Michigan Database Begins To Grow

The necessity of this central database was a result of the aberrant billing practices of the contractual arms of DHS and its county departmental level providers.

There has never been oversight of any of the operations within the state child welfare system as SCAO has demonstrated, in multiple Auditor General reports, that fraud is a standard in its activities.

This is the first time the state will begin warehousing credible data, as it has been well documented, even on county levels with its own Auditor General reports, that false billing and fraudulent documentation has allowed Medicaid fraud in child welfare to flourish. Collaboration needs to include the Department of Community Health, as the Director is the State Medicaid Director.

The final missing component to the construction of this database is for the legislature to mandate that any suspicion or substantiation of violation of federal or state law be immediately reported to the attorney general for prosecution and recovery. As it currently stands, the state's Medicaid Fraud Control Unit does nothing in the realms of acknowledging Medicaid fraud in child welfare.

An effort of this magnitude will be for naught if there is not included, a regulation mechanism, and that is reporting to the Attorney General. Recoveries of funds and efficiency of operations can now exist through contractual debarments, sanctions, license revocation, and fines.

Most importantly, there needs to be more transparency and accountability in the ability of consumers and whistleblowers to report questionable billing activities to the Attorney General Medicaid Fraud Control Unit, further allowing the Attorney General and the Auditor General to investigate double-billing, false claims, kiddy kickbacks, Stark law violations, and other forms of fraud, waste and abuse.

Ingenex needs to be under statutory control to report quarterly all activities.

Michigan is embarking on a groundbreaking initiative, but this may only be successful if all agencies are involved: Auditor General, Attorney General, Department of Community Health, Department of Human Services, SCAO. If not, then it shall be business as usual, meaning the state will continue its downward spiral of fiscal integrity, all done in the best interest of the child.

Michigan turns to data warehousing to improve child services

January 19, 2010
by Jeffery Smith

The state of Michigan recently announced the expansion of a pilot program, using data warehousing and analytics to develop performance measurements for children enrolled in protection services. Both the State Court Administrative Office (SCAO) and the Michigan Department of Human Services (MDHS) are using Ingenix technology to improve children’s safety, health and living situation stability.

First developed in 1994, Michigan was the first state in the nation to use data warehousing technology to monitor Medicaid quality of care, fraud, abuse and overpayment. For the last year, a pilot project launched in Genesee, Saginaw and Livingston counties have completed nine of 62 performance measurements to improve child welfare.

“Our goal is to do a better job protecting the children in our care, who may be in an abusive or neglectful environment, by measuring our performance and prioritizing the areas that need improvement most,” State Court Administrator Carl Gromek said in a statement.

As the administrative arm of the Michigan Supreme Court, SCAO is charged with collecting data on courts’ caseloads, including case history and type. SCAO is also in charge of child welfare oversight when the courts make a decision and they can act as advisor to the court when children are or may become court wards.

For the current project, SCAO teamed with MDHS in order to share information accumulated by each agency to protect children, DHS Director Ismael Ahmed said. “We’re pleased to work with SCAO on this ambitious effort. It’s an excellent example of working not only across agencies, but across branches of government, to achieve a worthwhile goal – in this case, doing everything we can to protect children,” he said.

MDHS has over 16,000 children currently receiving foster care, residential or adoptive placement services. And last year, more than 124,000 complaints of child abuse and neglect were filed with DHS. In addition to MDHS and SCAO, the Michigan Department of Community Health (MDCH) has expanded the data warehouse to include information from the state’s largest programs.

Ingenix is providing the informational and analytical backbone for the project, which seeks to monitor performance and case management in five areas: Safety, Permanency, Due Process, Timeliness and Well-being. more

Michigan, this is only the beginning. Thank you for finally listening.