a Better Bubble™
Whew… what a year. If you closely follow ag doings, you know there’s plenty to talk about. If not, well let me get you caught up. First, three stories that fall just a wee bit short of the most impactful agricultural story of 2022. The question of what waters the Environmental Protection Agency can regulate […]
The post The most impactful agricultural story of 2022 appeared first on Missouri Independent.
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In 1942, as Nazi Germany began to send hundreds of thousands of Jews to killing centers, Brazilian police swooped into a port city in the South American country and arrested a wealthy landowner.
To locals, he was Otto Uebele, a Brazilian manager of a prominent coffee trading company. He also served as honorary consul for Germany — and was an accused Nazi spy.
“One of the leaders of German espionage in South America,” Allied intelligence agents wrote in a secret document, later released by the CIA.
A local newspaper at the time called Uebele a man of “respectable appearance, who enjoyed the greatest prestige and influence in social and commercial circles.”
“Nobody,” the paper wrote, “could imagine him a spy. The fact went off like a bomb, such was the surprise.”
Historians have long chronicled the clandestine use of ambassadors and other professional diplomats by Nazi intelligence services. Far less attention has focused on the activities of honorary consuls, who for centuries have worked from their home countries to represent the interests of foreign governments.
ProPublica and the International Consortium of Investigative Journalists used declassified intelligence documents, media accounts and other reports to identify about 20 honorary consuls who were suspected of supporting the Third Reich through espionage and other illicit activities.
The consuls included a social hall vice president, a fertilizer merchant and a chemist. They largely lived and worked in neutral countries in Latin America, Europe and Africa, where Nazi Germany sought to cultivate allies or gain an advantage at critical ports and other strategic locations. A majority of the honorary consuls were appointed directly by Germany; some were named by other countries.
The use of honorary consuls by the Third Reich to cultivate power and influence is not a historical anomaly.
An ongoing investigation by ProPublica and ICIJ has exposed widespread exploitation of the largely unchecked honorary consul system, now embraced by most of the world’s governments. In exchange for their service, honorary consuls receive some of the same privileges and protections provided to career diplomats: They can move bags across borders without inspection and their offices and correspondence are protected from searches.
Terrorist groups and leaders of corrupt regimes have leveraged the volunteer diplomats as agents of disruption, part of a strategy to advance political and ideological agendas, the ProPublica and ICIJ investigation found.
Honorary consuls tied to the Lebanese terrorist group Hezbollah have stood accused of moving drugs and money. The intelligence service in North Macedonia alleged that two honorary consuls appointed by the Kremlin allowed their offices to be used as Russian “intelligence bases.” Other honorary consuls have supported President Vladimir Putin’s brutal invasions of Ukraine.
The names of honorary consuls suspected of supporting the Nazi regime appear in a series of declassified reports that describe a broader intelligence-gathering effort run out of German embassies.
Nazi spies were “usually built into the diplomatic staff accredited to a neutral government, their leaders being camouflaged as honorary consuls or other functionaries,” according to a 1946 U.S. Army report on German intelligence during the war.
(Declassified U.S. Army report)In Brazil, Uebele was captured and imprisoned. The U.S. ambassador at the time told officials in Washington that Uebele had provided fuel for Nazi boats and helped supply submarines, archival records show.
“I am a consul and our espionage will have to be entrusted to the shadow of the consulate,” Uebele said, according to a transcript of an interview with another accused spy published in Brazilian media in 1949 under the headline “Diplomacy and Espionage in Hitler's Germany.”
Uebele was ultimately acquitted in Brazil after a lengthy legal case, but the government refused to return his seized property, according to one media report. He died in 1956.
“That is the way the Germans did things,” said Priscila F. Perazzo, a history professor at Universidade Municipal de São Caetano do Sul Municipal in Brazil and author of a book on wartime espionage that described Uebele. “The center of espionage in Brazil ran through rich and powerful men in the private sector with connections to the embassy.”
In Spain, Germany appointed as honorary consul onetime brewery manager Wilhelm Leissner, who also used the name Gustav Lenz. He reportedly oversaw a large spy network in Europe, intercepting communications and forwarding information to Berlin in a diplomatic pouch, declassified records show.
“He is officially described as ‘Honorary Attache’ to the Germany embassy, but is in reality the controller of a large network of officers, agents and sub-agents,” according to a 1942 declassified document titled “Enemy intelligence activity in Spain.”
(Declassified U.S. Army report)In 1944, Leissner approved a payment to an American who had agreed to provide the Germans information about the Allied invasion of southern France, according to interrogation records in a U.S. military intelligence report.
The Germans “would have guys like that who would take care of certain regions. They’re the ones contacting other Germans and bringing other people into their espionage networks,” said historian David A. Messenger, who authored a book about Nazi spies in Spain. “A low-level diplomat has contacts in the Spanish governments, knows people in economics, people in industry.”
Records show Leissner was sent back to Germany in U.S. custody in 1946, but it is unclear what happened after that.
Elsewhere, at least two honorary consuls who worked for a well-known shipping company were suspected of providing intelligence from the coast of West Africa. In Argentina, a furrier who had served as honorary consul became one of the most notable spies in South America.
German espionage networks in Central and South America were a significant concern for the FBI, which by 1946 identified nearly 900 Nazi spies, according to the agency.
Honorary consuls supported Nazi Germany in other ways, archival records show. One in Sweden gave money to a Nazi party member and to the German “winter help” fund. Another in Spain was suspected in late 1945 of arranging to move jewels and a valuable collection of postage stamps out of Germany.
In 2005, Germany’s then-foreign minister called for an investigation of the Foreign Ministry, commissioning four historians. They found that the office, which had previously distanced itself from Nazi genocide, had been actively involved in the mass murder of Jews.
This year, Germany’s foreign minister publicly recognized the role that diplomats played during the Holocaust. The statements by Annalena Baerbock were made on the 80th anniversary of the 1942 Wannsee Conference, when high-ranking Nazi Party and German officials gathered in a Berlin suburb to plot what they called the “final solution of the Jewish question.”
“We remember the murdered Jewish women, men and children, and those who survived the Holocaust,” Baerbock said.
Foreign Ministry officials “who put themselves at the service of the crimes and genocide of the Nazi regime also bear responsibility for their suffering,” she said.
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As the COVID-19 pandemic continues to churn, Medicare spending on testing for the virus continued to increase in 2022 and is outpacing the two prior years.
Through Oct. 31, Medicare had spent $2 billion on COVID-19 tests in 2022, an amount that will surpass last year’s total as claims are filed, according to new data provided to ProPublica by CareSet, a research organization that works to make the health care system more transparent.
That compares to $2 billion for all of 2021 and $1.5 billion in 2020, a recent analysis by the Department of Health and Human Services’ Office of Inspector General shows.
Fraud and overspending are contributing to the increases, experts say, because federal money for COVID-19 testing is not subject to some of the same financial and regulatory constraints as other tests covered by Medicare, the government insurance program for people 65 and older and the disabled.
The growing costs concern some of these experts, who say the need for financial incentives to expand the availability of testing has passed.
Early in the pandemic, testing was both critical to slowing the spread of the virus and in short supply. So the federal government enacted measures to make it more profitable to get in the COVID-19 testing business. Good for the duration of the public health emergency, which has not yet expired, the measures include a generous Medicare reimbursement rate, requirements for private insurance to cover testing — even compelling insurance plans to pay whatever cash price is demanded by out-of-network labs — and a hefty fund for testing those people who didn’t have insurance.
The measures succeeded in drawing new and existing labs into the COVID-19 business and helped ensure most people had access to testing, even if some faced excessive waits to get their results. But the incentives also attracted price-gougers, fraudsters and people with no experience in the laboratory business. The result was a chaotic approach that ranged from bungled testing programs and confusion over new requirements to outright fraud.
“It was an unprecedented wave of fraud,” said Michael Cohen, an operations officer with the HHS Inspector General, which investigates crimes involving federal health care programs.
This year, ProPublica detailed how one Chicago-based lab, Northshore Clinical, used political connections in Nevada to speed its licensing and generated tremendous volume through agreements with school districts, universities and local governments. The story also detailed questionable billing practices that one insurance expert described as fraudulent. A study of Northshore’s testing on the University of Nevada Reno campus found the company missed 96% of COVID-19 cases during December 2021.
The company submitted 600 pages of documentation to state regulators to support its claim that it fixed deficiencies noted by inspectors, but it ultimately asked the state to close its license and pulled out of Nevada before the investigation was finished. Northshore repeatedly declined to comment to ProPublica.
The OIG, which had been investigating Northshore in Illinois, expanded its probe to Nevada after ProPublica published its report.
Cohen said OIG investigators have faced challenges responding to the onslaught of suspected fraud — from a lack of additional resources to constantly evolving policies.
In April, the Department of Justice announced criminal charges against people in eight states who allegedly submitted more than $149 million in COVID-19 false billings to federal programs. The OIG has also performed analyses on Medicare data, including for a report released this month that found 378 labs had billed Medicare for expensive add-on tests at “questionably high levels” after testing individuals for COVID-19.
Attorneys general in a handful of states have taken action against labs for forging results, charging fees for “expedited results” that arrived days later and deceptive marketing practices.
Programs to pay for COVID-19 testing aren’t the only pandemic assistance funds that have attracted people seeking to profit. Paycheck Protection Program loans went to fake businesses or were spent on luxury goods instead of keeping people employed, ProPublica and other news outlets have reported. Expanded state unemployment programs also saw unprecedented fraud that a partial accounting estimates is $57.3 billion.
Tolerating some fraud is a necessary trade-off to attain legitimate public policy goals, said Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy. But once the incentives and loose regulations boosted the availability of testing, they could have been revised to prevent abuse and overspending, he argued.
“We were in a very different world in April 2020,” Adler said. “We needed to overpay because we needed more capacity. Once we scaled up, it was no longer necessary. We could’ve saved a lot of taxpayer money.”
According to the data provided by CareSet, more than 2,300 new labs have enrolled as Medicare providers since the pandemic began and have been billing for COVID-19 testing, evidence of the increased capacity generated by the federal measures.
Total Medicare spending on COVID-19 testing is a small fraction of the $4 trillion federal response to the pandemic. That figure includes not only testing and treatment but also direct support for individuals, businesses, schools and local governments. Adler said that may be why lawmakers haven’t revisited the incentives.
Still, testing — as funded by Medicare, private insurance and other federal assistance programs — was a lucrative corner of the pandemic response for many providers.
Labs with troubled operations reaped millions from Medicare, the CareSet data shows.
Northshore Clinical, for example, submitted $6.2 million in Medicare claims for COVID-19 testing between Jan. 1, 2021, and Nov. 30, 2022. Doctors Clinical Laboratory, which is facing lawsuits filed by attorneys general in three states, billed $252,000 in 2021. Doctors Clinical did not respond to requests for comment.
Curative Labs, one of the largest COVID-19 testing providers in the country, has billed Medicare $32 million for testing since Jan. 1, 2021. Curative, launched in California by a 25-year-old college dropout, tapped political connections to land a no-bid contract to test in Colorado’s nursing homes, according to the Colorado Springs Gazette. But the state’s decision to use Curative tests on individuals without symptoms — a use the tests had not been authorized for — led to unreliable results, as Colorado’s nursing home death rate was the highest in the nation, according to CPR News. The FDA later revoked authorization for Curative tests and the state canceled its contract with the company.
“During the pandemic, Curative provided millions of Americans with a safe, accessible and reliable way to test for the virus, including when it was extremely difficult to obtain a COVID-19 test,” a Curative spokesperson said. “Our teams deployed tests in an efficient manner, helping to prevent the spread of outbreaks in communities across the state of Colorado and throughout the country.”
The spokesperson also pointed to a Colorado legislative committee’s decision not to audit the procurement process as an exoneration of Curative’s operations in the state. The request for the audit failed in a tied vote along party lines after a state official testified she made the decision to use Curative based on the best science available at the time.
Nomi Health, a lab startup in Utah, launched troubled testing programs in five states, according to a USA Today investigation. The Salt Lake Tribune detailed significant problems with Nomi’s operations in Utah. The company has billed Medicare a total of $1.9 million in 2021 and 2022. Nomi has challenged USA Today’s findings.
“Nomi Health was one of the first partners to provide open accessible testing at scale on behalf of our partners,” Nomi’s co-founder and chief operations officer Joshua Walker said in a statement. “We remain one of the few providers in the markets we serve providing important access to this needed service.”
Walker said Nomi continues to provide free tests for uninsured individuals despite the end of the federal program that paid for those tests. “We still feel strongly that open and easy access is an important part of keeping our communities safe and helping to drive our economy forward.”
The OIG’s Cohen said the most common crime investigated by his agency was identity theft. Nefarious labs would snag Medicare beneficiaries’ information and use it to bill for services not provided or expensive and unnecessary add-on tests.
“They would take it all. ‘We need your Medicare number. We need your Social Security number. Oh, we need credit card information.’ People were giving up just tons of information because people were understandably clamoring for tests,” Cohen said.
Medicare wasn’t the only government program targeted for laboratory fraud.
Health care providers found quick access to money in the federal fund for testing people without insurance. The program, run by another federal agency, the Health Resources and Services Administration, was designed to get money out fast and with few restrictions. “Bad actors bled the program for as much as they could,” Cohen said.
The program was initially funded by Congress with $2 billion. It ended up paying out $11 billion in testing claims. Congress opted not to allocate any more money into it and HRSA stopped accepting claims in March 2022 — leaving many uninsured individuals on the hook for COVID-19 care.
An HHS official said safeguards against fraud were put in place and any providers caught abusing the program could be subject to enforcement measures.
“The COVID-19 Uninsured Program was designed to ensure that every person in the United States had access to COVID-19 testing, treatment and vaccines — regardless of insurance status — and has been successful in getting care to the most vulnerable among us,” the official said.
As the pandemic has evolved, how people test for the virus has changed too. Now, instead of getting lab tests, many patients opt to use at-home rapid tests. And that has opened up another opportunity for fraud, experts say.
While the public health emergency is underway, Medicare is covering up to eight over-the-counter COVID-19 tests per member each month. Some providers are trying to design “subscription” services in which they mail eight tests every month whether the beneficiary needs them or not, Cohen said.
Indeed, the CareSet data shows a dramatic shift in spending for over-the-counter tests and away from PCR laboratory tests beginning in April.
And as investigators try to stay atop new scams, they’re busy investigating the old ones.
“We are still finding entities that defrauded us of just enormous amounts of money,” Cohen said.
How to Avoid Testing ScamsThe U.S. Department of Health and Human Services offers the following tips to protect yourself from COVID-19 testing scams:
If you think you may have been a victim of a scam:
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