Horizon, Host: Ted Simons

November 24, 2010


Host: Ted Simons

Medicare Payments

  |   Video
  • AARP wants Congress to stop a cut in Medicare payments to doctors from taking effect at the end of the year. The organization says a 25% cut in reimbursement rates could make it difficult for seniors to find doctors willing to see Medicare patients. David Mitchell, AARP Arizona State Director, and Dr. Zuhdi Jasser, Arizona Medical Association, discuss the issue.
Guests:
  • David Mitchell - AARP Arizona State Director
  • Dr. Zuhdi Jasser - Arizona Medical Association
Category: Medical/Health

View Transcript
Ted Simons:
The Maricopa County board of supervisors has authorized spending about $10 million on outside attorneys to defend Sheriff Joe Arpaio and former county Attorney Andrew Thomas against legal claims. Supervisors Don Stapley and Mary Rose Wilcox refused themselves from the vote. They've both filed claims against the county. A number of other claims have been filed by county employees and others who say they were wrongly investigated or sued by Arpaio and Thomas.

Ted Simons:
AARP wants Congress to stop a cut in Medicare payments to doctors from taking effect at the end of the year. The organization says a 25% cut in reimbursement rates January 1st could make it difficult for seniors to find doctors willing to see Medicare patients. Here with more on the issue is David Mitchell, AARP's Arizona state director. And Dr. Zuhdi Jasser, a Phoenix doctor in private practice who specializes in internal medicine and nuclear cardiology. Dr. Jasser is a past president of the Arizona medical association. Good to have you both here. How real are these threatened cuts and reimbursements?

David Mitchell:
They're very real. As a matter of fact, over the last year, there have been a couple of times when Congress has actually threatened to cut those payments, and at the last minute Congress has come and stopped that and doctors have been able to be paid. But our members are very concerned about this.

Ted Simons:
Are your members aware of this overall?




David Mitchell:
Many of them are, and those that aren't will certainly hear from us through our publications, alerting them to the fact that some of their doctors may opt out of Medicare if this continues.

Ted Simons:
And I want to get to that in a second, but the idea, I've heard the word catastrophic used by doctors if these reimbursement rates are cut? Is that close to fact?

Zuhdi Jasser:
It's complete fact. The bottom line is, I hope people understand that this is a recurring story. We've talked about this in June, we talked about it in March, and what happens is they put a gun to the head of practicing physicians that can't sustain the current solvency of our practice and we're told that basically the reward is that the extended, the sustainable growth rate and they won't put into effect, now it's a 23% cut. If that takes effect, we will become insolvent. But it doesn't, we're told, we'll leave it where it is, meantime over the past year to year after year, our expenses go up, payrolls go up, medical supplies go up, rent goes up, and yet we continue to get cut more and more. Physicians are opting out of Medicare or they're saying, in Massachusetts, 44% of physicians are no lower adding new Medicare patients.

Ted Simons:
And this is all based in a late '90s law, a congressional effort in the late '90s to go ahead and do something about the deficit. Are you telling me that we have had these extensions going on for 20 some-odd years, because it hasn't happened yet, or no one is going through with the -- what's going on?

Zuhdi Jasser:
They keep calling the doctor fix, which is still as big and the price tag is -- continues to increase, it's still a small part of the Medicare budget, most of which is hospital expenses, etc., yet every year they keep focusing all on the doctor fix, and we are the ones that are the bedside with the patients, and patients have absolutely no control, and people need to understand that it's going to decrease their access to the whole health care system because the good physicians, the physicians that are the ones that the patients want to have choices to see will no longer be there for them because of that.

Ted Simons:
Especially patients -- specialist who's have patients 65 and older, and I'm sure this is part of the folks you deal with, they've got to be concerned about this.

David Mitchell:
Absolutely. They're very concerned. Half of our membership is 65 years of age and over. They are very concerned about that, thinking that perhaps they'll lose the Services of the doctor that they've actually had for many years. But surprisingly, not only those that are under Medicare, but those that are going to be under Medicare just a few years down the road. They are as equally concerned. And they're not only concerned for themselves, but they're also concerned for their parents who are dealing with this Medicare issue.

Ted Simons:
These -- this fee reduction plan start back in the '90s here, the idea was to cut the deficit. Right now the mood in this country not to raise taxes and to cut, cut, cut, I understand Medicare reimbursement plans might be complicated for some folks, but this is something that I'm not sure the country is in the mood to address right now. What do you think about that?

David Mitchell:
I think you're right. The mood of the country is not to address that issue, but it's something that has to be done. And therefore we elect people in Congress to really deal with these issues, and it's something that Congress really needs to look at. Where are the trade-offs? But this is something that needs to be addressed.

Zuhdi Jasser:
If you look at the extension, the extension in June where physicians at the time, many wanted to boycott Medicare, even though they wouldn't ethically because of the stress, we had two weeks where we didn't receive payments, and we were expected to dip into some supposed cash flow, which no longer was there, they delayed it, kicked the can down to November 30th, which is after the election, so that this lame duck Congress can deal with it. And in fact, we were promised, physicians were promised this would be tied into medical reform, and it wasn't. It was separated from it. The Pelosi house separated it, nobody held them accountable for that. And now we're finding the physicians are on the verge of aborting it, some of them are retiring early, many of them are just -- one of the things I have to tell you, people need to understand that it's not just we fix it and kick the can down another six months. The fix needs to be tied to inflation so that physicians can see the light at the end of the tunnel. It's not just Medicare. All pricing for other insurance companies are tied to the Medicare fee schedule, so it actually tips the whole solvency of physicians' practices that are not just cash-based. Many of us -- over 60% of my practice is Medicare, I can't afford to stop taking Medicare. That would mean stop practicing or have a wholesale change, which is very difficult.

Ted Simons:
And you -- the can has been kicked down so times, I'm surprised there's still a can after all these years. We should be fair, both sides here have basically said, let's just deal with this some other time. It sounds like they might be doing this again. If I'm a member of Congress, what do you stay to me when I tell you my constituents do not want to see more spending, this looks like something we can address as far as the deficit cutting maneuver, what do you tell me?

Zuhdi Jasser:
You need to put shall are free market mechanisms back into it so you can have some competition. Patients get paid -- pay the doctor the same whether they've just graduated, they've been in practice 20 years. They tell me to make it up by volume. Physicians are told to see 20, 25, 30 patients a day. And if I spend an hour with a patient I. I get the same whether I spent 15 minutes or an hour and a half because there's a max payment per visit. I would tell them to start putting in some incentives, competition, variable scaling, attach to it inflation, give patients more ability to vote with their feet where they go. We award doctors through some type of reimbursement system where patients have more control of how payments are made, and all the overhead needs to be decreased. I can't tell you how much of my practice is wasted on billing, repayments, and a lot of the things behind the scenes. And all we can bill for is that office visit.




Ted Simons:
The idea of maybe a 13-month reprieve, another kick to the can, but a 13-month with a commitment from Congress and the Obama administration that both sides, I don't care what party you're from or how you see the health care reform debate, get together, fix the issue. Is that what you want to see?

David Mitchell:
That's what AARP wants. We want during this lame duck session for Congress to take a look at this issue, deal with the particularly over the next 13 months, the reality is it needs to be fixed permanently. Because it can't be done right now, let's at least get it done through the end of 2011.

Ted Simons:
The idea of a 13-month reprieve, what are you hearing? Is that possible? Is it likely?

David Mitchell:
It's being thought about, but then we also hear rumblings that they may only do a 30-day fix. That's not going to satisfy AARP. It's not going to satisfy our members. But we're hoping for the 13-month.

Zuhdi Jasser:
The -- what's so frustrating, every one of our members in our Arizona delegation told our association they will go to bat for us and make sure this doesn't happen. And yet the vote comes down and somewhere the house ends up kicking this down and the cuts go into effect and all of a sudden we're like playing roulette with this, and next thing you know it passes just with a 1% increase, which really doesn't say what's happening.

Ted Simons:
The same constituents, excuse me, the same delegation, they have constituents who are telling them, you know, buckle down, cut, tighten, the whole nine. You understand. You've heard it. How does a congressional representative hear this and the voters voted this way as well, and then look that the and say, we've got to find money for this. We don't have the money for this.

Zuhdi Jasser:
I think most reasonable rational American citizens know that you do not expense quality -- you do not compromise quality medical care and access in order to fix the budget. There are other aspects to the budget that need to be looked at if you want to look at fiscal conservatism, but not compromising good quality care, which at the end of the day will end up costing Arizona and the United States a lot more money.

Ted Simoms:
Do you agree that there are people out there that are that rational about all this?

David Mitchell:
Well, I would hope so. That they are rational about that. They have to look at offsets. They have to look at trade-offs, because this is very critical. Medical care is so critical to everyone in this country, not just our members, but the whole population.

Ted Simons:
OK. Final question, what does it all mean in terms of health care access overall and for AARP folks?

David Mitchell:
Well, if this is not dealt with and doctors choose to bow out of Medicare, then our members don't have access to the medical care that they deserve and the medical care that they expect to get in their retirement because people have been putting money all their working life into Medicare, and they expect to see a return.

Ted Simons:
To the business side of patient care, what does it mean?

Zuhdi Jasser:
It means that physicians -- remember, physicians are businessmen and women that are looking to survive and the ton keep their lights on. So at the end of the day, this continued hamster chase that we're doing, we're going to start looking for alternatives. Ways to either at least shut the hemorrhaging that we're doing through Medicare, and then look at alternatives. And if you look at the data, physicians that opt out or find other alternatives don't end up ever coming back to Medicare. So if you don't want to see physicians starting to sign off slowly over the next few years, extending it even 13 years, I'm concerned, bawl you'll start seeing physicians say I have to figure out what I'm going to do, because come 2012, I gotta have a life vest and it's not going to be the government.

Ted Simons:
All right. Gentlemen, thank you so much for joining us. We appreciate it.

Mortgage Fraud

  |   Video
  • Assistant U.S. Attorney for the District of Arizona Bill Solomon discusses what his office is doing to fight mortgage fraud.
Guests:
  • Bill Solomon - Assistant U.S. Attorney for the District of Arizona
Category: Mortgage Crisis

View Transcript
Ted Simons:
Good evening and welcome to "Horizon." I'm Ted Simons. Preventing mortgage fraud is one of the U.S. attorney's top priorities. I recently spoke with Bill Solomon, assistant district attorney for the district of Arizona about what his office is doing to fight mortgage fraud. Thanks for joining us.

Bill Solomon:
Thanks for having me.

Ted Simons:
Mortgage fraud, what are we talking about here?

Bill Solomon:
We’re talking about several different schemes we've seen in the valley. It started during the height of the real estate bubble with loan origination fraud. Basically, the fraudsters would buy a property at a low price and find a real estate agent to assist them and find an appraiser who would assist in elevating the cost of the property, once they bought it – fraudulently elevating it, and so it started with mortgage origination fraud and devolving into mortgage modification assistance and mortgage rescue fraud, because we’re having some many people who are underwater with their homes and people needing assistance with their homes and there are companies popping up telling them they can assist with their mortgages and getting loan modifications but aren't helping them and these people are losing their homes. So that’s what we’re seeing now, and we're also seeing reverse mortgage fraud. That's for seniors over the age of 62 who have built up equity. They can take out cash based on the equity they’ve built up on their homes, and use it for any purpose and we're finding that the fraudsters are taking the cash from the seniors once they take it out of their house.

Ted Simons:
Is this something that was always going on below the radar but once the bubble, the burst hit, it went all over the place?

Bill Simons:
With loan origination fraud, yes. I think it was happening for quite a while. When the bubble burst, people were no longer able to afford homes that they couldn’t begin to afford in the first place. And they were losing their jobs and in dire financial straits and that's when it came to light.

Ted Simons:
You've got the mortgage fraud initiative. What's is that?

Bill Solomon:
It's an initiative that the U.S. attorney -- he wants to educate the public. We -- there's so much of it out there. We want, number one, to educate the public and let them know what mortgage fraud we're seeing and how to avoid being a victim. We want to let them know how they can look for assistance if they're having trouble making payments on their home and we want to ask them to report to us mortgage fraud they see.

Ted Simons:
Mortgage fraud that they see or mortgage fraud they think they see? Because some of these violations can be awfully difficult to detect.

Bill Solomon:
They can be. That's why we're doing the mortgage fraud initiative. It's difficult to detect. With a traditional crime, maybe a robbery on the street, they call 9-1-1 and report it to police. That's how law enforcement learns about the crime. With these crimes, especially the crimes against consumers, they're difficult to detect and sometimes found in reams of paper and we need the public to help us.

Ted Simons:
So basically, the public gets a hold of you and I've got concerns, maybe someone in the real estate industry says I know of some concerns? These kinds of things?

Bill Solomon:
Exactly. We want to reach out both to those who have been victimized by what they think is mortgage fraud, as well as those in the industry who may see others in the industry doing things that seem to be fishy, and may be mortgage fraud.

Ted Simons:
True or false, you can share maybe in some the recovery and reward if you doprovide information?

Bill Solomon:
That is true. There's a formal process for you to provide information to our office. Congress established this clear back in the 1990s to deal with the savings and loan crisis. But if you file with our office a formal declaration giving us specific information on the violations of the mortgage fraud laws, if that results in recovery of fund or assets or if it results criminal conviction you can be entitled to share in the civil recovery and may be entitled to a reward if a criminal conviction leads from your information.

Ted Simons:
Interesting. Give us some warning signs to watch out for involving scams and fraud, etc.

Bill Solomon:
First of all, with the mortgage rescue scams as we sometimes call them, people get notices from these companies, either in the mail, they send out mass mailings, they get notices over radio ads, over the television and these companies promise to help them modify their loans. Some of the warning signs are guarantees of a loan modification, guaranteed lower interest rates principle reductions and promising money-back guarantees to some consumers and we’re finding that they're finding ways to give consumers hope. The people they're targeting are in very desperate financial circumstances. No one wants to lose their home and they're finding ways to make people feel comfortable with the services to get them hooked in and pay a fee and then they really don't do much to help them and it's a sad story. Most of the people we interview, a mortgage is a complicated thing and they feel they need assistance to get help from their bank and they don't. But these companies are selling them a bill of goods, making them believe they need assistance and they're just not giving much assistance to them.

Ted Simons:
Is that the most common scam you're seeing?

Bill Solomon:
Right now, especially with the number of foreclosures. Arizona ranks second in the number of foreclosure filings in the country, behind Nevada and we think because of the record number of foreclosure filings we’re seeing, these fraudsters are seeing this as their next avenue to get money.

Ted Simons:
Real quickly, a couple of operations. Operation cash back, talk to us about that and I know and couple people were involved and already been sentenced, I believe. Talk to us about that.

Bill Solomon:
Operation Cash Back was a operation we had here in Arizona, it concluded, I believe, last year. Most of the folks that were arrested under operation cash back have been prosecuted. Operation Cash Back involved the indictment of 46 individuals here in Arizona. Most of them involved in what we talked about the origination, the loan origination fraud. One of those individuals, Mario Burnadell was sentenced to 17 years in prison. For a white collar offense, that's a hefty sentence. Another individual by the name of Jeffrey Crandall was sentenced to five years for a similar scheme. As an example, they again were loan origination fraud schemes. They would find houses and buy them at low prices, they would then find what we call a straw buyer, someone who was not really going to move into the house to purchase the home and falsify the loan documents, making it look like they had a job they maybe didn't have and their income was substantially higher than it was. The straw buyer would purchase the home and turn around and sell the home at an inflated price with the help of an appraisal professional. Sell it at an inflated price and that's basically what the scheme was. Then they would take the cash proceeds from that second sale and pocket those proceeds.

Ted Simons:
For someone watching right now and hears this and goes, hmm, that sounds familiar, whether they're in the business or not, how do they report? Where do they go?

Bill Solomon:
Report informally to the FBI or to myself directly. They can reach me at 602-514-7547. And we want to know both from those who have been victimized and those who have family members who have been victimized and from the professionals, we want them to report to us.

Ted Simons:
All right, very good. Thank you very much for joining us.

Pop-up Galleries

  |   Video
  • See how Arizona’s depressed real estate market is giving artists a chance to showcase their work in one of the Valley’s premier locations.
Category: The Arts

View Transcript
Ted Simons:
Artists are getting a chance to show their work in one of premier locations. Galleries here today but could be gone tomorrow. We go to some of these pop-up galleries.

Ted Simons:
Arizona’s depressed real state market is giving artists a chance to show their work In one of the valley’s premier locations the artists are popping up in galleries in Scottsdale’s arts district. Galleries that are here today but could be gone tomorrow.

Colton Showne:
Jean RASHKIND has been an artist all of her life. Her medium of choice? Paint.

Jean Rashkind:
The painting is about the pure excitement and joy of paint and an opportunity to express everything that I am, that I can't really express in my day-to-day life. They'd probably lock me up.

Colton Showne:
Her work has been featured in shows across the country but for the past five months, she's had a taste of what having my own gallery would be like.

Jean Rahskind:
I just said, I'm interested in this space and basically they signed me up without looking at my work.

Colton Showne
Her space is called pop-up gallery. A play on words for what it is. A pop-up gallery. She temporarily rents out the space for a cheaper rate until someone rented it out for the going rate.

Bently Calverly:
Pop-up galleries are something that I first came in contact with in London. As storefronts were empty, someone had -- and I don't know whom, but someone had the great idea of putting artists in there because it creates some energy, it's much better than looking at a dark hole as you're walking down a retail street.

Colton Showne:
Bently gallery owner Bently Calverly is responsible for bring this art gallery concept to Scottsdale art district.

Bently Calverly:
Didn't really make the connection to Scottsdale. Until the building across the street was empty for so long.

Colton Showne:
Calverly cut A deal with landlords to start these galleries and many local artists were interested but it wasn't easy to sign them up.

Bently Calverly:
Some of them were reluctant to be in such a tenuous situation where they would have expended a great effort and could be removed in a short period of time.

Colton Showne:
Emmett potter is also a temporary gallery owner. He says the concept has done wonders for his art sales.

Emmet potter:
About a week after we got in, we sold our first piece. So we started getting more art work in and a week later, we sold our second piece and finally started bringing in more people.

Colton Showne:
His gallery, squeeze, has been here since February. He hopes he'll be able to rent out the space long term.

Emmet potter:
People like this. I've had people come in here telling me they're happy a gallery like this in Phoenix and Scottsdale exists.

Colton Showne:
Many people across the valley spend Thursday evenings on the art block. Going inside to meet localartists. Calverly said these pop-up galleries bring people to theatre that would not otherwise come.

Bently Calverly:
One the spaces had an opening and we figured there were about 600 people. And that 600 people in my opinion we would not have had on the street if it weren't for that gallery.

Colton Showne:
As for the pop-up galleries, are they here to stay? Only time will tell. But rashkin knows it was just supposed to be a temporary setup.

Jean Rahskin:
Unfortunately, that's already come to pass because it turns out somebody did rent the space and so pop-up gallery is going to have to pop-up somewhere else after this month.

Colton Showne:
She's losing her space this month, but happy she got the opportunity.

Jean Rashkin:
It's been awesome. I mean, just to be able to participate in the art walk every Thursday night and, you know, have all of that exposure and be able to, you know, make the space mine and just set it up how I want to show the works I want to show and, yes, it's been awesome.

Ted Simons:
The pop-up galleries are great for artists and landlords and good for surrounding businesses that say they benefit from the additional foot traffic.

Ted Simons:
That's it for now. I'm Ted Simons. Thank you very much for joining us. You have a great evening!

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