Someone, the Detroit Free Press, is reporting upon Medicaid Fraud in Child Welfare?
Noooooo......
The Michigan Tale Of Medicaid Fraud In Child Welfare Slush Fund: Campaigns, Trust Funds & Land Bank Authorities
Learn more: BEVERLY TRAN: The Michigan Tale Of Mediciad Fraud In Child Welfare Slush Fund: Campaigns, Trust Funds & Land Bank Authorities http://beverlytran.blogspot.com/2018/05/the-michigan-tale-of-mediciad-fraud-in.html#ixzz5T5UErL7s
Stop Medicaid Fraud in Child Welfare
Now, all we need is for someone to finally ask the question to how this geographic area came to report the highest rates of autism.
It was intentional.
It was for profit.
It was privatization.
They stole the children, the land and the votes.
Loving the infographics.
Abuse caught on video at Michigan's biggest autism therapy provider
CENTRIA HEALTHCARE FIRED THE EMPLOYEE, BUT LOSES $5-MILLION CONTRACT WITH MACOMB COUNTY AFTER THE ABUSE CASE, ADDING TO ITS MYRIAD OF PROBLEMS
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| Doris Owens, a former Centria Healthcare employee, is sentenced for fourth-degree child abuse at 41B District Court in Clinton Township on Wednesday, Sept. 5, 2018. The abuse occurred while Owens was working with an autistic child. |
The decision follows a similar move by Lapeer County last year, which dumped Centria amid mounting frustrations with the company. Centria said it was told Lapeer wanted a cheaper provider but documents obtained by the Free Press show broader problems in both counties.
In Macomb, community mental health officials cited Centria repeatedly for things like patient care, billing and training issues. Last year, it placed the company on probation. Then after a video showed a Centria employee taunting, dragging, pushing and swatting a 5-year-old autistic girl during a therapy session in March, the county decided to part ways. The transition to new providers is expected to be completed by the end of the year.
Nearly a year ago, the Free Press began examining thousands of internal and public documents related to Centria and interviewed former executives and employees who claimed the business has engaged in billing fraud, violating patient privacy, forgery, falsifying reports and employing unqualified people in an effort to boost profits.
Centria denies any wrongdoing and sued three former employees for defamation. That case is pending in Oakland County.
In February, in response to inquiries from the Free Press, the Michigan Attorney General's Office confirmed it is investigating Centria, a probe the agency says is still ongoing. State economic development officials rescinded an $8-million state grant that had been awarded to Centria contingent on creating 1,200 new jobs over five years, following newspaper coverage of the investigation.
Losing contracts to serve Medicaid clients in Macomb and Lapeer counties has frustrated some families who said they liked Centria’s services. But it is unlikely to hinder the rapidly expanding health care behemoth, which serves 2,300 autistic children in eight states and plans to grow to 20,000 children in the coming years.
As Oakland County-based Centria plans expansion into new states, issues in its own backyard help explain why some Michigan health officials are seeking new companies to provide autism therapy to children.
Child abuse
Over the summer, former Centria technician Doris Owens, 22, pleaded no contest to a misdemeanor charge of child abuse in Clinton Township. A judge sentenced her to one year of probation and ordered her to complete an anger management course in September.
“I apologize for my actions that led up to today,” Owens told Judge Sebastian Lucido. “I would like to apologize to (the girl) and her family. In hindsight, I would have done things differently.”
Centria said in a statement it reported the incident to mental health officials and police.
“The safety and well-being of the children we serve is our most urgent priority. An issue arose in March involving an employee, which resulted in that employee being immediately terminated,” the statement said. “Our policies and training are designed to protect our clients and help them to achieve optimal outcomes.”
The abuse came to light when the girl had bruises to her neck, chest and arms after a 7-hour therapy session.
Video of the session that took place at a Centria facility, showed Owens losing her patience and abusing the girl. Owens also ridiculed the girl and used a Lysol wipe to clean her runny nose, according to a transcription of the video reviewed by the Free Press.
“I want my mom,” the girl said.
Owens refused, saying: “No one cares! You can keep crying. She’s not coming. No one cares.”
County mental health investigators substantiated more than 100 allegations, including abuse, neglect, use of unreasonable force, denying dignity and respect and inflicting emotional harm. Their findings came after the police investigation concluded.
Clinton Township Police wouldn’t release the video of Owens and the child to the Free Press, citing crime victim privacy.
During Owens' sentencing, her attorney, Donald Andrews, told the judge she received little training from Centria before being assigned to autistic children. In a statement, Owens said she has learned from the situation.
“I believe that there must be changes in the company’s expectations of their employees for everyone involved to be safe and successful,” Owens wrote. “Thorough training and adequate policies and requirements need to be fully explained and required before employees are hired, which I believe didn’t happen in my experience with the company.”
In a letter to Macomb officials, Centria CEO Scott Barry called the Owens case an “isolated matter” and called her actions “rogue.”
Company officials declined to answer Free Press questions about Owens' training, but on the company website, they defended the training they provide to therapy providers, known as behavior technicians. They must “demonstrate mastery of our extensive and structured training program,” which includes coursework covering autism, ethics, patient privacy and other skills, a posting said. They also must undergo background checks before being hired.
In February, in response to inquiries from the Free Press, the Michigan Attorney General's Office confirmed it is investigating Centria, a probe the agency says is still ongoing. State economic development officials rescinded an $8-million state grant that had been awarded to Centria contingent on creating 1,200 new jobs over five years, following newspaper coverage of the investigation.
Macomb never spelled out a specific reason for ending its relationship with Centria, but records obtained by the Free Press show the company had been cited for missing background checks and other documentation.
Barry and Macomb County Community Mental Health CEO John Kinch, both called the breakup “mutual and amicable” but neither would agree to an interview about it. Kinch told board members Sept. 26 that he expected to have the last of Centria's 126 Macomb clients placed with new providers by the end of the year.
Market leader
The abuse case is one of the latest problems for Centria, which touts itself as the nation’s largest provider of autism therapy, a service that has boomed across the country in recent years as more states require health insurance carriers to pay for it.
Centria’s rapid growth has fueled some of the criticism against the company, including from former employees who contacted the Attorney General’s Office with claims of Medicaid fraud. Over the summer, a Centria spokesman had said the Attorney General's investigation was in the process of being formally closed. The company also posted on its Facebook page that Centria had been “cleared.”
But a spokeswoman for the Attorney General's Office said this week that the investigation remains "open and ongoing." She declined further comment.
In May, one month after Owens was charged with abuse, a Macomb official wrote in a letter that Centria's contract to provide autism therapy to children on Medicaid would not be renewed.
In its own letter, dated June 29, Centria said it no longer planned to continue with Macomb County after its contract expired Sept. 30.
The two entities have agreed to extend the contract through the end of the year “to allow for transition of consumers to new providers,” according to Community Mental Health Board records.
Macomb also has disputed $76,317 in Centria billings, saying they lacked proper documentation. Centria eventually provided supporting documentation for those claims, but the county rejected them, saying they were too late.
The amount represents a tiny fraction of Centria's business in Michigan.
Centria has become the dominant provider of autism services in Michigan. Last year, it billed almost $29 million for services to patients on Medicaid in metro Detroit, records show. The billings include:
- Wayne County $22 million
- Macomb County $5.1 million
- Oakland County $1.6 million
Overall, the state expects spend $187 million this budget year to provide Medicaid-funded autism services. In 2013, the state spent just $5.6 million.
Other Macomb problems
The county's latest problems with Centria follow two other patient rights investigations last year that substantiated wrongdoing.
Those cases included accusations that a Centria behavior technician failed to help a choking child and that another tech treating a combative child used restrictive holds that had not been properly approved.
Centria declined to answer Free Press questions about those cases.
The choking incident was in September 2017, when a child started choking on his lunch and a Centria technician, Breonna Jones, thought he was faking it.
“He packs food in his mouth all the time and hacks for attention,” Jones said, according to the report.
When the boy started turning blue and another staffer bent him over and smacked his back to dislodge the food, according to the report.
“Now he got all the attention he wants,” Jones said, according to the report.
Investigators asked Jones how she could distinguish between the boy’s gagging noises for attention and a real case of choking.
“That’s the difficult part,” she responded, the report said.
Jones claimed she tried to help the child but witnesses disputed her account. Investigators confirmed neglect against the technician, according to the report.The newspaper was unable to reach Jones.
The case involving the restrictive holds came in a situation where a violent child was posing risks to himself and others in March and April 2017.
According to the heavily redacted report, behavior technician Victoria Engel said the holds were needed to manage an autistic boy who was attacking her as well as his mom and his sister. At one point, the attacks became so dangerous, they locked themselves in a bathroom and the child almost broke down the door.
Engel said she had been told she had permission to use the holds. But she later learned she couldn't use them.
“I did not know until the county case manager told me I could not use holds,” Engel said, according to the report. “I did not use holds after the county case manager told me not to.”
Engel said that when the boy would try to head-butt the glass doors of a cabinet, she would stand in front of him to keep him away from the glass, absorbing the brunt of his aggression with her body.
The boy punched, kicked and bit her, Engel said. Her injuries, documented in medical records shared with the Free Press, forced Engel off the job and she collected workers' compensation.
“I looked like I had been in a horrific car accident where I wasn’t wearing a seat belt," she said.
Engel acknowledged using restrictive holds and was cited for using unreasonable force. Macomb officials also cited three other Centria employees in the investigation, including the company’s vice president of autism services, Alicia Decker.
Decker disputed some of the report’s allegations and said the case was placed on hold because of the injury of a behavior tech. According to the report, she told investigators: “We always say in case of an emergency of immediate harm, do what you can."
Lapeer problems
In December 2016, after months of difficulties, Lapeer mental health officials notified Centria that they were ending the company's contract. Centria had billed about $1.24 million for autism services in Lapeer county between 2014 and 2017.
Like in Macomb, the precise reasons for the split are not spelled out in the termination letter.
“I am so incredibly frustrated with Centria and their overall timeliness and lack of communication,” Kimberly Perrin, supervisor of autism services in Lapeer wrote to a colleague in an October 2016 email. “How soon can we move on the new plan?”
Centria said it was told Lapeer ended the contract because it had found a lower-cost provider. Records reviewed by the Free Press show the county had tried to negotiate steep rate cuts, but Centria declined.
But a Lapeer official said in an email that the contract ended “due to several clinical reasons.”
The email references ongoing lawsuits Centria has filed in Lapeer County. Centria is suing competing firms and three former employees who went to work for them. Centria claims the employees violated non-compete clauses in their employment contracts, which bars them from working for Centria competitors for 18 months.
Centria said it has spent millions of dollars and years creating and developing its autism programs. In litigation, the company accuses a company called Helping Hand Nursing Service and other defendants of hurting its bottom line by poaching employees.
Attorneys for Helping Hand argued Centria filed the lawsuits to harass and intimidate a business competitor and accused company officials of misusing the legal process.
In the litigation, Lapeer mental health officials vowed never again to use Centria.
“Given the nature of the events that have (preceded) this letter, no other contract negotiations are desired,” Perrin said in a letter to the company, adding Centria should not contact her again.
An email obtained by the Free Press through a Freedom of Information Act request show Lapeer officials also questioned some Centria billing.
“Centria staff provided documentation with forged/fraudulent signatures,” said an email from Lapeer County mental health staffer sent in January 2017. It went on to say payments should be recouped.
Lapeer County Community Mental Health CEO Lauren Emmons wouldn’t quantify the disputed claims or say whether they were resolved.
“I am unable to provide any additional information," he said. "As there is an open and ongoing investigation.”
John Wisely and Elisha Anderson are members of the Free Press Investigations team.
To view complete coverage of their investigation into Centria Healthcare go to https://www.freep.com/news/investigations/
Contact Wisely: 313-222-6825 or jwisely@freepress.com
Contact Anderson: 313-222-5144 or eanderson@freepress.com
Contact Anderson: 313-222-5144 or eanderson@freepress.com
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