[nobody9999]

>Take note that all these victims were either employed or had insurance coverage. It's telling that they're not targeting the local homeless individual for 'care.' Which makes this more disgusting.

Apparently, "Medicaid is the single largest payer for mental health services in the United States"[0]

That said, one will likely have to dig through quite a bit of data to determine, on a state-by-state basis, what the reimbursement rates are for inpatient psychiatric services. And they don't make it easy, either.

For example, reimbursement rates for Texas[1], California[2] and New York[3] (chosen because they're large states which, together, make up a significant chunk of the US population) are available, but need to be parsed to figure out which specific code corresponds to daily reimbursement rates for psychiatric care.

[0] https://www.medicaid.gov/medicaid/benefits/behavioral-health...

[1] https://public.tmhp.com/feeschedules/Default.aspx

[2] https://mcweb.apps.prd.cammis.medi-cal.ca.gov/rates?tab=rate...

[3] https://omh.ny.gov/omhweb/medicaid_reimbursement/

Edit: In case my point isn't obvious, I'm wondering aloud whether or not Medicaid (the US medical insurance program for those under 65 who can't afford to pay for insurance) reimbursement rates make it a target for similar shenanigans. While Medicaid is significantly funded by the US Federal government (via block grants[4]), it's administered (in vastly different ways) by each state, which set their own eligibility and reimbursement rates

[4] https://en.wikipedia.org/wiki/Block_grant

[genewitch]

Medicaid is the largest payer because the state is who determined that an individual needs 24/7 hospitalization. There's nothing even remotely remarkable about this. If you drink heavily your entire adult life, your brain is swiss cheese before retirement age. You can no longer "function" in society. The courts cannot do anything until you present a problem for society at large. State run hospitals are very nearly entirely comprised of people who will be in the hospital until they die, with a marginal few matriculating into a group home or another facility (for instance, end-of-life facility).

I don't remember offhand what the facilities "charge per day" but i imagine it wouldn't be too difficult to ask someone in billing the next time i have a chance.

[Spooky23]

Unlike Medicare, which won’t pay for poor performance, Medicaid pays for services rendered, period. If you’re a shitty provider, there’s a calculus for when to bill Medicaid for a lower, guaranteed payment vs Medicare.

There’s a wide variety of shenanigans at the provider, managed care and state/county level. A big part of the performative shipping of migrants and poor people to northern states is all about shifting Medicaid expenses.

This happens often to mental patients, who often find themselves released from a police station or hospital, at a bus station with a ticket to NYC.

[nobody9999]

>Unlike Medicare, which won’t pay for poor performance, Medicaid pays for services rendered, period.

I don't believe that's true. Do you have any evidence for this?

I have never heard of anyone challenging a Medicare reimbursement for "poor performance." In fact, billing codes often don't make a whole lot of sense, yet are approved without question just because the billing code exists.

What's more, Medicare and Medicaid fraud are often perpetrated[0] by the same folks without and done in exactly the same way.

[0] https://www.cnbc.com/2023/03/09/how-medicare-and-medicaid-fr...

[Spooky23]

https://bmchealthservres.biomedcentral.com/articles/10.1186/...

The most common way they do this is with hospital re-admissions. The hospital eats the cost, which is often because of poor hygiene and nursing practices.