Kiddy Kickbacks

Before diving into the world of what I call "kiddy kickbacks", let's begin by understanding the term,Kickback.

A kickback, under the theories of fraud, is generally when when a person provides false information to benefit from federal funds.

Recently, the U.S. DHHS OIG and U.S. DOJ AG partnership to end health care fraud, Detroit H.E.A.T. identified another multi-million dollar Medicare Fraud scheme. This is an excellent example to apply to Medicaid Fraud profit-maximizing schemes in child welfare.

In this particular setup, the clinic routinely billed the Medicare program for services that were medically unnecessary or were never provided. Patients were prescribed medications at the clinic based not on medical need, but on what medications were likely to generate Medicare reimbursements. Falsified medical files were maintained by the clinic to make the treatments purportedly being given there appear legitimate, when in fact they were not.

Medicare beneficiaries were not referred to the clinic by their primary care physicians, or for any other legitimate medical purpose, but rather were recruited to come to the clinic through the payment of kickbacks. In exchange for those kickbacks, the Medicare beneficiaries would visit the clinic and sign documents indicating that they had received the services billed to Medicare. Kickbacks came in the form of cash and prescriptions for narcotic drugs.

Now, here is how it works in child welfare:

Targeted Case Management is a Medicaid funding source in foster care and adoption. Child Placing Agencies (CPA) routinely bill the Medicaid program for services that were unnecessary or were never provided. These services could range from individual therapy for the child to MRIs. Children referred to mental health clinics by a CPA are prescribed medications at the clinics, not based on medical need, but on what medications were likely to generate Medicaid reimbursements. Falsified medical files are maintained by the clinic, the CPA and the courts to make the treatments purportedly being given there appear legitimate, when in fact they were not. The higher the dosage of medication, the higher level of payment. This scheme was explained in the court transcripts of the adoptive father of Ricky Holland that was murdered in Michigan.

The next question on everyone's mind is, "Why haven't I heard about this before?"

The answer is quite simple: Freedom of Information Act (FOIA).

Quite simply, under FOIA, anything dealing with a child, especially a child under the auspices of the state in foster care are protected from review and disclosure. The best part is when a child in foster care is adopted out, those records are not just sequestered from public scrutiny, they are shredded forever. There is no possible way for a federal audit to detect the blatant false claims and fraud...until now.

Kiddy Kickbacks go deeper than the FBI Medicare investigation I presented. In foster care, the entire system operates on kiddy kickbacks. It is relatively easy to find the connections, just look at the board of directors.

Let's start with the Archdiocese of Detroit.

For example, Robert Asmussen, is Vice President of Strategic Planning at St. John Health and is the Chairman, Board of Directors, St. Vincent and Sarah Fisher Center, a residential institution for foster care youth, I shut down. (I dare anyone to challenge me on that one.) Children who were physically harmed while at St. Vincent and Sarah Fisher Center were taken to Providence, a health care facility of St. John Health. As mandatory reporters, the doctors would never, ever, ever file incident reports to the state of children who were harmed.

St. John would shoot the kids back to St. Vincent Sarah Fisher Center to be diagnosed by Psychiatrist Howard Weiner, M.D., to be in need of higher dosages of medication, generating more reason for the children to remain in care and opening the door to increases in funding for higher levels of special needs.

Services were never provided to the children in St. Vincent Sarah Fisher Center but they were documented, signed by Dr. Weiner and submitted into court.

It gets better.

Patricia M. Moylan, Ph.D. would conduct physicals for the children at St. Vincent Sarah Fisher and submit for billing. Dr. Moylan was signing physicals for children she had never seen because on one document, she conducted a physical for a 12 year old girl, who was a boy. (Yes, I have the documents stored in various locations.)

But wait, there is more.

Judge Michael J. Talbot sits on the Michigan Judicial Tenure Commission. This is the place where one would file a complaint against a Referee or Judge challenge conduct and procedure in a child protection case. Needless to say, the Commission has never found any fraud, wrong doing, or any transgressions by the those presiding over cases. The reason why is most judges sit on the boards of these CPAs.

Just look at Michigan Supreme Court Justice Maura Corrigan. She is a Director of Vista Maria, a Commissioner of the Pew Commission on Children in Foster Care, and participates in various child welfare task forces. In fact, she focuses on funding, or rather the construction of federal funding-maximizing schemes for foster care, because we all know, the Chief Justice of the Supreme Court is the overseer of the State Court Administration Office, which is in charge of child welfare funding. Justice Corrigan is the former Chief Justice who ran her campaign telling the public to thank her for everything she has done for foster care and adoption in Michigan.

Then there is Nancy J. Diehl who has worked as a prosecutor for over 24 years and currently heads the Felony Trial Division in the Wayne County Prosecutor's Office overseeing the Child and Family Abuse Bureau. She lectures extensively throughout the state and nationally on domestic violence and child abuse investigation, prosecution and related issues. Diehl is the coauthor of four booklets pertaining to children and the legal system.

Not one CPA has ever been prosecuted in Wayne County. Even more interesting, it is the Attorney General who prosecutes abuse and neglect in Wayne County and not the county prosecutor.

In the end, Kiddy Kickbacks are a great way of keeping a system functioning at peak performance, never giving any cause for alarm of fraud. CPAs refer children to contracted psychological service providers. In turn, the service providers known as therapists and psychologists, generate court reports that will have the child medicated for higher levels of billing and longer stays in the system. As the end goal is termination of parental rights, the service providers guarantee court reports that will support the CPA activities. The more the service providers support the CPA activities, the more clients are referred to them. And that is what is called a Kiddy Kickback.