Thursday, August 17, 2017

Michigan & Texas Profit Millions In Educational Neglect & Abuse In Medicaid Fraud

The U.S. Department of Health and Human Services Office of Inspector General just presented its audit findings for the State of Texas Medicaid Reimbursement for School-Based Health Services and it found over $18 million dollars in fraud.

Now, here is the background.

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"Your goal is to generate profits for the LLC."
Fairbanks, LLC is the state privatized company that has the contract for Texas schools special needs billing programs.

This is its mission statement:
Our goal is not the maximization of what a client can claim from Medicaid.

The mission is not to maximize revenues from the submission of Medicaid cost reimbursements, but to generate profit for Fairbanks through the submission of fraudulent billing to Medicaid to generate "fees".

Yes, it is all about the fees for those for-profit privatized human service agencies, particularly when dealing in child welfare, because, as always, those records are secured through privacy laws, in the "best interests of the child", literally.

Medicaid fraud in child welfare is a multi-billion dollar industry.

The "leadership" of Fairbanks, LLC hails from Deloitte.

Deloitte sucks because it is the same company which set up Michigan's BRIDGES IT system, where, there the system is so horrible, it will cut, confiscate, severe and omit remittance of federal program assistance payments to "The Poors" (SNAP, Medicaid) due to its horrific internal 3 month audit reset mechanism, which generates more fees, and your basic, poorly constructed online application and case management services, of which I aver was intentional for purposes of up-billing.

This is taken directly from the Michigan-Deloitte microcontract:
Effective 5/8/2017, this Contract is increased by $8,980,640.00 for Design, Construction, Testing, and Implementation of the Universal Case Load (UCL) portion of the Integrated Service Delivery (ISD) Project. All other terms, conditions, specifications, and pricing remain the same. Per Contractor and Agency agreement, DTMB Procurement approval, and State Administrative Board approval on 1/24/2017.
This is now the aggregated contract value:  $163,587,804.00

Basically, for doing a half-ass IT job, causing extreme hardship for the residents of the State of Michigan, Deloitte got a bonus, and I bet it comes from fraudulent billing to Medicaid, and switcho-chango federal funding shuffles the state calls "gaming the system".

I have always speculated that the Michigan allows its privatized contractual arms to secure kickbacks to fund political campaigns.

That is correct, Deloitte has a FEC Political Action Committee.

And Deloitte has its dirty little hands all up in Fairbanks, LLC down in the Texas school system in ripping off those special needs students who deserve these services, but hey, do not let me interfere in a tried and true business model of maximizing profits for a privatized, state contracted corporation.
Not all of the direct medical service costs that the State agency claimed for Medicaid SHARS were reasonable, adequately supported, and otherwise allowable in accordance with applicable Federal and State requirements. Specifically, the Contractor coded random moments incorrectly. Of the 3,161 random moments coded as an IEP-covered direct medical service, 274 were coded incorrectly. As a result of these errors, the State agency received $18,925,853 in unallowable Federal reimbursement for the Medicaid SHARS program during the period October 1, 2010, through September 30, 2011.

See, Texas and Michigan have the same mission in educating students of the State: Profit by abuse and neglect.

See, these children who do not receive proper educational services, do not learn and eventually will grow up to become adults who rely upon more Medicaid services, ultimately, furthering diffusing this Medicaid fraud model of "gaming the system", from state, to state to eventually other nations.

Always remember, it is in the best interests of the child to generate a profit!

Snyder's attorneys say DPS students have no right to literacy

In federal court today, attorneys responding to a suit naming Gov. Rick Snyder as a defendant argued that the state of Michigan, which has been so intimately involved with Detroit Public Schools for almost 20 years, has no responsibility to ensure students in the district are able to learn to read.

The suit, brought by seven Detroit schoolchildren in September of last year, charged Gov. Snyder, the members of the Michigan Board of Education, and various other state officials with failing to provide an opportunity to learn.

Now, before you out-county city-bashers erupt in unanimous invective about inner-city pathologies, children who don't want to learn, and babies having babies, read on and decide if any child could learn under the circumstances outlined in the lawsuit. The lawsuit describes classrooms without books, teachers, or even functioning climate control, where temperatures can exceed 90 degrees in the summer and drop to 32 degrees in the winter. The lawsuit describes vermin and nonfunctioning restrooms. The lawyers associated with the case describes an environment where since no books exist no homework can be assigned. Students are essentially warehoused in a building for several hours a day. Yes, in such conditions, even Brad and Ashley from the prosperous precincts of Independence Township might find it a challenge to learn.

What's more, before the state of Michigan intervened, the district had a surplus of $93 million, healthy enrollment and test scores that were on the rise. After the state's "rescue" in 1999, and then under the ensuing succession of emergency managers, little remained of those promising figures. In 2015, as Curt Guyette reported, enrollment had plummeted by nearly 50 percent, the number of schools cut in half, and a tide of red ink annually amounted to tens of millions of dollars, and sometimes hundreds of millions of dollars.

But this afternoon, with a straight face, Deputy Attorney General Timothy Haynes argued before Judge Stephen J. Murphy III that the state of Michigan didn't agree that state officials had any responsibility to provide DPS students with literacy. They also challenged that the state has controlled Detroit Public Schools since 1999. The Bill of Rights, Haynes argued, mentions no specific right to literacy. Instead, counsel pointed to the charter operators, authorizers, boards, and intermediaries as possible culprits. The courtroom gallery was dense with a cross-section of inner-city students, teachers, and their families, who showed remarkable restraint to sit in polite silence through this effort to explain away the grotesque barriers to education that prevail at many of their schools.

Then Mark D. Rosenbaum addressed the judge on why the suit should not be dismissed. Never in his life had he imagined he would stand before a court in the year 2017 arguing that the state had an obligation to provide students with textbooks, teachers, and a building in which they could learn without being distracted by the sweltering heat or having to put on a second jacket to stay warm. As the judge and the attorney brought up the fine points in the relevant case law, the discussion was probably heady for even those fine legal minds holding down their side of the bar. At the end of the hearing, Judge Murphy declared he'd issue a decision, though it would likely take longer than the usual 30 days.

Later Thursday afternoon, officials of the American Federation of Teachers blasted the state's motion to dismiss the suit. “The state created these poor learning conditions," their statement read, "and now Gov. Rick Snyder and Attorney General Bill Schuette are further abdicating their responsibility to the children of Detroit by moving to dismiss this case. All these children and families are asking for is what we owe all families — great, well-resourced public schools where parents want to send their kids, teachers want to teach, and children are engaged.”

After the plaintiffs and lawyers streamed out onto Lafayette Boulevard, they spoke to media about the barriers they've faced. Many of them were excited to speak to reporters, to share their stories on camera. Catching a bit of shade in front of the courthouse, it was tempting to dwell on the irony of students being denied everything the Brads and Ashleys of our world take for granted — and ending up fighting the system in the company of legal wizards and well-spoken activists. Talk about gaining an education!

In about 30 or so days, we'll begin to see if the state gets taught a lesson too.

Privatization cannot thrive nor can corporations generate profit, unless the children fail in schools.

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