| Medicare Provider Bureaucratic Nightmare Posted: 19 Mar 2011 10:57 PM PDT John Peters, a practicing psychologist, just sent me an email regarding a complete bureaucratic nightmare that has prevented his firm from obtaining a Medicare Provider Number. John writes ... Hi Mish,
I'm writing at the request of Customer Service at Palmetto GBA, the firm which handles all our Medicare processing.
As a practicing psychologist with offices in Fairfield and Albany, California, I have been attempting to obtain a Medicare Provider number.
I applied despite horror stories from doctors who informed me that just the enrollment process takes a few years and I may need to hire a professional to assist me.
Being a geek by nature, and already on the panels of five insurance companies and workman's comp, it seemed like a trivial matter to get one additional certification.
The first problem involved needing to complete a mandatory electronic payment form that I found via a Google search since the provider analyst never responded to any of my inquiries.
Months later I received a notice telling me that my application had been rejected with no reason given. By phone, I found out that they needed a canceled check which hadn't been included. However, I had received no request for a canceled check.
The provider analyst then said I needed to seek permission to re-enroll, a process that takes up to three months.
Persevering, I went through the process, getting "permission" to re-apply. After carefully seeking help going through exactly what would be needed in the new application, resubmitted it.
Months later I received another rejection. This time it was because they wanted a specific contact person's name from the bank on the electronic payment form instead of the general customer service name and number.
I was told that the provider analyst had sent me a request for the needed information, but that she had sent it to the wrong email address. Still, there was "nothing that they could do," since my application number no longer existed and I needed to once again seek permission to re-apply with another three month wait.
Persevering, I noted the reasons for the rejection, and reapplied for permission to re-apply. Months later my request was rejected on the grounds that I had exceeded the 60 day period for requesting reconsideration.
It turns out the provider enrollment analyst used the initial versus current request number, despite my including the current request number in bold letters at the top of my letter.
Next, I send a letter which noted the error, and enclosed a copy of the rejection letter which confirmed that my response had been the following week. A month later, I received another rejection letter from the same analyst that merely copied her original reason for rejection. Clearly, the analyst had not even looked at the letter.
Since the customer service representative has no access to records, she can only direct me to a number for "complex cases." I have tried for a month at various times of day, and have never been able to get through to anyone. Generally, after an extended message, the call is disconnected, or I am put on hold for about an hour before it disconnects. I was told that the reason for this is that they are "busy."
In a period where the issue of government involvement in healthcare is being considered, I ask myself why there is absolutely no accountability for the worse than horrible management of Medicare?
The customer service representative at Palmetto noted that she deals with phone calls similar to mine all day, every day, that involve pure incompetency and the unwillingness of provider enrollment analysts to do their jobs. The representative went on to say that she is helpless to do anything, because they do not give her access to any records, and that contacting a congressman is about the only option available.
I've sent this email out to several congressional representatives in California.
Sincerely,
John Peters, PhD If anyone out there can help John, please shoot me an email. I will pass it on. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com
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| French Jets Strike Libyan Forces, Attack Tanks, Crowds Cheer; Hillary Clinton Influential in Decision to Attack Posted: 19 Mar 2011 11:43 AM PDT The Libyan intervention has begun, led by French military jets. The attack goes beyond a no-fly zone, striking at Libyan forces in the city of Benghazi, which is under heavy bombardment by Qaddafi's forces. At least one Libyan tank has been destroyed. Please consider Obama Takes Hard Line With Libya After Shift by ClintonIn a Paris hotel room on Monday night, Secretary of State Hillary Rodham Clinton found herself juggling the inconsistencies of American foreign policy in a turbulent Middle East. She criticized the foreign minister of the United Arab Emirates for sending troops to quash protests in Bahrain even as she pressed him to send planes to intervene in Libya.
Only the day before, Mrs. Clinton — along with her boss, President Obama — was a skeptic on whether the United States should take military action in Libya. But that night, with Col. Muammar el-Qaddafi's forces turning back the rebellion that threatened his rule, Mrs. Clinton changed course, forming an unlikely alliance with a handful of top administration aides who had been arguing for intervention.
Within hours, Mrs. Clinton and the aides had convinced Mr. Obama that the United States had to act, and the president ordered up military plans, which Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, hand-delivered to the White House the next day. On Thursday, during an hour-and-a -half meeting, Mr. Obama signed off on allowing American pilots to join Europeans and Arabs in military strikes against the Libyan government.
The president had a caveat, though. The American involvement in military action in Libya should be limited — no ground troops — and finite. "Days, not weeks," a senior White House official recalled him saying.
The change became possible, though, only after Mrs. Clinton joined Samantha Power, a senior aide at the National Security Council, and Susan Rice, Mr. Obama's ambassador to the United Nations, who had been pressing the case for military action, according to senior administration officials speaking only on condition of anonymity. Ms. Power is a former journalist and human rights advocate; Ms. Rice was an Africa adviser to President Clinton when the United States failed to intervene to stop the Rwanda genocide, which Mr. Clinton has called his biggest regret.
Now, the three women were pushing for American intervention to stop a looming humanitarian catastrophe in Libya.
In joining Ms. Rice and Ms. Power, Mrs. Clinton made an unusual break with Secretary of Defense Robert M. Gates, who, along with the national security adviser, Thomas E. Donilon, and the counterterrorism chief, John O. Brennan, had urged caution. Libya was not vital to American national security interests, the men argued, and Mr. Brennan worried that the Libyan rebels remained largely unknown to American officials, and could have ties to Al Qaeda.
"Hillary and Susan Rice were key parts of this story because Hillary got the Arab buy-in and Susan worked the U.N. to get a 10-to-5 vote, which is no easy thing," said Brian Katulis, a national security expert with the Center for American Progress, a liberal group with close ties to the administration. This "puts the United States in a much stronger position because they've got the international support that makes this more like the 1991 gulf war than the 2003 Iraq war."
Allied Intervention Begins as French Jet Strikes Libyan ForcesThe New York Times reports Allied Intervention Begins as French Jet Strikes Libyan Forces
President Nicolas Sarkozy said French military jets had begun enforcing the no-fly zone over the eastern city of Benghazi, which is under heavy bombardment by Qaddafi's forces.
American, European and Arab leaders began the largest international military intervention in the Arab world since the invasion of Iraq on Saturday, in an effort to stop Col. Muammar el-Qaddafi's war on the Libyan opposition.
Leaders meeting in Paris on Saturday afternoon announced that air operations to enforce a no-fly zone and protect civilians had begun over Libya, as approved by the United Nations Security Council on Thursday. And the French military announced that a Rafale jet fighter had destroyed a government tank near the de facto rebel capital, Benghazi, in eastern Libya.
Earlier in the day, people in Benghazi reported heavy bombardment and fighting, despite an ultimatum from Western powers that Mr. Qaddafi hold to a cease-fire. A rebel fighter, speaking over the phone, described a procession of tanks as well as rooftop snipers fighting for the Qaddafi forces in the west of the city. And a steady stream of vehicles, some bearing rebel flags, was seen pouring out of Benghazi toward the rebel-held city of Bayda, where crowds were cheering the first French overflights.
"Our assessment is that the aggressive actions by Qaddafi forces continue in many places around the country," Secretary of State Hillary Rodham Clinton said after the meeting in Paris concluded. "We saw it over the last 24 hours, and we've seen no real effort on the part of the Qaddafi forces to abide by a cease-fire despite the rhetoric."
Even as Colonel Qaddafi defied demands to withdraw his military, he issued letters warning Mr. Obama and other leaders to hold back from military action against him.
The tone of the letters — one addressed to Mr. Obama and a second to Mr. Sarkozy, Prime Minister David Cameron of Britain and Secretary General Ban Ki-moon of the United Nations — suggested that Colonel Qaddafi was leaving himself little room to back down.
"Libya is not yours. Libya is for all Libyans," he wrote in one letter, read to the news media by a spokesman. "This is injustice, it is clear aggression, and it is uncalculated risk for its consequences on the Mediterranean and Europe.
"You will regret it if you take a step toward intervening in our internal affairs."
Colonel Qaddafi addressed President Obama as "our son," in a letter that combined pleas with a jarring familiarity. "I have said to you before that even if Libya and the United States enter into war, God forbid, you will always remain my son and I have all the love for you as a son, and I do not want your image to change with me," he wrote. "We are confronting Al Qaeda in the Islamic Maghreb, nothing more. What would you do if you found them controlling American cities with the power of weapons? Tell me how would you behave so that I could follow your example?"
The initial stage of the military operation will be run by France and Britain with significant American help, including radar planes, command and control, and precision-guided munitions, including cruise missiles and B52 bombers, NATO officials said.
But Mrs. Clinton emphasized that the United States was not leading the effort. "We did not lead this," she said. "We did not engage in unilateral actions in any way, but we strongly support the international community taking action against governments and leaders who behave as Qaddafi is unfortunately doing so now." Limiting the US role to support would be wise, assuming one believes we should do anything at all. Other than provide radar guidance for British and French jets, that decision having clearly been made already, the less US intervention the better. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com
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| Gallup Poll Pegs Unemployment Rate at 10.2%, Underemployment at 19.9%, Same as Last Year Posted: 18 Mar 2011 11:49 PM PDT I am very skeptical of BLS unemployment rates inching lower. Not only do the BLS reports discount millions of marginally attached and discouraged workers but BLS seasonal adjustments seem more than a bit unusual. Gallup polls paint a far different picture. Please consider Gallup Finds U.S. Unemployment at 10.2% in Mid-MarchUnemployment Rate Part-Time Workers Wanting Full-Time Job
Underemployment Click on any chart for a sharper image. The only valid way to compare not seasonally-adjusted numbers is to compare the numbers to the same month a year ago. I added the red circles on the above charts to show just that. Note that year-over-year comparisons of the unemployment rate, the underemployment rate, and the part-time for economic reasons rate, all show no significant change compared to a year ago. Meanwhile the BLS would have you believe the unemployment rate fell from 9.7% to 8.9% over the course of the last year. Jobs Situation About the Same as It Was a Year AgoThe government's February report on the U.S. unemployment situation suggests that 192,000 jobs were created last month and the unemployment rate declined to 8.9%, down from 9.7% a year ago. Federal Reserve Bank of New York President William Dudley and others said they were encouraged by this report.
However, Gallup's unemployment and underemployment measures have not shown the same gains in early 2011. Gallup finds an unemployment rate (10.2%) and an underemployment rate (19.9%) for mid-March that are essentially the same as those from mid-March 2010.
In part, the difference between Gallup's and the government's current job market assessments may be due to the government's seasonal adjustments. Gallup's U.S. unemployment rate is also more up-to-date -- its mid-March data include jobless figures for much of March, whereas the government's latest unemployment rate is based on the jobs situation in mid-February.
Most importantly, a key reason the government's unemployment rate is dropping apparently has to do with the so-called participation rate: the percentage of Americans who are counted as being in the workforce. The government's participation rate in February was at its lowest level since 1984. In essence, this tends to suggest that the government's unemployment rate may be declining because many people are becoming discouraged and leaving the workforce -- not because they are getting new jobs.
If this is the case, then neither Gallup's unemployment report nor that provided by the government is good news for the economy. It is equally bad news if people are out of work and looking for a job or just too discouraged to say they continue to do so. Either way, a lack of sufficient job creation to increase employment among those who want to work remains a major obstacle to U.S. economic growth in the months ahead. Gallup offers reasonable commentary. There is no reason to be excited over the BLS dip in the unemployment rate. Here is another way of looking at it, using the BLS' own numbers.
Nonfarm Payroll Employment - Seasonally Adjusted Total
According to the BLS, non-farm employment is lower than it was in 2002! Household Data In the last year, the civilian population rose by 1,853,000. Yet the labor force dropped by 312,000. Those not in the labor force rose by 2,165,000. In January alone, a whopping 319,000 people dropped out of the workforce. In February (this months' report) another 87,000 people dropped out of the labor force. Were it not for people dropping out of the labor force, the unemployment rate would be over 11% (Rosenberg pegs it at 12%). On a year-over-year basis the number of people employed dropped by 125,000 yet we are supposed to believe things are getting better. From a jobs standpoint the best we can say is things are no longer getting worse. However, we can also state the BLS unemployment rate is a complete distortion of reality. Finally, take a look at that employment chart and tell me where the demand for housing is going to come from. Here's a hint: you can't do it. For further discussion of housing, please see Shrinking Labor Pool Means Shrinking Demand For Housing. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com
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