Here are some things that cost taxpayers a lot of money, based on the sources you provided:
Fraud and Waste in Medicare: The sources point to significant concerns about potential fraud and waste within the Medicare system, particularly related to billing for intermittent urinary catheters. [1, 2] While the exact dollar amount of wasted spending is not specified, the Centers for Medicare & Medicaid Services (CMS) is so concerned about the impact of this "significant, anomalous, and highly suspect billing activity" that they are implementing new rules to address it. [2-6] The sources suggest that these fraudulent activities could lead to significant financial losses from the Medicare Trust Funds. [6]
Rural Housing Preservation: The Rural Housing Service (RHS) has allocated over $107 million in funding for rural housing preservation in Fiscal Year 2024. [6, 7] This suggests that maintaining and improving rural housing is a significant expense for taxpayers.
Department of Defense Funding for Technology: The Office of Strategic Capital (OSC) is offering up to $984 million in direct loans to companies developing technologies in areas such as advanced computing, artificial intelligence, and semiconductors. [8] This highlights the substantial taxpayer investment in fostering technological innovation and national security.
Administration of Marketing Orders: The Agricultural Marketing Service is proposing to increase the assessment rate on potatoes in parts of Idaho and Oregon to support the administration of the marketing order. [9, 10] While the source doesn't mention the total cost of administering these programs, the fact that they require assessments on specific agricultural products suggests that they are a considerable expense.
It's important to note that this is not an exhaustive list of everything that costs taxpayers money. The sources primarily focus on specific examples of government spending and regulatory activities, and they don't provide a comprehensive overview of the federal budget.
Potential Inefficiencies and Wasteful Spending: A Focus on Medicare
The sources highlight a significant concern regarding potential inefficiencies and wasteful spending within the Medicare system. Specifically, the Centers for Medicare & Medicaid Services (CMS) has identified "significant, anomalous, and highly suspect billing activity" (SAHS) related to intermittent urinary catheters in calendar year (CY) 2023. [1-42]
This issue has prompted CMS to take several actions:
Retroactive Adjustment of Shared Savings Program Calculations: CMS is implementing a new rule to retroactively remove payment amounts for the specific HCPCS codes (A4352 and A4353) associated with the SAHS billing activity from Shared Savings Program expenditure and revenue calculations for CY 2023. [10-32, 34-54] This measure is aimed at protecting the program's integrity and ensuring fairness among Accountable Care Organizations (ACOs). [15, 22, 26, 29, 37, 49, 50, 55-60]
Proactive Measures for Future Years: CMS is proposing adjustments to address SAHS billing activity in CY 2024 and subsequent years. [16, 27, 61-64] This suggests that CMS is taking a more preventative approach to combat potential fraud and abuse in future years. [59, 65, 66]
The sources do not explicitly mention specific dollar amounts of potential wasted spending, but the analysis indicates that the SAHS billing activity had a substantial impact on ACO expenditures and national expenditures. [26] CMS's concern about the impact on the Medicare Trust Funds underscores the potential for significant financial losses due to these fraudulent activities. [56]
Note: Some information in this response, particularly regarding the potential financial impact and the specific dollar amount of wasted spending, is based on inferences from the source material and may not be explicitly stated in the sources. You may want to independently verify those insights.
Urgent Regulatory Actions and Notices: Insights from the Federal Register
The September 27, 2024 Federal Register excerpts you've provided contain several urgent and high-impact items. These items primarily consist of new rules, proposed rules, and notices that signal important regulatory changes and funding opportunities across various government agencies. Let's break down some of the most noteworthy points:
Medicare Program Adjustments Due to Unusual Billing Activities: The Centers for Medicare & Medicaid Services (CMS) has implemented a new rule to address "significant, anomalous, and highly suspect billing activity" (SAHS) observed in 2023, particularly related to certain intermittent urinary catheters. [1, 2] The rule aims to mitigate the impact of this unusual billing pattern on Medicare Shared Savings Program financial calculations. [1] This highlights the government's proactive approach to safeguarding Medicare funds and ensuring fairness in healthcare payments.
Withdrawal of Proposed D-SNAP Rule: The Food and Nutrition Service (FNS) is withdrawing a 2016 proposed rule regarding the Disaster Supplemental Nutrition Assistance Program (D-SNAP). [3] The withdrawal aims to maintain flexibility in adapting D-SNAP to unique disaster situations, especially in light of experiences during recent public health emergencies. [3, 4] This decision underscores the government's commitment to efficiently responding to evolving crises and minimizing bureaucratic hurdles in providing aid.
Funding Opportunity for Rural Housing Preservation: The Rural Housing Service (RHS) has announced the availability of funds for the Multifamily Housing Preservation and Revitalization (MPR) Demonstration Program and Section 515 Rural Rental Housing Subsequent Loans for Preservation Activities in Fiscal Year 2024. [5, 6] The agency has allocated $80,491,882 for MPR and $27,000,000 for Section 515 loans, aiming to address preservation needs in rural housing. [7] This funding opportunity presents a significant development for rural communities and underscores the government's commitment to improving rural housing conditions.
Numerous Antidumping and Countervailing Duty Orders and Determinations: The Federal Register contains multiple notices from the Department of Commerce concerning antidumping and countervailing duty orders and investigations. [8-14] These actions, targeting products from countries like China, Israel, and Japan, demonstrate the government's active role in protecting domestic industries from unfair trade practices.
Department of Defense Funding for Covered Technology Categories: The Office of Strategic Capital (OSC) is offering up to $984,000,000 in direct loans to support equipment financing for companies developing technologies within specified "covered technology categories." [15, 16] These categories encompass crucial areas like advanced computing, artificial intelligence, biotechnology, and semiconductors, reflecting the government's strategic focus on fostering innovation and bolstering national security through targeted investments.
These items represent only a fraction of the content within the provided Federal Register excerpts. However, they highlight significant government actions and funding opportunities with potentially far-reaching consequences for businesses, industries, and individuals across various sectors. For a more comprehensive understanding, you may want to review the complete Federal Register notices referenced in this response.
New Saved Note
Obscure and Onerous Regulations: Examples from the Federal Register
The provided excerpts from the September 27, 2024, Federal Register contain numerous examples of regulations that an average American might find obscure or onerous, highlighting the extensive reach of government into various aspects of daily life. Here are a few examples:
Regulation of Potato Assessments: The Agricultural Marketing Service proposes a rule to increase the assessment rate on potatoes grown in specific counties in Idaho and Oregon [1]. This rate would impact potato handlers and, potentially, consumers through increased prices. While the increase is intended to support the administration of the marketing order, an average American might question the necessity and impact of such a specific regulation.
Complexities of Buy America Act Waivers: PHMSA proposes waivers to the Buy America Act for pipeline projects in Philadelphia and Springfield, Missouri [2, 3]. While these waivers aim to address the non-availability of specific pipeline components domestically, the process for obtaining such waivers, as outlined in the document, is quite complex, potentially burdening project developers and highlighting the intricacies of navigating federal regulations.
Stringent Information Collection Requirements: Various agencies, including the TSA, NIH, and SSA, have submitted information collection requests to the OMB [4-6]. These requests highlight the significant amount of information these agencies collect from individuals and organizations. While this information may be necessary for program administration, an average American might find the breadth of data collection to be intrusive.
These examples illustrate the pervasiveness of government regulations, impacting even seemingly mundane aspects of life like potato production. The complexity of these regulations and the extensive information collection practices might be perceived as burdensome and intrusive by the average American.
Federal Register Redux - 2024-09-27