DOJ: Contract Rehab Provider to Pay $4 Million to Resolve False Claims Act Allegations Relating to the Provision of Medically Unnecessary Rehabilitation Therapy Services - Just Like They Do In Foster Care

The same thing happens in foster care.

Encore Rehabilitation Services LLC (Encore) has agreed to pay $4.03 million to resolve allegations that Encore violated the False Claims Act by knowingly causing three Michigan skilled nursing facilities to submit false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary or skilled, the Department of Justice announced today.  Encore, based in Farmington Hills, Michigan, provides rehabilitation services to patients at over 600 health care facilities, including skilled nursing facilities, in over 30 states.

“Today’s settlement reflects our continuing efforts to protect patients and taxpayers by ensuring that the care provided to beneficiaries of government-funded healthcare programs is dictated by clinical needs, not a provider’s fiscal interests,” said Deputy Assistant Attorney General Michael Granston of the Department of Justice’s Civil Division.  “Rehabilitation therapy companies provide important services to our vulnerable elderly population, but they will be held to account if they knowingly provide patients with unnecessary or ineligible services.”

This settlement resolves allegations that Encore’s policies and practices at three Michigan skilled nursing facilities resulted in the provision of unreasonable, unnecessary, or unskilled rehabilitation therapy or the recording of therapy minutes as individual therapy when concurrent or group therapy was actually provided.  The settlement relates to Encore’s alleged conduct at the Autumn Woods Healthcare Facility in Warren, Michigan between Sept. 1, 2012, and July 31, 2018, the Bay Shores Senior Care and Rehab Center in Bay City, Michigan, for the period from April 1, 2013, to April 6, 2017, and MediLodge of Yale in Yale, Michigan, for the period from Oct. 1, 2010, to April 6, 2017.

“Billing federal healthcare programs for medically unnecessary rehabilitation services not only undermines the viability of those programs, it exploits our most vulnerable citizens,” said U.S. Attorney Matthew Schneider for the Eastern District of Michigan.  “We are committed to working with our federal partners to protect both vulnerable Michiganders and these helpful healthcare programs.”

“The resolution announced today demonstrates my office’s commitment to aggressively pursuing providers who utilize fraudulent practices to knowingly put their own financial self-interest over a duty to patients,” said U.S. Attorney Andrew Byerly Birge for the Western District of Michigan.  “It is imperative that providers make healthcare decisions based upon a patient’s need for services rather than a self-serving desire to maximize financial profits.”  

Contemporaneous with the civil settlement, Encore entered into a five-year Corporate Integrity Agreement (CIA) with the U.S. Department of Health & Human Services, Office of Inspector General (HHS-OIG) requiring, among other things, the implementation of a risk assessment and internal review process designed to identify and address evolving compliance risks.  The CIA requires training, auditing, and monitoring designed to address the conduct at issue in the case.

“The submission of claims for unreasonable, unnecessary or unskilled rehabilitative services is improper and unacceptable,” said Special Agent in Charge Lamont Pugh III, HHS-OIG – Chicago Region.  “The public expects that proper services will be provided and that tax payer dollars will not be wasted.  OIG Corporate Integrity Agreements help to ensure that contracted providers, who have caused improper billing practices change their behavior.”

The settlement resolves allegations originally brought in lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act by Linda Anderson, Reza Saffarian and Audrey Theile, and Adam LaFerriere, former Encore employees.  The False Claims Act permits private parties to file suit on behalf of the United States and to share in any recovery.  The amount to be recovered by the private parties in this matter has not been determined.

The matter was handled by the Civil Division’s Commercial Litigation Branch, the U.S. Attorneys’ Offices for the Eastern District of Michigan and the Western District of Michigan, and the HHS-OIG.

The three qui tam cases are docketed as United States ex rel. Anderson v. Encore Rehabilitation Services, LLC, No. 2:14-cv-13759 (E.D. MI), United States ex rel. Saffarian, et al. v. Encore Rehabilitation Services, LLC, et al., No. 1:16-cv-605 (W.D. MI), and United States, et al., ex rel. LaFerriere v. Encore Rehabilitation Services, LLC, et al., No. 1:17-cv-95 (W.D. MI).  The claims resolved by the settlement are allegations only; there has been no determination of liability.

The year 2020 marks the 150th anniversary of the Department of Justice.  Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.

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The Official Perkins Coie Sucks Page Launch

"Aye, The Celestial Goddess of the Woodshed has posted the decree of the land,
#perkinscoiesucks!"

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There is even a convenient hashtag just for you, to use when you share with your  family, friends, and those pesky trolls.

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Illinois Senator Mattie Hunter Calls Out Out-Dated Child Welfare Administration To Resign

Alas, do my eyes deceive me?

An elected official calls out incompetence in a decades old system that has yet to demonstrate any benchmarks or overall benefits for its young citizens besides keeping their paycheck and saving their pensions?

Thank you, Senator Mattie Hunter...for becoming a national leader.

Let us only hope there are other state elected officials who are willing to speak out on the betterment of the future of children.

IL lawmaker calls on child welfare agency admins to resign

An Illinois State Senator is calling on top administrators running the state’s child welfare agency to  resign.  That’s after they revealed the agency had mis-reported how many Illinois children died from abuse or neglect for the past several years.  

 Officials from the state’s Department of Children and Family Services say they’ve counted the number of kids who died from abuse or neglect wrong for the past five years.  Sometimes - one child was counted more than once.  The new numbers still show more kids are dying from abuse or neglect in recent years.  Two state senators attended a hearing into the matter Tuesday.

 State Senator Mattie Hunter - a Chicago Democrat - says she doesn’t trust anything department officials say about their own numbers.

 HUNTER: Every single one of you need to resign. Every single one of you need to resign. Because we are not getting the outcomes that we need to protect our children.

 Denise Gonzales is the acting director of the department. She says she won’t resign.  And she’s trying to build better communication between law enforcement and agency investigators to prevent more deaths.  

Summaries of death investigations, with a full investigative report submitted to the Director, are included in the Investigations Section of this Report on page 7. Summary of all child deaths reviewed by the Office of the Inspector General in FY 12 can be found on page 52 of this report. 

Illinois OIG Child Welfare Annual Report 2013

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A CPS Christmas Carol

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Rep. Hansen Clarke Asks Attorney General To Investigate Michigan Child Protective Services

U.S. Representative Hansen Clarke's Letter to U.S. Attorney General Eric Holder requesting investigation of Michigan Department of Human Services Child Protective Services.U.S. Representative Hansen Clarke's Letter to Attorney General Eric Holder TO Investigate Michigan CPS 5-9-12 Voting is beautiful, be beautiful ~ vote.©

Maura Corrigan Is A Medicaid Gamer

The purpose of removing families from the rolls is to have them transition to the federal welfare Social Supplemental Income program.  Tapping the federal funding streams is the basis for this analysis and the schemes are typical Maura Corrigan.

Michigan officials disagree on strain caused by removal of thousands from welfare rolls

LANS­ING - There has been no major fall­out af­ter thou­sands of Michigan fam­i­lies were re­cently re­moved from the welfare rolls, the di­rector of the De­part­ment of Human Ser­vices tes­ti­fied today.

Michigan DHS Director Maura Corrigan and her alter ego
The Queen of Child Welfare Fraud (a.k.a. "Queen Gamer")

"There hasn't been an uptick in the food banks; there hasn't been an uptick in the home­less shelters," Maura Corrig­an told the House Appropriations Subcommittee on Human Ser­vices.

"We've been looking at that," Corrig­an said. "It's a dog that didn't bite, as far as we're concerned."

But Gilda Jacobs, pres­ident and CEO of the Michigan League for Human Ser­vices, which opposed the welfare cuts, said Corrig­an's information is inconsis­tent with what she is hearing.

"It is way too early to get some hard data," Jacobs told the Free Press. But she said at least two agencies she's heard from are expe­ri­enc­ing increased de­mands for food and oth­er as­sistance.

The de­part­ment projected more than 11,000 Michigan fam­i­lies would lose their cash as­sistance late last year af­ter the state set a new four-year cap on receiving the ben­efits. Of­ficials pre­vi­ously used a five-year fed­eral lim­it, but said some fam­i­lies had received ben­efits for 10 years or longer, due to exceptions.

Asked if she is mon­itor­ing what hap­pens to heads of house­holds and their chil­dren af­ter the ben­efits are cut off, Corrig­an said her de­part­ment is mon­itor­ing.

TRANSLATION: Child Protective Services has not submitted total removals for the month of March.

About 1,000 fam­i­lies are taking advantage of a program offered through her de­part­ment and the Michigan State Hous­ing Devel­op­ment Au­thor­ity under which they can receive an­oth­er six months of hous­ing as­sistance as long as they show they are in a work program or have a job, Corrig­an said.

Thou­sands of oth­ers rejected offers of that as­sistance and Corrig­an said she be­lieves a signif­icant number of those did not want to come forward because they are in­volved in the "under­ground econ­o­my."

"We're at the epi­center of the enti­tle­ment cul­ture," Corrig­an tes­ti­fied.

"This is the vulnerable against the gamers. We have a fair number of people gam­ing the system. The gamers take away resources from the truly vulnerable."

Stop.  Hold that thought.

"Gamers".  I have heard that term used before.  Actually, I know that term well.  I had previously attributed Madame Corrigan with authorship and may now state that I was correct.

Michigan "Health Insurance Claims Assessment Act of 2011"  Public Act 142 of 2011.



Signed by Gov. Rick Snyder on February 20, 2011.

Introduced by Sen. Roger Kahn (R) on April 27, 2011, to repeal a 6 percent use tax on medical services health care providers, and replace it with a 1 percent tax on health insurance claims. These taxes are designed to “game” the federal Medicaid system in ways that result in higher federal payments to Michigan’s medical welfare system. This bill creates the new tax.

Continue reading.

Jacobs said Corrig­an and her de­part­ment should not be looking at the system through a lens that as­sumes widespread cheating "as opposed to how can we help people who are struggling in an econ­o­my that is just starting to recover."

How about focusing on Medicaid fraud in child welfare?   How about antitrust violations of child placing agency contracts?  Perhaps, Madame Corrigan, if you spent a few moments admitting that fraud flourishes throughout your Department in its entire cost reimbursements to the feds, you may find out that there are hundreds of millions being gamed under your leadership.


Madame Corrigan, how dare you attribute the financial woes of the state on a handful of people who are struggling to make it.  How much are we really looking at?  A million?  Let me show you where the big Medicaid bucks are being gamed.

What is the difference between the welfare gamers and Medicaid gamers?  I am going to answer this.  A welfare gamer is a person who trying to survive off state assistance of 200 percent below the poverty level, whereas, a Medicaid gamer is how your Department scams the feds through taxes to make up for the hundreds of millions in Medicaid fraud penalties you have to pay back?

Did I get that correct, Madame Corrigan?

Disability Rights New Jersey Exposes Child Drugging Scheme

The purpose of this post is to enlighten the public of what goes on behind the iron curtain of child welfare.


Even though this particular case does not showcase children, it does provide a working model for child welfare fraud.

As the revenue-maximizing scheme is unraveled, we have core elements of child welfare Medicaid fraud.  First you have a U.S. Department of Justice Civil Rights for Institutionalized Patients Act investigative finding report in August 2009 citing multiple violations in patient care addressed to the Governor.  Then, in June 2010 you have the state put on a dog and pony show and hand out a pretty shiny trophy to the party of the aforementioned federal investigative report.

N.J. group sues state for medicating mental patients without consent

One patient, restless from forced injections of psychotropic drugs, is said to constantly pace the halls of Ancora Psychiatric Hospital, wearing down the skin on his legs. Another, allegedly uninformed about her right to refuse medication, agreed to take pills despite concerns about side effects only when confronted with forced injections.

Both cases were cited by Disability Rights New Jersey in a lawsuit accusing the state of giving patients almost no opportunity to object to being involuntarily medicated with powerful drugs with potentially severe side effects.

"It’s abysmal," said Emmett Dwyer, litigation director for the federally funded advocacy organization. "New Jersey is running the worst mental health system I have ever encountered."...more

This may be the worst mental health system Emmett Dwyer has ever encountered, but it is not what the New Jersey Department of Health thought of its patient care.

Ancora Staff win Richard Codey Behavioral Healthcare Quality Improvement Trophy

DMHS is extremely proud to announce that the Lean Six Sigma-Birch Hall Restraint Reduction Quality Improvement project at Ancora Psychiatric Hospital is the 2010 winner of the Richard Codey Behavioral Healthcare Quality Improvement Trophy!

The Ancora Quality Improvement project was selected from a field of over sixty competing projects that were submitted as part of the 2010 Behavioral Health Care Quality Improvement Fair sponsored by the University of Medicine and Dentistry-University Behavioral Healthcare (UBHC) in Somerset , New
Jersey on June 2, 2010. UMDNJ Senior Vice President Christopher Kosseff, and New Jersey Senator Richard J. Codey presented the trophy, named in Codey’s honor because of the significant contributions he has made to mental health services in New Jersey...more

And this is what the U.S. Department of Justice thought of Ancora Psychiatric Hospital Patient Care:

CRIPA and ADA Investigation of Ancora Psychiatric Hospital,Winslow, New Jersey  
Instead of going into drawn out, enumerated detail as to how this is a mirrored child welfare revenue-maximizing scheme, I will allow Disability Rights New Jersey to describe of what goes on behind the iron curtain of child welfare. 

What you are about to conceive actually happens everyday in child residential institutions and children placed in foster care homes. 

What you are about to receive is relevant evidence to validate my supposition on the generation of child abuse propaganda.  Most children who are placed in residential treatment settings and therapeutic traditional foster care homes are done so, not for instances of what is promoted in child abuse literature as abuse and neglect, but are placed in the child welfare system as it is the only way to access mental health treatment.

Once a child is placed in the system, the child is overmedicated and/or unnecessarily medicated causing =>
a higher rate of cost reimbursement for the state leading to => increased lengths of stay =>stays in the least restrictive setting => reduced cost of care due to the drugging of children (i.e. catotonic and sleeping children require no oversight)  => termination of parental rights for the children have exceeded the 15 out of 22 months stay in foster care => increased need in adoption=> Medicaid fraud.
All of this is done without parental authorization for medication of their children because children under the auspices of the state are wards, be it temporary or permanent, of the state, and the state, thereby becomes the possessor of parental rights.


This is the reality of foster care.  Thank you DRNJ for your dedication and compassion to transparency and accountability.

As you read this, just replace the word "adult" with "child"...then multiply by 4.
Disability Rights New Jersey Involuntary Medication Complaint