In the name of the U.S. and us: stop fraud now

Now that all the excitement in the child welfare reform movement has died down, it's my time to step in.

The Law Project for Psychiatric Rights (PsychRights®) announced the unsealing of a major Medicaid Fraud lawsuit against psychiatrists, their employers, pharmacies, state officials, and a medical education and publishing company for their roles in submitting fraudulent claims to Medicaid.

Great.

So why do I have the authority to analyze Jim Gottstein's actions? Well, because I have been there, done that and bought the rhinestone t-shirt.

Interestingly, Gottstein brought the suit as a corporate individual PsychRights®, but did not clarify the authority of PsychRights® nor its standing to bring forth the action. As a corporate individual, does he meet the criteria as an original source? I doubt it because it was never addressed in the original complaint.

PsychRights®, owned and represented by Gottstein, did not submit any proofs, which, normally, would get him kicked right out when the defendants file their motion to dismiss for failure to state a claim, which the complaint fails.

Just because the case was unsealed does not mean the case will proceed, as we do not know if there were any other filing or pending motions before the court.

The U.S. government failure to intervene in the matter is not a serious issue, as it preserves the right, at any time to intervene. It is best, at times for the government to not intervene, giving the relator, the person who is the whistleblower, grounds for the highest level of percentage of the bounty, being 30%. The more the feds step in and intervene, the lower the percentage ratio.

I am betting the feds did not intervene for possibly two reasons:

(1)PsychRights® has no legal standing as an original source, even beyond the open and obvious issue of self-representation;

(2)The feds are currently learning how to approach the issues of Medicaid fraud in child welfare. I know DHHS OIG is only beginning to identify and understand the fraud schemes in child welfare, (the purpose of this blog) but it is still in the initial phases. The federal government is a slow yet deliberate process of handling matters. The purpose being, once they do anything, it will be done effectively. Currently, there is the federal task force of H.E.A.T., the joint partnership with DOJ and DHHS OIG developing its tasks forces to attack Medicaid fraud in child welfare. They will approach from a different angle, leaving a stronger punishment by deterrence message upon the public.

Fraud detection and prevention in health care (Medicaid, Medicare, Tricare, Children's Health Insurance Program) is an industry that has the potential to create a massive number of jobs. The push in the direction of informational technology will only enhance the ancient mechanism called the writ of qui tam.

Qui tam pro domino rege quam pro se ipso in hac parte sequitur,

meaning,

"[he] who sues in this matter for the king as [well as] for himself."

Actions such as this benefits all of us, all taxpayers as it is taxpayer monies that are being taken, threatening our economic security, which is our national treasure. The feds cannot be everywhere at all times, contrary to most beliefs; the feds rely upon us, the taxpayer to communicate and to blow the whistle when we know of fraud schemes. The qui tam was created within the platform of the Magna Carta to do just that. President Lincoln reanimated this ancient writ, as well as a few others like habeus corpus, to fight the war within the Civil war, and that was the war on businesses defrauding the federal government. It was called the False Claims Act.

The only setback to the qui tam is the language of the False Claims Act statute, which has been ambiguously interpreted by the Supreme Court to make it impossible for an individual to bring an action without an attorney.

PsychRights® and Gottstien have once again pushed this envelope back in the face of the judicial community.

Just as we had in the financial industry with the likes of the ponzi scheme, there are similar, yet far more intricate fraud schemes in child welfare. Child welfare is an industry that has never been regulated as there is no transparency nor accountability. The con artists in child welfare are far more sophisticated when it comes to public awareness campaigns of abuse and neglect, and the subsequent fundraisers.

It takes individuals such as Gottstein and his non-profit PsychRights® to remind the people that we are the ones who possess the power of government, and can call it in at any time through the extraordinary writs.

I wish him, PsychRights®, the Department of Justice and the Department of Health and Human Services the best of luck in their fight to end Medicaid fraud in child welfare.

The Three Fraudketeers

Well, well, well, what do we have here?  It's the Three Fraudketeers.

We have over here, Mr. Senate Bill 891 (a.k.a. Mark Jansen.)

Public Act 220 of 1935 authorizes the MCI superintendent to consent to the adoption, marriage, or emancipation of any child who has been committed to the MCI, according to applicable law. Under the bill, the superintendent's designee would have the same authority. In addition, the superintendent or his or her designee would be authorized to consent to the guardianship of any child committed to the MCI, as provided in Section 19c of the juvenile code (the section that Senate Bill 893 would amend). A child for whom a guardian was appointed under Section 19c would cease to be a ward of the State.

Over here we have Mr. Senate Bill 892 (a.k.a. Bill Hardiman)

The Adoption Code requires each parent to give consent to the adoption of a child, unless the rights of the parent have been terminated, the child has been released for the purpose of adoption to a child placing agency or the DHS, or other circumstances exist.

Consent must be given by the authorized representative of the DHS or of a child placing agency to whom the child has been released or permanently committed by an order of the family court.

Under the bill, consent could be given by the authorized representative of the DHS or his or her designee.

And last, but not least is Mr. Senate Bill 893 (a.k.a. Jim Barcia.)

Under Section 19c of the juvenile code, if a child remains in placement following the termination of parental rights to the child, the family court must conduct review hearings and permanency planning hearings. The court may appoint a guardian for the child, if it determines that doing so is in the child's best interest. The court may not appoint a guardian without the MCI superintendent's written consent. Under the bill, the court could not appoint a guardian without the written consent of the superintendent or his or her designee.

The code requires the MCI superintendent to consult with the child's lawyer guardian ad litem when considering whether to grant consent. Under the bill, that requirement also would apply to the superintendent's designee.

These are the three primary sponsors of a package of bills that would glorify legislating from the bench, but would crazy glue the lid on Medicaid fraud in Michigan's Child Welfare.

With amazing speed the Three Fraudketeers fast tracked these bills through the Senate in 56 days.  There were no announcements that the bills were even to be on the agenda of the Committee on Families and Human Services because the day they were introduced, they were referred.

In 28 days, the Committee summaries were completed by a fiscal analysts: David Fosdick who found the bills to have no fiscal impact on State or local government.  This finding alone should automatically set off the fraud alarm system because the entire purpose of these bills is to get the state to become eligible for increases in federal recovery funding.  Obviously, David Fosdick has not climbed very high on the intelligence food ladder because the Three Fraudketeers made him their prey to publish such blatant lies.

The purpose of the bills is to get the kids out of the custody of the state and into permanent placements.  The feds want this and so do we.  Since the state is very slowly, I mean at a squamulose, slithering, laggering pace, the state is..., hell, the only reform in child welfare is to make sure it does not change, so I guess fraud reform can be considered as legitimate in child welfare reform.

So, instead of providing services to reduce the rate by which children must enter care, or instead of designing legislation to regulate child welfare to end fraud, the Three Fraudketeers came up with a solution to convince the obtuse Senatorial leadership that it is impossible for the state to come into federal grant compliance, in no way, shape or form. 

Of course, one may ask: "Why have these Three Fraudketeers come together, now?"Let me tell you:

I filed the Quo Warranto.  In the State Court of Appeals, an action regarding a public official may be filed there, so I did.  I found that the State Court Rules were written with a significant procedural error when it was propped up in the 1980's; there is no ex-parte procedure.  If there is no ex-parte procedure, then it becomes impossible to execute an application in the nature of information for quo warranto.  I knew this but the Court did not, so I began my litmus test to see how far the Courts would go to cover up Medicaid fraud in child welfare and filed the action.

The Michigan Judiciary blew me away with the lengths it would go to cover up Medicaid fraud in child welfare.  Presiding Judge Michael J. Kelly, let's just say he knows me pretty well, decided, without finding of fact and conclusion of law, it would not be in his personal best interests to allow a gal her due process...again.

But, right before that  I was honored with a wonderful birthday present.   The Michigan Supreme Court Adopted amended Court Rules and a new Court Rule, all due to my lil' ol' quo warranto.  See, there is a Fourth Fraudketeer, and she goes by the name of Maura Corrigan.

The Fourth Fraudketeer

Maura D. Corrigan

Madame Fraudketeer was a party to the quo warranto, so, it also would not be in her best interest to remove Bill Johnson from the position of Superintendent of Michigan Children's Institute because she, with the greatest of frequency, advocates for Bill Johnson while cases are pending before her Court.

Basically, the Michigan Supreme Court came up with a federal revenue-maximization scheme to expedite adoptions of child wards of the state and to exterminate all evidence of Medicaid fraud in child welfare.  Superintendent Bill Johnson, according to the Court Rules, is no longer the legal guardian of over 7,000 children who decides to grant consent to adoption, he now "approves of the appointment of a guardian."

The state continues to refuse to contractual debarment, license revocation, fines, sanctions, refer violations of law to the Attorney General and continues to allow double-billing, false billing, phantom billing, kiddy kickbacks, etc.  Even though the Federal Funding Percentage for the state is 50%, when it could be 70%, it is still fiscally beneficial to state and local governments to continue its practice of fraud in child welfare. Accountability and transparency will remain strangers to the child welfare system as Bill Johnson and his newly crowned accomplice in fraud, Bruce Hoffman, will be cranking out adoptions, because once a child is adopted, there is no way to go back and find the evidence of fraud in the service files.

And that is how the Three Fraudketeers and Corrigan, got together to ram these bills down the throats of Michigan's unsagacious senate.