Latest news with #CaleCase
Yahoo
24-05-2025
- Health
- Yahoo
Wyoming lawmakers consider addressing health insurance fraud concern by Blue Cross
CHEYENNE — The state's ability to curb a spike in fraudulent health care filings under Blue Cross Blue Shield of Wyoming is limited, but lawmakers agreed Thursday to do what they can to navigate this issue in their respective committees. An 'unusual uptick' in Native American health care enrollment set off alarm bells at Blue Cross Blue Shield of Wyoming (BCBSWY). As of March 2025, Native American enrollment in BCBSWY health care plans on the federal marketplace is up 500%, and Native American claims are up by more than 1,000%. Overall, mental health and substance abuse disorder claims have increased over 300% in 2025. Investigators suspect Wyoming is the latest target in a nationwide health care scam of illegal claim filings. 'Body brokers' are scouting out homeless shelters to find victims and ship them to out-of-state facilities, where the insurance company is then billed for substance abuse treatment that is not actually being provided. Stories collected by BCBSWY found that Wyoming victims are showing up in these fraudulent treatment centers, most of them in California, with others in Arizona and Florida. Furthermore, an internal investigation found many health insurance enrollees are not legitimate Wyoming residents. Out of more than 1,500 potentially fraudulent enrollees identified in Native and non-Native federal health care plans, less than 40 have been confirmed as legitimate, according to a BCBSWY news release. BCBSWY representatives raised this issue before state lawmakers during the Legislature's Select Committee on Tribal Relations meeting in Fort Washakie. Co-Chairman Sen. Cale Case, R-Lander, found the situation alarming, and asked how the state can help. 'Awareness is the main reason that we're here today,' said BCBSWY Government Affairs Principal and Privacy Officer Kelsey Prestesater. 'We want to get this news out to as many people as we possibly can, and encourage individuals if they feel like they have fallen victim to this, or know somebody who has, to certainly reach out.' Potential state solutions Prestesater offered a few remedies for state lawmakers to pursue. One solution is to draft a bill that requires stronger oversight of licensing requirements for in-state behavioral health and substance abuse treatment facilities. 'Currently, there are virtually no regulations for these types of residential treatment centers,' Prestesater said. 'While these treatment centers are not here now, we've seen a pattern where these treatment centers move from state to state, where they can find the least amount of regulation and begin to victimize those people.' She also suggested revisiting a bill that was filed in the recent legislative session by the Joint Corporations, Elections and Political Subdivisions Committee, but failed to be introduced. House Bill 71, 'Insurance fraud reporting,' would have required insurers to report suspected and known fraud. 'That would really help us and give us some teeth in being able to report these bad actors and provide a shield from civil liability,' Prestesater said. Case, who is also co-chairman of the Joint Corporations Committee, said he will bring up HB 71 at the committee's next meeting for consideration. He told the WTE in a phone call after the meeting 'there's more of an urgency now with the story out there.' But it's ultimately up to the committee, he said. Sen. Eric Barlow, R-Gillette, who co-chairs the Joint Labor, Health and Social Services Committee, said he will speak with his co-chair about studying professional licensing requirements as an additional interim topic for the committee. BCBSWY Vice President of Legal Services Rocky Redd suggested a third option, which is to allow a pause in claim payments to fraudulent actors if the insurance company finds credible evidence of fraud. In Wyoming, the insurance company has 45 days to sift through thousands of pages of records before making a claims payment. 'Some of the other states have … passed legislation that would allow you to pause that, to take a little bit more time to look into it before you have to go ahead and pay them,' Redd said. Otherwise, Blue Cross risks getting sued for not making the payment by deadline. A federal government issue Since Native American health insurance is regulated only at the federal level, there is little action the state can take on this issue, Deputy Commissioner Tana Howard at the Wyoming Department of Insurance told the Wyoming Tribune Eagle earlier this week. 'The solution needs to come from the feds. It needs to come from (the Centers of Medicare & Medicaid Services), since they are the ones who regulate these plans,' Howard said. From her understanding, Blue Cross cannot deny claims in question under federal law, as these are federally regulated plans. Howard said she was recently informed that the case was forwarded by CMS to the Center for Program Integrity, an internal division of CMS that detects fraud, waste and abuse. North Dakota has reported a similar issue in health insurance fraud with its own Blue Cross insurance company, Howard added. The northern state implemented a waiver program in response that requires insured members to justify out-of-state health care. But this isn't a solution that would fit in Wyoming, she said. 'North Dakota is completely different than Wyoming. They have a lot more providers. They have a lot more hospital systems,' Howard said. 'There are not very many facilities in Wyoming that really offer (substance abuse treatment). And so it's not uncommon for it to go out of state.' A similar situation Cowboy State Daily reported a 'mysterious' incident in 2023, where a dozen unhoused individuals were taken from Fremont County and dropped off at a homeless shelter in Casper. Northern Arapaho Business Council Co-Chairwoman Kimberly Whiteman Harjo reminded lawmakers of this situation during Thursday's meeting. She told committee members the scheme described by Blue Cross representatives reminded her of that incident. 'There are places in Riverton that will say that they help homeless people, but I don't know what their rules are, the procedures,' Harjo said. 'But a lot of our people were put out in the freezing cold during the wintertime, and it was at night.' The Wind River Indian Reservation is a constant target of fraudulent companies, she said. Case recalled the incident when he later spoke with the WTE. The committee co-chairman said he was disappointed the 'kidnapping,' as he referred to it, was not taken more seriously by local entities. Authorities never discovered who was behind taking people and dropping them off at the Casper shelter, he said. 'People were rounded up, given promises (for treatment),' Case said. 'And they were taken to Casper and kind of dumped off, and that just made me really angry.' A Blue Cross spokesperson confirmed to the WTE this situation is not related to the health care insurance fraud reported by the insurance company.
Yahoo
11-04-2025
- Politics
- Yahoo
Corporations Committee: Educating on election process top priority; affordable housing low priority
CHEYENNE — Affordable housing isn't likely to be studied by Wyoming lawmakers for the first time in years. Meanwhile, the topic of studying Wyoming's election processes is priority No. 1 for the Legislature's Joint Corporations, Elections and Political Subdivisions Committee this interim. The Management Council recently reduced the number of days a committee can meet from six to four, in hopes of narrowing down the focus of topics studied this interim. The chairmen of the Corporations Committee requested back the extra two days, given the heavy lift of topics the committee wants to study. The interim is the Legislature's off-season, where legislators break up into 12 different joint committees to study a variety of topics and draft legislation. This time is also spent educating lawmakers on Wyoming issues, including catching new members up to speed. The Corporations Committee is the only group that listed workforce housing as an interim topic this year. But co-Chairman Sen. Cale Case, R-Lander, told the Wyoming Tribune Eagle last week he didn't consider this a top priority for the committee. 'I think a lot of housing difficulties are caused by the way communities have chosen to regulate housing,' Case said, 'and that's an internal thing.' Sen. Cale Case, R-Lander (2025) Sen. Cale Case, R-Lander The topic was added to the committee's list because several members believed state government should play a role in addressing this issue. Using a ranked-choice voting system, Case listed it as the fourth priority. 'I'm not a heavy-handed chairman. I'm a person that believes we have to talk about things and make decisions and make your point,' Case said. 'You know, it passed the committee before — it could pass again.' Several affordable housing bills sponsored by various committees were filed in the recent legislative session, but all failed to pass the Legislature. Case said he wasn't impressed with any of the bills. Co-Chairman Rep. Chris Knapp, R-Gillette, said there's an apparent 'lack of interest' in having state government address this issue. 'And I think that's been the case for the last six years, and continues to be the case,' Knapp said. 'It's probably time to bring those (bills) individually.' Rep. Christopher Knapp, R-Gillette (2025) Rep. Christopher Knapp, R-Gillette Since legislative leadership reduced the amount of days committees can meet, it's likely affordable housing will not be addressed this interim, Knapp added. However, election integrity remains the top priority for the committee. Forty-five election-related bills were filed during the recent general session, making up 8% of total proposed legislation, according to Only a fraction of these bills made it to the governor's desk. Case invited Fremont County Clerk Julie Freese to walk committee members through the election process in the first meeting. 'I want to let the committee have some discussion and education first before we dig into (election bills),' Case said. However, Knapp told the WTE he didn't think an education on the election process will change anyone's mind. 'I understand the idea of bringing (election machines) in and looking at them. I don't know that will necessarily change the mind of any committee member,' Knapp said. Failed election bills, including a ban on ballot drop boxes and getting rid of voting touch screens (which are only used in Laramie County), are among those that will be reconsidered by the committee, he said. Why election laws? Secretary of State Chuck Gray announced his top priorities to boost election integrity before the start of the general session. He told the media he'd work closely with lawmakers during the session to push through legislation that reforms Wyoming's election laws. There have only been four reported cases of election fraud in the Equality State since 2000, according to The Heritage Foundation, a conservative think tank. In addition, a randomized survey of 739 adults conducted by the University of Wyoming for the 2024 election year found 89% of respondents believed their county's tally of presidential votes to be somewhat or very reliable. Case said taking on the topic of revising Wyoming's current election laws is a 'waste of time.' However, amid a rise of questioning election processes across the state, he noted it's important to educate the public on this issue. 'Part of our job as policymakers is to provide a forum for people to learn and ask questions and satisfy their curiosity about this,' Case said. 'If we spent 10 hours and we didn't do a darn thing other than teach people … I don't ever look at that as being a waste.' Knapp said it's 'because of the influx that we've had of illegal immigrants.' County clerks previously testified they've caught four or five individuals who tried to illegally vote in an election, he said, and four more are being investigated. 'So it does happen in Wyoming,' Knapp said. 'I think it's important to safeguard our elections as much as we can. That's part of (the) title of our committee.' Other top priorities Management Council member Sen. Barry Crago, R-Sheridan, brought up corporate fraud issues to the Corporations Committee chairmen on Tuesday. He said this is an issue that's being reported in the news, and he asked if it was discussed as a potential interim topic, since it's currently not on the list. Case mentioned to the WTE last week that corporate fraud is an issue he wants to address, but he's holding off for two reasons. One, it's a 'big lift' to study and the next session is a budget session — meaning non-budget bills need to pass a two-thirds introductory vote in order to be considered. Two, a new federal law, the Beneficial Ownership Information Report, recently went into effect that requires companies to list their beneficial ownership. 'I think we need to understand the implications of the disclosures that will occur federally,' Case told the WTE. 'The real problem is anonymity in Wyoming, and the fact that we may have fraudulent filings. That's going to be a lot harder to do with the federal checklist.' He told the council 'it would be prudent' to gather a report from various entities and 'keep that topic open.' Public records is another top priority for Case, which is listed in the interim topic letter for the committee. His constituents have approached him with complaints about the associated fees with these requests and their ability to access public records. To view the interim topics letter, go to or visit
Yahoo
07-02-2025
- Business
- Yahoo
Net metering bill fails in Wyoming Senate
CHEYENNE – A bill to amend the calculation for net metering compensation and how it applies to new small customer generators has failed on third reading in the Senate. Wednesday evening, the Senate voted 17-11 against Senate File 111, 'Net metering revisions.' According to bill sponsor Sen. Cale Case, R-Lander, similar bills have passed in the Senate, but have faced challenges in the House. 'Net metering' means measuring the difference between the electricity supplied by an electric utility and the electricity generated by a small customer who generates their own electricity, that is then fed back to the electric utility over an applicable billing period. SF 111 would have revised how net metering compensation applies to new small customer generators, authorizing the Public Service Commission to use a different system of compensation for excess energy production, if that service was being subsidized by other customers. Under SF 111, existing small customers who owned an electrical production system before Dec. 31, 2025, would have been be exempted at existing rates. "This doesn't hurt utilities. This comes out of other customers (pockets) who have to pay higher rates to cover (utility) costs," Case said on the Senate floor Monday. However, during committee testimony Jan. 27, members of the public called the proposed legislation a solution in search of a problem. John Burrows of the Wyoming Outdoor Council said the bill directs a foregone conclusion that rooftop solar owners are being subsidized by other ratepayers. The idea that rooftop solar owners are 'not paying their share' of the utilities' network cost, he said, does not adequately portray the system in place. On the other side of the Capitol, the House passed its own net metering bill, House Bill 183, 'Net metering amendments,' on three readings. That bill would amend the generation capacity for net metering systems. HB 183 will head to the Senate for introduction there.
Yahoo
28-01-2025
- Business
- Yahoo
Net-metering bill passes through Senate committee
CHEYENNE — Lawmakers have thrown support behind a bill to revise the state's net metering compensation model, or the rate at which utilities buy surplus energy from small-scale customers with solar panels in Wyoming. The Senate Corporations, Elections and Political Subdivisions Committee voted 4-1 to approve Senate File 111, 'Net metering revisions,' on Monday. 'Net metering' means measuring the difference between the electricity supplied by an electric utility and the electricity generated by a small customer who generates their own electricity, that is then fed back to the electric utility over an applicable billing period. SF 111 would revise how net metering compensation applies to new small customer generators, authorizing the Public Service Commission to use a different system of compensation for excess energy production, if that service is being subsidized by other customers. Under SF 111, existing small customers who own an electrical production system before Dec. 31, 2025, would be exempted at existing rates, according to bill co-sponsor Sen. Cale Case, R-Lander. Sen. Cale Case, R-Lander Sen. Cale Case, R-Lander, speaks on the Senate floor last week. Case is a co-sponsor on SF 111, 'Net metering revisions.' 'We have tried to wrestle with the issue of net metering and how it's applied by statute in Wyoming' for years, Case told the committee on Friday. 'There's a lot of confusion about the concept of net metering. It's frequently promoted as a way to 'stick it to the man,' or to 'stick it to your electric utility,' to go off the grid to be energy independent.' However, net metering simply involves installing a special electric meter or reprogramming an existing meter so that electrical flow can be measured in both directions: electricity flowing from the utility company to the customer, and vice versa, according to the University of Wyoming. Some see it as a way to reduce their monthly electric bill, and some electricity provided by a renewable, local or alternative-generating resource. Opponents argue that net metering has the potential to reduce revenue for utility companies, which will then pass that loss on to other customers in the service area. Every utility in Wyoming has a tariff structure consisting of a connection charge, as well as a charge for energy, according to Case. The energy charge does recover the cost of the network, and an additional 'customer charge' comes in at $20 to $50, depending on the utility. 'That subsidy is built in. It's not something I like, but it has one purpose, and that's to provide very small users with small bills, so it is a fixed cost that doesn't get recovered from net metering producers,' Case said. Bills similar to SF 111, Case said, have been debated before, but did not include pre-exemptions. 'This bill is virtually the same as the bills that you've seen before, but there's one significant difference,' Case said. 'Somebody that has an existing system ... is grandfathered under the current system for as long as they have it under existing rates, for as long as they own the system. That's the bottom line.' If SF 111 is to pass, anyone with a system installed after Jan. 1, 2026, will face new rates set by the Public Service Commission (PSC). Chris Petrie, deputy chairman of the PSC, told the committee on Monday during public comment that the commission exists 'primarily to ensure just and reasonable rates.' Chris Petrie Then Wyoming Public Service Commission Chairman Chris Petrie, center, speaks in May 2022 at the PSC. 'We've looked at this bill, and with that in mind, I think that it, in fact, does create a path to establishing just and reasonable rates for utilities, and the treatment of net-metering customers,' Petrie said. New customer generators would face a rate set according to the PSC's usual public process, according to Petrie. Bruce Asay with MDU Resources said he believes the revision would provide a 'necessary compromise' in the system. However, many others commented against the proposed legislation on Monday, saying it was a solution in search of a problem. John Burrows of the Wyoming Outdoor Council said the bill directs a foregone conclusion that rooftop solar owners are being subsidized by other ratepayers. 'We think it is premature to require the PSC to revise rates for this small group of customers, when net metering represents such a tiny fraction of electricity generated in Wyoming,' Burrows said. The idea that rooftop solar owners are 'not paying their share' of a utility's network cost, he said, does not adequately portray the system already in place. 'Consider the example of rural customers who depend on miles and miles of grid network, but still pay the exact same rate as customers who live next to a substation in town,' Burrows said. 'Cost shifting from an urban to a rural customer is a common and accepted practice.' Natalie Johansen, a renewable energy community organizer for the Powder River Basin Resource Council, said the bill would create 'unnecessary barriers' for rural families who may want to invest in solar energy. Net-metered systems in Wyoming only make up about 0.2% of the system, and so Johansen said the 'bill is solving no real problem.' Wyoming resident Stef Kessler testified on Zoom, similarly saying SF 111 'addresses a problem that doesn't exist, and affects small users.' 'I urge you to consider the little people of Wyoming,' Kessler said. 'I have only ever seen utilities themselves and regulators speak in favor of these bills.' Sen. Bill Landen, R-Casper, said he would support SF 111. Sen. Bill Landen, R-Casper (2025) Sen. Bill Landen, R-Casper 'I am ready to support this one, because we grandfather everybody in at this point, (protecting) those who are passionately involved in this now,' Landen said. Further, Landen said he trusts the PSC to create a system that is also fair for future users, who he said will likely still see returns for investing in their own energy infrastructure. Sen. Dan Dockstader, R-Afton, said he also would vote in favor of SF 111, citing faith in the PSC process. Also voting in favor were Case and Sen. Cheri Steinmetz, R-Torrington. Only Sen. Brian Boner, R-Douglas, voted against the measure Monday morning.
