyers, think of the inundation of the system with calls for dismissal.
The Affordable Care Act was a sweeping statute amending numerous, longstanding provisions of America’s health laws. Anyone prosecuted under any one of these provisions may now claim that they are immune from consequence. And the Justice Department will need to awkwardly explain itself in every single case.
The Agent Of Chaos strikes again. We’re fucked.
And all because Trump and the Republicans hate President Obama.