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.

SCOTUS Meets Kiddy Kickbacks

The scandal reported by Alex Jones about U.S. Attorney Richard I. Fine, imprisoned without charge, trial, or any other form of due process, for being a whistleblower.

What did Mr. Fine blow the whistle on? He uncovered the revenue maximization scheme in California Family Court surrounding child protection proceedings, exactly what was exposed in the Pennsylvania Cash For Kids scandal, or what I prefer ton call "Kiddy Kickbacks."



It looks as though the Supreme Court of The United States (SCOTUS) is about to finally be introduced to the world of Kiddy Kickbacks.

No. 09A827
Title:
Richard I. Fine, Applicant
v.
Leroy D. Baca, Sheriff, Los Angeles County, California, et al.
Docketed:
Lower Ct: United States Court of Appeals for the Ninth Circuit
Case Nos.: (09-56073)

~~~Date~~~ ~~~~~~~Proceedings and Orders~~~~~~~~~~~~~~~~~~~~~
Mar 1 2010 Application (09A827) for a stay, submitted to Justice Kennedy.
Mar 12 2010 Application (09A827) denied by Justice Kennedy.
Mar 30 2010 Application (09A827) refiled and submitted to Justice Ginsburg.
Apr 7 2010 DISTRIBUTED for Conference of April 23, 2010.
Apr 7 2010 Application (09A827) referred to the Court.


~~Name~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~Address~~~~~~~~~~~~~~~~~~ ~~Phone~~~
Attorneys for Petitioner:
Richard I. Fine 1824367
Men's Central Jail
441 Bauchet Street
Los Angeles, CA 90012
Party name: Richard I. Fine
Attorneys for Respondents:
Paul B. Beach Lawrence Beach Allen & Choi PC (818)-545-1925
100 West Broadway Suite 1200
Glendale, CA 91210-1219
Party name: Sheriff, Los Angeles County, California, et al.

Actually, the issue of Kiddy Kickbacks was first exposed by Dr. Shirley Moore. Over 30,000 foster care cases in L.A. County were reviewed under her actions to find more than half did not have to be in care due to fraud.



It is raw, but it had to start somewhere.

New York Kiddy Kickbacks

Here we have it, another case of kiddy kickbacks in residential institutions that has been reduced to a case of injunctive relief.

This is a case of the inherent conflict of interest. Legal Aid, a state funded entity cannot "bite the hand that feeds it". That is why there is no action of monetary or punative reliefs.

Continuing along the line of inherent conflicts of interests, then you have the Attorney General, the same power that prosecuted these foster care cases. The same power that will represent these contractual agencies and residential institutions in a court of law is the same power that holds authority over its federally funded Medicaid Fraud Control Unit.

The Attorney General will not intervene as it does not want to "bite the federal Medicaid hand" that feeds it.

So, what you have is a recipe for the fraud scheme called kiddy kickbacks. The city gains greater levels of funding for extended stays in foster care and submits questionable costs when keeping the child in a contained environment. The institutions, in turn, receive more referrals from Administration of Children and Families and are allowed to keep a child longer in stay, not authorizing the release to the least restrictive settings.

On top of that, I will put some money on the fact that there is more than likely no pre-ten waiver, meaning there was no authorized approval according to federal mandated provisions.

The DHHS Office of Inspector General is encouraging innovation to end all forms of health care fraud, including Medicaid fraud. Innovation has never been a strong suit with Legal Aid.

This is a CRIPA and FCA case addressing kiddy kickbacks.

Foster Children Mistreated, Suit Against City Claims
By A. G. SULZBERGER
Published: May 12, 2010

A federal lawsuit is seeking to bar New York City from allowing troubled foster-care children to be kept in psychiatric hospitals after doctors have recommended their release, a practice that routinely adds months to a hospitalization despite laws that require such children to be placed in the least restrictive environment possible.

The suit, filed on Wednesday in United States District Court in Brooklyn, claims that the practice means that children who no longer require hospitalization are being kept in locked quarters where they have limited access to schooling, family visits and even walks outside.

The suit also claims that the Administration for Children’s Services, which oversees the care of about 16,000 foster children in New York City, and its subcontractors have been “using certain psychiatric hospitals as if they are detention centers,” sending some children to hospitals for disciplinary reasons, like breaking curfew, running away or getting in fights, rather than for mental health reasons.

A spokeswoman for the city’s Corporation Counsel declined to comment on the suit, saying the city had not yet had a chance to review it.

The suit was filed by the Legal Aid Society on behalf of three unnamed foster-care children who are currently hospitalized despite doctors’ recommendations that they be released.

“Every day that it continues, plaintiffs’ extended, wrongful confinement in these institutions is causing them irreparable damage,” the lawsuit says.

One of the children, a 6-year-old boy identified as S. M. who was placed into foster care last year, was hospitalized in Westchester in January, after “misbehavior” in his foster home, according to the complaint. The boy, who was in kindergarten, has been ready for discharge since April 2.

Another child, a 13-year-old boy identified as M. M., remains hospitalized on Long Island, though he was recommended for discharge on Jan. 26.

Legal Aid, a nonprofit group that represents foster-care children in New York, is seeking a preliminary injunction ordering the release of the three children, as well as a court order prohibiting the city from continuing to place foster-care children in hospitals unless doing so is medically necessary, and requiring that less-restrictive placements are made available for any child ready for release within 24 hours. The lawsuit also seeks financial damages.

Legal Aid requested class-action status for the lawsuit and identified two dozen more cases in which it claimed that children were held inappropriately, Nancy Rosenbloom, one of the Legal Aid lawyers handling the case, said. There is a high incidence of mental illness among foster-care children, who have been separated from their families, many after suffering physical or sexual abuse, said Marcia Lowry, executive director of the advocacy group Children’s Rights.

The suit cited a study by the group that estimated that about 14 percent of the foster care children in New York had been admitted to a psychiatric hospital in the course of a single year. Under both state and federal law, the city is required to place the children in the “most homelike” environment.

But foster homes, group homes and residential treatment centers can be unable or unwilling to accept children with mental illness or severe behavioral problems. The city has a policy against transferring children discharged from psychiatric hospitals to its Children’s Center, which temporarily houses other children during transition periods, according to Legal Aid.

“Some of these kids do have serious mental-health needs that may require hospitalization,” Ms. Rosenbloom said. “But the point of this case is once they’re ready to get out, they should get out.”

Kiddy Kickbacks Are Judicial Dysfunction

I ran across this op-ed in the New York Times on judicial dysfunction and had to take a moment to review.  Needless to say, it was nothing but a reiteration of what I have been screaming about for years.

Kiddy Kickbacks.

No one ever discusses the issues in child welfare and the courts but one must understand that the same principles, if not worse, exists in dependency courts dealing with these matters as there is absolutely no regulation or ramifications to any misconduct.

Well, I retract that last statement.  The feds did set precedence with the "Cash 4 Kids" scandal.

A Study in Judicial

Dysfunction

Harsh state judicial campaigns financed by ever larger amounts of special interest money are eating away at public faith in judicial impartiality. There are few places where the spectacle is more shameful than Wisconsin, where over-the-top campaigning, self-interested rulings, and a complete breakdown of courthouse collegiality and ethics is destroying trust in its Supreme Court.

Maura Corrigan, the leader in
special interest campaigning

One of those "few places" is Michigan where Supreme Court judicial campaign, which are suppose to be non-partisan, are bankrolled by special interests.  Just ask former Chief Justice for the Michigan Supreme Court, now Director of the State Department of Human Services, Maura Corrigan.

On Monday, a special prosecutor was named to investigate an altercation between two justices on opposite sides of the court’s bitter ideological divide. Ann Walsh Bradley, a member of the court’s liberal wing, has charged that David Prosser, a conservative, put her in a chokehold during a heated exchange shortly before the court upheld the new state law eliminating most collective-bargaining rights for public employees.

Justice Prosser has disputed Justice Bradley’s version of what occurred, and the facts remain unclear. What is certain is that Justice Prosser should have recused himself from that ruling. His vote to uphold the law occurred shortly after his re-election campaign in which he benefited from heavy anti-union independent spending.

Justice Prosser won the April election by a very small margin, prompting a recount. The Milwaukee Journal Sentinel reported that he then raised more than $270,000 for the recount, much of it in $50,000 chunks. (The contribution limits that apply under Wisconsin’s public financing system for judicial races do not extend to recounts.) Some $75,000 of the haul was used to pay fees to a law firm led by an attorney representing conservative groups in a case challenging state campaign disclosure rules, which is scheduled to be heard by the court next month.

Maura Corrigan has ensured that disclosure of her campaign contributions does not exist  due to the incumbent waiver but her audacity is engrained in the minds of those who have been affected through her questionable campaign activities.

Given the lawyer’s role in Justice Prosser’s recent recount success, a reasonable person might well question the judge’s impartiality on that case, too. After first saying he had no intention of recusing himself, Justice Prosser on Thursday asked the parties in the campaign finance case to file memos stating their views about recusal. It should not take a formal request for him to step aside.

A contentious 4-to-3 decision by the court last month declared recusal decisions by the justices to be unreviewable. In another sign of the court’s dysfunction, the deciding vote came from Justice Patience Roggensack, whose involvement in an earlier case was the subject of the disqualification motion that the court was reviewing. Like the ruling itself, Justice Roggensack’s participation in judging her own conduct showed astounding disregard for legal ethics and every litigant’s right to impartial justice. The problems don’t even stop there. A year ago, by another 4-to-3 vote along ideological lines, the court weakened the recusal standard by adopting a rule saying that campaign fund-raising or expenditures can never be the sole basis for a judge’s disqualification. The rule was largely written by a business group that has spent lavishly in judicial campaigns.

Members of Wisconsin’s top court need to focus on restoring civility and public trust. For starters, they should scrap last year’s decision on campaign money in favor of strict disclosure requirements for lawyers and litigants. They should also adopt an appeals process for recusals, so the final decision is no longer left to the judge whose impartiality is being questioned. The court’s credibility, and justice in Wisconsin, are on the line.

In the Michigan, the higher court rules allows the court to "entertain a case".  This means that not all cases are guaranteed to be given the light if day, particularly when these judges sit on the boards of the defendant parties and get kiddy kickbacks. 

Kiddy Kickbacks Is A Safe Harbor Of Stark's Law

Kiddy Kickbacks: n. The "safe harbor" provision of the federal anti-kickback statute which allows a contractor of a child welfare program to get away scott free when engaging in a Medicaid fraud scheme.

No TINA In Kiddy Kickbacks

In Child Welfare, there is no Truth in Negotiations (TINA):

• Contracts are no-bid
• Freedom of Information Exclusion and Exemptions allow not-for-profits to forgo disclosures on pricing or risk
• Child Placing Agencies operate as geographic monopolies, with uncapped access to 100% federally funded Title IV-E and Targeted Case Management reimbursements
• Child Welfare contracts are "padded" with extra costs to fund major public relations campaigns to promote revenue maximization fraud schemes.

This is why child welfare fraud has remained untouched and unstoppable for decades: kiddy kickbacks will never allow TINA in the fraud game.

Compare the following fraud scheme litigated in 2004 with the above child welfare fraud scheme. The only difference is the Department of Defense contracted was prosecuted. Child Welfare organizations are untouchable.

In a federal lawsuit filed in the Western District of Texas in September 2004, Science Applications International Corporation (SAIC) is accused of violating the Truth In Negotiations Act. SAIC was awarded numerous firm-fixed price no-bid contracts to perform environmental clean-up at Kelly Air Force Base in San Antonio, Texas. The contracts required SAIC to fully disclose any and all cost and pricing data to ensure that the negotiations between the Air Force and SAIC were conducted on a level playing field.

In computing their cost estimates, SAIC is accused of having built in undisclosed risk reserves to help ensure profitability. Internally, SAIC estimated the risks associated with each project, assigned a dollar figure to each risk and then “padded” their proposals to ensure funds would be available if the risk were realized. SAIC did not disclose this methodology or the existence of these risk reserves to the government. This practice helped contribute to an average profitability of 38% and as high as 260% on contracts with negotiated profit margins of 8-10%.

Indicators of this Scheme:

• Profit margins higher than negotiated that cannot be logically explained
• Contractor refusal or reluctance to provide post-award / in progress actual cost data
• Non-disclosure of the existence of risk or management reserve data during negotiations

Ways to Reduce the Risk:

•  An open dialogue with contractors on their perceived project risks where TINA applies 
• Aggressive surveillance / post-award audit of actual costs on fixed price no-bid contracts 
• Ensure no-bid firm-fixed price contracts are used only when appropriate and justified

Whistleblowers Need To Writ Kiddy Kickbacks As False Claims

Whistleblower attorney in the act
of filing a sealed writ of
Medicaid fraud in child welfare

Remember the "Kids for Cash" scandal where the judge was busted getting kiddy kickbacks for sending kids to jail, for no reason?

Well, here is another one.

To be honest, I believe the Judge should dismiss the case, without prejudice, as it was not properly filed.

Why?  Because this should have been filed, under seal, as a False Claims case as it deals with Medicaid funding.

Since we all know the States Attorney General are constrained from going after Medicaid fraud in child welfare, the only other venue to pursue legal recourse would be federal.

To the attorneys on the case, go forth and proceed with the writ!

(My apologies for not pulling the complaint.  I have been a bit busy, lately.)

Judge to decide whether whistleblower suit should be dismissed

A judge in Washington County said he will consider whether the county’s former president judge and two other court officers should face trial in a whistleblower lawsuit brought by a former court employee.

Visiting Senior Judge William Nalitz from Greene County heard arguments Thursday from lawyers representing former Common Pleas Judge Debbie O’Dell Seneca and two other defendants who were sued by former juvenile probation officer David Scrip.

Mr. Scrip, 54, of Carroll, alleges he was unlawfully fired by Judge O’Dell Seneca after reporting a relationship between his former supervisor and a woman who worked as a placement officer for a treatment center for juvenile offenders.

Mr. Scrip claims he and other probation officers were pressured by Daniel Clements, his superior and the former chief probation officer of Washington County, to recommend placement for juveniles at Abraxas Youth and Family Services, where Mr. Clements’ girlfriend worked.

After he reported his concerns, Mr. Scrip said he was retaliated against and eventually fired by Judge O’Dell Seneca and Thomas Jess, the former director of the county’s probation services department.

“He worked in the juvenile probation department for 25 years and was never disciplined until the last 18 months, when he was written up three times then fired,” said Noah Geary, Mr. Scrip’s lawyer.

Along with former Judge O’Dell Seneca, Mr. Scrip sued Mr. Jess and Mr. Clements, neither of whom remain employed by the county. Judge O’Dell Seneca retired in January 2015, shortly after being stripped of her administrative duties when other judges complained to the Administrative Office of Pennsylvania Courts, which oversees the judiciary.

Mr. Scrip initially filed a lawsuit in federal court, but it was dismissed last year, prompting Mr. Geary to seek relief from the state court.

Judge O’Dell Seneca’s lawyer, Caroline Liebenguth and Robert Grimm, the lawyer representing the county, Mr. Jess and Mr. Clements, argued that their clients were immune from lawsuits as members of the state judiciary and under provisions in the state constitution.

“His client has no cause of action,” Mr. Grimm told the court. “The case should be dismissed.”

But Mr. Geary argued the suit shouldn’t be dismissed because the defendants were sued in their private capacity.

He also cited the code of conduct for judicial officers, revamped in 2011 after the “Kids for Cash” scandal in Luzerne County, in which two judges were accused of being paid to send juvenile offenders to certain facilities. According to the new code, court employees have “a duty to report wrongdoing without fear of reprisal,” Mr. Geary said.

Judge Nalitz is expected to rule within a month.

Voting is beautiful, be beautiful ~ vote.©

University of Minnesota Fails Miserably in Child Welfare

The Center for Advanced Studies in Child Welfare has been created at the University of Minnesota School of Social Work.

Let us take a moment of silence to realize that the industry of Medicaid Fraud in Child Welfare is encouraged through the promotion of pseudo-empirical research by educators who are breathtakingly deficient in the disciplines of ethics and policy.

Taken from the Center for Advanced Studies in Child Welfare (CASCW) is the objective for its learning modules.

CASCW's learning modules are developed by affiliated faculty within the School of Social Work. Child welfare-relevant evaluation findings, which include current policies and practices affecting Title IV-E eligible families and children, are incorporated into these supplemental training materials.

Now, at this point, many are wondering what is wrong with the research and evaluation findings that have led to the development of these learning modules used in child welfare training, so let's look at what is not present.

Definition of parental rights: I wrote extensively on the subject of parental rights, complete with identified model, definition and usages. The University of Minnesota Center for the Advancement of Studies in Child Welfare, therefore, has no authority in child welfare as it has not properly demonstrated the skills, knowledge and abilities to execute research nor the credibility to implement policy.

Accountability: There is nor has there ever been any mention of contractual disbarment, license revocation, fines, sanctions, well, anything dealing with federal funding criteria has been avoided like the plague and here is the reason why:

The Center for Advanced Studies in Child Welfare (CASCW) was established in 1992 with federal Title IV-E funding and a grant from the Bush Foundation. The Center brings the University of Minnesota together with county and state social services in a partnership dedicated to improving the lives of children and families.

That's right, Social Security Title IV-E funding. Many do not know that Title IV-E funds training for child welfare agencies through education. Here's how the scheme works.

A state will receive funding through the U.S. Department of Health and Human Services Administration for Children and Families to provide training to all federally funded Child Welfare programs.

In most states a person must be licensed as a social worker to work in child welfare. Some states partner with manoeuvrers, such as the University of Minnesota's Center for Advanced Studies in Child Welfare, who receive state funding grants like demonstration grants and traditional university funding, to design programs and initiatives to support the state's revenue-maximization schemes in child welfare.

The university will design curriculum and theory to enhance the current state administrative policies and practices. In some states, such as New York, the state canceled all private training to redirect all activities to Cornell. When this happens, a question of ethical practices occurs. In the New York situation, Cornell has designed a subsidiary structure where a child welfare worker may go to receive the necessary training for licensing.

The problem is there is no competition, hence, they can instruct workers to do whatever they wish.

Another problem is with fraud. There are double-billing, treble-billing, phantom billing, kiddy kickbacks, phantom organizations, phantom employees, phantom programs and the state will do nothing to stop it. Most of the fraudulent billing activity remains in the state coffers to be re-allocated to cover the state's percentage of state-federal funding formula percentage.

Here is an easier way of looking at the funding situation:

Taxes => Feds => States => Universities => States => Child Welfare Policy

You pay federal taxes. That money then goes as SSA Ttle IV-E grants to States. States fund universities to train and create policy. False claims are generated and the money goes to pay it's portion of the funding. This is a maximization of revenue that is then put into more child welfare programming to continue generating funds to create more activities.

In Michigan, the training is all in-house, or rather in the Judicial Branch under the State Court Administrative Offices. What this brilliant state did was to manoeuvre around titles and create the legislative term of "case managers". One no longer needed to be a social worker to work in child welfare, meaning a G.E.D. was the minimum requirement. Even if a social worker was licensed, there is no regulatory state entity to file grievances in child welfare, meaning the state is not appropriately using its ADA grievance funding nor is it properly using it Attorney General consumer protection funding.

Then the training, in the Child Welfare Institute, is conducted by young, community college students, as most of the seasoned uneducated staff left. Much of the training sessions consist of internet cut and paste that has nothing relevant to do with the state.

The worst parts with the Michigan training model are that it relies upon whatever it fabricates and private child placing agencies are not mandated to send their child welfare "case managers" to any kind of training. This way, more of the double-billing, treble-billing, phantom billing, kiddy kickbacks, phantom organizations, phantom employees, and phantom programs continue to thrive in the never ending supply-chain of families falling into poverty.

Transparency: There is not one single reference to public education on administrative operations, fiscal reporting, internal audits, external audits, grievances, ethics or anything else in the realm of organizational integrity, but this is understandable because the University of Minnesota CASCW knows nothing about this area of study. In fact, it encourages unethical behavior in all its programming.

Again, I have examined in depth the barriers to transparency in child welfare, so I am in a position of authority, along with the U.S. DHHS OIG and U.S. DOJ, to state that fraud, in its various shapes and forms, will continue to flourish in the unethical academic environments.

I make the assertion that all research hailing from the University of Minnesota CASCW is suspect as it fails to identify its biases and limitations in constructing a valid definition of parental rights and fails to identify its inherent conflict of interests with SSA Title IV-E funding, and neglects to raise the issues of fraud in child welfare.

My overall grade for the work of University of Minnesota CASCW is F.

Did Michigan Appeals Judge Colleen O'Brien Consent To Dissent An Adoption For MCI Trafficking Tiny Humans Under Foreign Duress?

The following is a unanimous ruling, with dissent if that makes sense, of an aunt trying to adopt her niece, but the Michigan Children's Institute Superintendent said, "NO" because, more than likely, as per the norm, there was fraudulent billing to Medicaid, mixed in with a sprinkle of the child being Legally Kidnapped, on paper, which is why there was a dissent.

Before we get to the dissent of the unanimous ruling (yea...I am still working on this on), you have Michael Kelly, who must have been reading my blog.

Michigan Judicial Tenure Commission Sucks

Because I would conclude that the trial court misapplied 
MCL 710.45, I would reverse the trial court and reinstate the 
superintendent’s decision to deny petitioner consent to adopt RC.
Colleen O'Brien

I am not familiar with Meter, so I am just going to fast forward to this Colleen O'Brien, who just had to throw in her two cents on the unanimous ruling, with her dissent.

Colleen O'Brien is a judge on the Michigan Second District Court of Appeals. Governor Rick Snyder (R) appointed her on September 29, 2015, to finish the unexpired term of Pat Donofrio, who retired the following day.[1]

Donofrio's retirement came as a surprise.

O'Brien was elected to the seat for a full six-year term in 2016. Her current term expires on January 1, 2023.

I do not have a grasp of her campaign funding yet, but it is quite odd.

She has been granted campaign filing waivers, yet, generated over $500,000 for her campaign.

https://cfrsearch.nictusa.com/documents/379145/details/filing/summary?changes=0

Make sure to check out the broken English

I am not going to harp on this too much for the simple fact that Michigan Campaign Finance Law was set up where you can just ask for a filing waiver if you think you are going to generate and spend less than $1,000, or $5,000 for other campaigns.

That way, a candidate can run whatever money they want through a campaign because no one is going to check the bank accounts.

She is endorsed by:

https://mcrgo.org/

• Right-to-Life (there are 217 filings of this network, with the Detroit chapter of the most interest in marketing citizenship opportunities through young girls.);
• Citizens for Traditional Values;
• Michigan Chamber of Commerce; and,
• Coalition for Responsible Gun Owners (a group connected to an ongoing, foreign political influence investigation, among other matters of interest).

So, in a nutshell, I am trying to find out why this woman would "consent to dissent" by saying, basically, MCI was not whimsically pulling decisions out its arse in denying consent for the aunt to adopt her niece because it was due to a technical error of the lower court not to rule in favor of MCI keeping the kid as a ward of the state, even though the parents voluntarily terminated their parental rights for the aunt to adopt.

What I see is that Colleen O'Brien seems to be one of those "foreign-influenced" individuals who are part of the newest trend to rebrand foster care and adoption, starting in Michigan, of course, by privatizing the courts, starting in child welfare, like they always do.

Tag, Colleen. You are it.

http://www.ffkids.org/

It also seems Colleen deferred to Fostering Futures, to support MCI Superintendent denying consent of an aunt to adopt her niece.

So, allow me to tell a little tale of Fostering Futures.

Carmine DeVivo is an individual who needs to be permanently extracted from human existence.

Carmine DeVivo came out of Michigan State University School of Social Work to run one of the first trafficking tiny humans networks out Orchards Children's Services in Michigan.

What he used to do was to run what is called concurrent planning ops that go like this.

The kid is Legally Kidnapped by CPS and placed in the private, state contracted Child Placing Agency for foster care.

While in foster care, Orchards bills Medicaid twice, thrice or even under different names of the kid, in phantom billing, double billing, treble billing, or just made up cases to bill.

Hell, Orchards even ran a juvenile case on a woman who was in her 30s, where they phantom billed, double billed, treble billed, for whatever they came up with.

While all this was going on, Carmine, in his infinite wisdom, would set up concurrent planning, which is a code in Michigan for Medicaid billing for adoption services, while billing for foster care services, at the same time....concurrently....contemporaneously....simultaneously.....fake billing.

Anyway, Carmine would refer his foster care cases to himself for adoption counseling.

Yes, this is how I came up with the term "Kiddy Kickbacks".

https://beverlytran.blogspot.com/search?q=Kiddy+Kickbacks

Curriculum Vitae of Carmine... by on Scribd

Back to Colleen.

She basically deferred to the authority of Fostering Futures, which is run by some chick with the same last name as Carmine, who is probably his adoptive daughter or sister, or something like that, which just so happens to be registered as a Michigan LLC and a domestic non-profit.

But, hey, what do I know?

I know Colleen sucks.

Before: M. J. KELLY, P.J., and METER and O’BRIEN, JJ.  PER CURIAM.  Petitioner, Lucinda Carrier, the paternal aunt of the minor child RC, sought consent to adopt RC after the parental rights of RC’s biological parents were voluntarily released.  The superintendent of the Michigan Children’s Institute (MCI) withheld consent to adopt.1  Carrier challenged the denial of consent to adopt in the circuit court.  After conducting a hearing pursuant to MCL 710.45(2) (Section 45 hearing), the circuit court found that the superintendent’s decision to deny consent was arbitrary and capricious.  The MCI appeals that decision as of right.

LUCINDA CARRIER, v. Michigan Children's Institute on Section 45 Appeal for Grandparent Adoption 01 17 2019... by Beverly Tran on Scribd

Voting is beautiful, be beautiful ~ vote.©

New York Catches A Medicare Fraud Scheme

When reading this press release, change "Medicare" to "Medicaid" and replace "physical" with "individual or group". Then, you will have the actual makings of a child welfare fraud scheme.

See, in foster care, the legal guardian is the state, so the state authorizes all Medicaid services provided to the child. The kiddy kickbacks come in the form of extended lengths of stay in foster care and the small stipend of adoption bonuses.

Department of Justice

Office of Public Affairs

FOR IMMEDIATE RELEASE

Wednesday, May 5, 2010

Brooklyn Physical Therapy Clinic Executive and Three Employees Charged in Health Care Fraud Scheme

 

Four Brooklyn, N.Y.-area residents have been charged in connection with a health care fraud scheme operated out of the Solstice Wellness Center, a Brooklyn-area clinic that purported to specialize in providing physical therapy and various diagnostic tests, announced the Departments of Justice and Health and Human Services (HHS).

Solstice executive Dmitry Shteyman, 35, and Solstice employees Aleksey Shteyman, 41; Maxsim Shvedkin, 38; and Sara Kalantarov, 22, were each charged in an indictment unsealed today in U.S. District Court in the Eastern District of New York, with conspiracy to defraud the United States, to submit and cause the submission of false claims and to pay health care kickbacks. In addition, Dmitry Shteyman, Aleksey Shteyman and Shvedkin were each indicted on one count of conspiracy to commit health care fraud and 16 counts of health care fraud. Dmitry Shteyman, Shvedkin and Kalantarov were arrested today in the Eastern District of New York. Aleksey Shteyman remains at large.

According to the indictment, Dmitry Shteyman was the chief operating officer and vice president of Solstice, Aleksey Shteyman was a consultant at Solstice, Shvedkin assisted in the recruitment of Medicare beneficiaries at Solstice, and Kalantarov was an employee at Solstice who worked at the front desk. All four individuals are alleged to have been involved in paying cash kickbacks to Medicare beneficiaries to induce those beneficiaries to be transported to and from Solstice, to purportedly receive physicians’ services, physical therapy and diagnostic tests. The false and fraudulent claims that were submitted to Medicare were for services that were not actually rendered and that were not medically necessary...more

Michigan Doctor Senentenced in Medicare Fraud Scheme

Even though this deals with Medicare, it is a classic example of a healthcare fraud scheme, the same ones found in child welfare.

Detroit-Area Doctor Sentenced to 72 Months in Prison for Medicare Fraud Scheme
Patient Recruiter Sentenced to 40 Months in Prison

WASHINGTON—Dr. Toe Myint was sentenced today in Detroit to 72 months in prison for participating in a conspiracy to defraud the Medicare program, announced the Departments of Justice and Health and Human Services (HHS). A patient recruiter was also sentenced today in Detroit to 40 months in prison for his role in the conspiracy.

No one ever goes to jail for participating in conspiracies to defraud the Medicaid program in foster care.

U.S. District Court Chief Judge Gerald E. Rosen ordered Myint, of Bloomfield Hills, Michigan, to pay more than $3.1 million in restitution, jointly with co-defendants, and to serve two years of supervised release following his prison term. Chief Judge Rosen also ordered Terrence Hicks, a Jackson, Michigan, resident and patient recruiter, to pay more than $4.9 million in restitution, jointly with co-defendants, and to serve three years of supervised release following his prison term.

There can never be a federal case against a state privatized child placing agency as the co-defendants would be the state, acting as a contracted arm of the state.  What normally happens is that the state is hit with a reduction in its Federal Medicaid Assistance Percentage.

Myint, 56, was convicted by a Detroit jury on January 22, 2010, of one count of conspiracy to commit health care fraud, following a week-long trial. In the last three months, three Michigan-area doctors have been convicted at trial of separate health care fraud offenses as part of the Medicare Fraud Strike Force operations in Detroit. Hicks, 43, pleaded guilty to one count of conspiracy to commit health care fraud on December 18, 2009.

In most instances, there are no bids for local child placing agencies so it would be detrimental, allegedly, to shut down any of facilities down, yet found to provide the greatest good to the community to continue its current patterns of fraud.

Between approximately October 2006 and March 2007, Myint, Hicks, and their co-conspirators caused more than $4.2 million in false and fraudulent claims to be submitted to the Medicare program for services supposedly provided by Myint at Sacred Hope Center Inc., a purported infusion clinic. Medicare actually paid more than $3.1 million of those claims. Hicks also worked at a second, related infusion clinic, called Xpress Center, Inc., which billed an additional $2.3 million in false and fraudulent claims to Medicare.

In 2004, more than $700 million in false and fraudulent claims had been submitted to Medicaid and Title IV-E programs for services supposedly provided by Michigan child placing agencies, but nobody did anything about it except to keep funding the agencies.

Evidence presented during Myint’s trial established that beginning in approximately October 2006 and continuing until March 2007, Myint routinely prescribed medications for patients at Sacred Hope that they did not need, and that in many cases, were never provided to the patients at all. In fact, the clinic existed for the purpose of causing fictitious claims for injection and infusion therapy services to be billed to Medicare. Myint was the only doctor who worked at Sacred Hope, and the owners of the clinic asked him to prescribe particular drugs to patients because they believed that Medicare would reimburse the medications at a high rate. Evidence at trial showed that Myint agreed to prescribe the medications even though he knew the patients did not need them.

Children in foster care are routinely prescribed antipsychotic medications that they did not need, and that in many cases, were never provided to the children at all.  In fact, there are child placing agencies that exist for the purpose of causing fictitious claims for child abuse therapy and preparation for adoption therapy services to be billed to Medicaid.  Typically, there is only one doctor who works with the child placing agencies and even residential institutions and the owners would ask for particular drugs, like Seroquel, be given to children to secure higher rates of foster care payments and Medicaid reimbursements.  These doctors prescribe the medications even though they know the children do not need them.

According to court documents and evidence presented at trial, Medicare beneficiaries were not referred to Sacred Hope or Xpress Center by their primary care physicians, or for any other legitimate medical purpose, but were recruited by Hicks to come to the clinics in exchange for the payment of cash kickbacks. Hicks recruited the beneficiaries in downtown Detroit and drove them to the suburbs of Southfield and Livonia, Michigan, where the clinics were located. Trial evidence showed that in exchange for the cash kickbacks Hicks paid them, the Medicare beneficiaries visited the clinics and signed documents indicating that they had received the services billed to Medicare...more

According to civil lawsuits and state audits, children were not allowed to stay in the home, but were legally kidnapped and pushed through the foster care system to eventually be adopted.  Once adopted, all records of Medicaid fraud are destroyed.  Mental health providers are then recruited to generate fraudulent reports to keep the children in foster care for extended lengths of time and in exchange for false court reports to support the decision to terminate parental rights, the mental health providers, the mental health providers received kiddy kickbacks, with the child placing agencies signing documents indicating the services were provided to the children.

Feds Sentence Novartis For Drugging Kids

Trileptal is a common drug that was readily prescribed to foster children and other low income children for false claims and false diagnoses.  Novartis paid off doctors to ghostwrite reports to drug kids.

Children in foster care are still being prescribed Trileptal as mood stabilizers and not was it was approved for.  Someone needs to ask Maura Corrigan about this.
Novartis Pharmaceuticals Sentenced For Off-Label Drug Marketing

DOJ Makes Novartis Pay $420 Million For Kiddy Kickback Scheme

I cringe when I see the growing list of pharmaceutical corporations that not only drugged kids for cash, but drugged the entire industry of child welfare to believe that it was a good thing for kids.

When you look at the national statistics, you will see a category labeled as " physical neglect".  Physical neglect has 12 codes assigned to break down the different categories for purposes of research studies.
There are two specific codes which address issues of medical neglect:

1. Refusal to allow or provide needed care for diagnosed condition or impairment.
2. Unwarranted delay or failure to seek needed care

TRANSLATION: When a parent refuses psychotropic medication to the child, this constitutes medical neglect, a reportable condition to increase the national statistics of child abuse and neglect, and grounds for removal.

This is a classic Title IV-E funding training technique (usually billing at the improper higher rate of 75%) where a Child Welfare Worker will use the tactic of performing an Axis III diagnosis, without medical license, to support the placement of the child in foster care and to automatically classify the child as special needs, accessing Targeted Case Management funding benefits called kiddy kickbacks.

Novartis resolves its own kiddy kickback liabilities, generated from Social Securitydollars while the States child welfare systems continue its pattern of practice of promoting the drugging of children.

Trileptal is a commonly prescribed as a psychotropic drug for foster children.

Wolverine Human Services of Michigan uses this drug liberally with foster children.

Here are two physicians who participated in the illegal and wrongful marketing of Trileptal.

Demitri and Janice Papolos

Trileptal Illegal Marketing Material

DOJ Makes Novartis Pay $420 Million For Kiddy Kickback Scheme

I cringe when I see the growing list of pharmaceutical corporations that not only drugged kids for cash, but drugged the entire industry of child welfare to believe that it was a good thing for kids.

When you look at the national statistics, you will see a category labeled as " physical neglect".  Physical neglect has 12 codes assigned to break down the different categories for purposes of research studies.

There are two specific codes which address issues of medical neglect:

Refusal to allow or provide needed care for diagnosed condition or impairment.

Unwarranted delay or failure to seek needed care

TRANSLATION: When a parent refuses psychotropic medication to the child, this constitutes medical neglect, a reportable condition to increase the national statistics of child abuse and neglect, and grounds for removal.

This is a classic Title IV-E funding training technique (usually billing at the improper higher rate of 75%) where a Child Welfare Worker will use the tactic of performing an Axis III diagnosis, without medical license, to support the placement of the child in foster care and to automatically classify the child as special needs, accessing Targeted Case Management funding benefits called kiddy kickbacks.

Novartis resolves its own kiddy kickback liabilities, generated from Social Security dollars while the States child welfare systems continue its pattern of practice of promoting the drugging of children.

Trileptal is a commonly prescribed as a psychotropic drug for foster children.

Wolverine Human Services of Michigan uses this drug liberally with foster children.

Novartis Pharmaceuticals Corp. to Pay More Than $420 Million to Resolve Off-label Promotion and Kickback Allegations

WASHINGTON – Novartis Pharmaceuticals Corporation has agreed to pay $422.5 million to resolve criminal and civil liability arising from the illegal marketing of certain pharmaceutical products, the Justice Department announced today.


According to the agreement reached with the government, the East Hanover, N.J.-based company will plead guilty to a misdemeanor and pay a $185 million combined criminal fine and forfeiture for the off-label promotion of Trileptal in violation of the Food, Drug and Cosmetic Act. The Food and Drug Administration (FDA) approved Trileptal as an anti-epileptic drug, for the treatment of partial seizures, but not for any psychiatric, pain or other uses. Once a pharmaceutical is approved by the FDA, a manufacturer may not market or promote it for any use not specified in its new drug application. The unauthorized uses are also known as "unapproved" or "off-label" uses.
In addition to the criminal fine and forfeiture, Novartis has agreed to pay $237.5 million to resolve civil allegations under the False Claims Act that the company unlawfully marketed Trileptal and five other drugs, and thereby caused false claims to be submitted to government health care programs. Specifically, the civil settlement resolves allegations that Novartis illegally promoted Trileptal for a variety of uses, including psychiatric and pain uses, which were not medically accepted indications and therefore not covered by those programs. In addition, the agreement resolves allegations that the company paid kickbacks to health care professionals to induce them to prescribe Trileptal and five other drugs, Diovan, Zelnorm, Sandostatin, Exforge and Tekturna. The federal share of the civil settlement is $149,241,306, and the state Medicaid share of the civil settlement is $88,258,694.


"This resolution demonstrates the Department of Justice’s ongoing dedication to taking action against pharmaceutical fraud in all its forms," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "Unlawful off-label promotion and providing illegal inducements to health care professionals undermine the integrity of our health care system and we will continue to pursue these types of violations."


"Off-label marketing can undermine the doctor-patient relationship and adversely influence the clear judgment that a doctor’s patients have come to rely on and trust," said Zane D. Memeger, U.S. Attorney for the Eastern District of Pennsylvania. "Pharmaceutical companies have a legal obligation to promote the drugs they manufacture only for uses that the Food and Drug Administration has deemed are safe and effective. That legal obligation takes priority over a company’s bottom line. This prosecution demonstrates our continuing commitment to ensure that pharmaceutical companies comply with the law."


The civil settlement resolves four lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens with knowledge of fraud to bring civil actions on behalf of the United States and share in any recovery. The four cases are: U.S. ex rel. Austin v. Novartis Pharmaceuticals Corporation; U.S. ex rel. McKee v. Novartis Pharmaceuticals Corporation; U.S. ex rel. Copeland v. Novartis Pharmaceuticals Corporation; and U.S. ex rel. Garrity v. Novartis Pharmaceuticals Corporation. As part of today’s resolution, the whistleblowers, all former employees of Novartis, will receive payments totaling more than $25 million from the federal share of the civil recovery.


"This settlement represents a landmark victory in our district’s continuing battle against health care fraud. We intend to bring to justice any pharmaceutical company that attempts to cloud physicians’ medical judgment through kickback practices and illegal promotional activities," said A. Brian Albritton, U.S. Attorney for the Middle District of Florida.


Novartis also signed a Corporate Integrity Agreement (CIA) with the Department of Health and Human Services, Office of Inspector General (HHS-OIG). The company is subject to exclusion from Federal health care programs, including Medicare and Medicaid, for a material breach of this CIA and subject to monetary penalties for less significant breaches. Among other things, the CIA requires the board of directors (or a committee of the board) to annually review the company’s compliance program with the help of an outside expert and certify its effectiveness; that certain senior executives annually certify that their departments or functional areas are compliant; that Novartis send doctors a letter notifying them about the settlement; and that the company posts on its website information about payments to doctors, such as honoraria, travel or lodging. The five-year agreement further requires the implementation of a compliance program addressing promotional activities.


"OIG will carefully monitor the Corporate Integrity Agreement to ensure that Novartis is more transparent in its business transactions, that its Board of Directors is held more accountable, and that the names of physicians receiving payments are publicly disclosed," said Department of Health and Human Services Inspector General Daniel R. Levinson. "The result will be stronger protections for patients and the nation's taxpayers."


The U.S. Attorney’s Office for the Eastern District of Pennsylvania and the Justice Department’s Office of Consumer Litigation prosecuted the criminal case. The Justice Department’s Civil Division, the U.S. Attorney’s Office for the Eastern District of Pennsylvania, and the U.S. Attorney’s Office for the Middle District of Florida handled the civil lawsuit, with assistance from the National Association of Medicaid Fraud Control Units and the offices of various state attorneys general.


This settlement is part of the government’s emphasis on combating health care fraud and another step for the HEAT initiative, which was announced by Attorney General Eric Holder and HHS Secretary Kathleen Sebelius in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover approximately $3.445 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 have topped $4.595 billion.

HHS OIG Corporate Integrity Agreement with Novartis Pharmaceuticals Corporation

Petition To Judiciary To Hold Hearings On Penn State

As some of you may well know, I consult the U.S. House Judiciary which means I have met lots of people in Washington, D.C.

And as some of you who personally know me, you know I will open my mouth anytime, anywhere, with the greatest of eloquence, in my elegant fashion, and rip holes in any stupid, fallacious statement regarding child abuse propaganda and its imperialistic morality parade.

With that said, I have decided to create a petition to end Medicaid fraud in child welfare.

My petition is to have U.S. Representative Lamar Smith, House Judiciary Chairman and U.S. Representative John Conyers, Jr, Judiciary Chairman Emeritus to send a letter to U.S. Attorney General Eric Holder requesting investigation of the States on Medicaid fraud in child welfare.

Of course, we all know who will be writing the letter.  Me.

Here's the plan.  I plan on riding the coattails of this Penn State scandal.  U.S. Representative Shelia Jackson Lee has already called for hearings...and she sits on Judiciary.  Many of the Judiciary members are from States who have been hit with HHS OIG findings in the millions for child welfare fraud, where H.E.A.T.  has set up shop for the unreal levels of Medicare fraud.

Unfortunately, there are Members of Congress who are stuck on broken record of revving up mandatory reporting of child abuse.  You cannot report child abuse in child welfare because it is a conflict of interest.  It is hard for a state to snitch on itself so legislation is going to have other snitch.  This snitching panic for the smallest delusion of a transgression will lead to an increase of child rape in foster care, paid with Medicaid dollars.

This petition is to wake up the nation.

The only thing left to do is your signature.

Send this petition to your elected officials and administrators.  Send it anyone with an email or a facebook account.   You wanted a voice in Washington, well now you have it.

Greetings,

I just signed the following petition addressed to: Representatives Lamar Smith and John Conyers, Jr..
-----------------------
In the wake of the Penn State child sexual abuse matter, the issues of fraud in child welfare must finally be addressed as the children were under the care of the state as foster children.

Under the shroud of confidentiality laws, the number of children who are murdered, raped, tortured and have committed suicide while in foster care go unreported. What is even more egregious is not the fact that these foster children have suffered were billed under Medicaid; it is the fact that there have never been national hearings on the matters of Medicaid fraud in child welfare.

Quintessentially, child welfare service providers are paid through Social Security to literally get away with murder and rape of children.

States do not maintain policies to refer Medicaid claims violations of law by its privatized Child Placing Agencies to the Medicaid Fraud Control Units, typically housed in the States Attorney General Office, due to the fact that the States Attorney General defends its privatized Child Placing Agencies under the grant of immunity.

Children in foster care are prescribed psychotropic drugs at an alarming rate because there is no enforcement oversight mechanism beyond the False Claims Act. As a result, children in foster care are improperly and unnecessarily overmedicated creating fraudulent claims for Medicaid cost reimbursements.

There have been a number of Corporate Integrity Agreements between the U.S. Department of Justice and major pharmaceutical corporations for "illegally and wrongfully" marketing psychotropic drugs, which were never FDA approved, to children; yet, in foster care, children continue to be medicated with these same drugs.

State child welfare contracts are not competitive by nature, creating breeding grounds for numerous antitrust violations which remain omitted from national discussions. Coupled with institutionalized patterns of practice in double-billing, phantom-billing (i.e. billing for non-existent, poor quality, or unnecessary services) and kiddy kickbacks (i.e. similar to physician kickbacks), and false statistical reporting of child abuse, you have the makings of Medicaid fraud in child welfare.

Most people have heard of Medicare fraud, and the campaign to stop it, but nobody knows about Medicaid fraud in child welfare. Medicaid fraud in child welfare is a multi-billion dollar industry which exists without any penalty.

Contrary to popular belief, the largest federal funding source in foster care is not Title IV-E, Title IV-A Emergency Assistance or Title XX of the federal Social Security Act, it is Title XIX (Medicaid) and the area that we are addressing is Targeted Case Management.

Targeted Case Management (TCM) is considered a “pay-as-you-go” program. This means, whenever there is a bill in child welfare, it will be paid, in full by the feds. Unlike Medicaid Federal Financial Participation (FFP), TCM in foster care and adoption is 100% covered which means the states do not pay any portion. Then, a portion of these funds was set aside to suspend regulation, called a moratoria, on TCM.

So, now we have a basic formula for the child welfare fraud:

100% FFP + MORITORIA = TCM REVENUE-MAXIMIZATION SCHEME

TRANSLATION: It becomes financially beneficial for states to place children and keep them in foster care than to provide community-based services because there is no regulation of the legitimacy of TCM costs.

TCM funds exactly what it says, the management of cases from targeted populations. So what are targeted populations?

Targeted populations are children who are considered as “at-risk”, meaning the likelihood of them being in need of child welfare services is substantial because they meet the following criteria:

At or below the Federal Poverty Level
Minorities
Single parent homes (this includes divorced and widowed)
Sibling groups
Unemployed
Living in low-income neighborhoods
Special needs (education, medical, psychological)
Disabilities (caregivers and/or children)
Homeless
Lack of medical coverage
Victims of domestic violence
Children of undocumented immigrants

These are populations who have no access to legal recourse nor opportunity to redress grievance as confidentiality laws silence any whistleblower with threats of termination of parental rights.

To first properly understand Medicaid fraud in child welfare, we must conduct a forensic autopsy, meaning, it may only be examined after the billing has been submitted and costs reimbursed. The complexity of TCM child welfare fraud varies from state to state, and from child placing agency to child placing agency, but they exist, in a multitude of shapes and forms.

Concerns of the pervasiveness of these revenue-maximizing schemes have been federally expressed, but ignored by Congress.

Therefore, gentlemen, I strongly encourage you to send letter of request to the Attorney General Eric Holder to investigate Medicaid fraud in child welfare and for this honorable body to hold judiciary hearings to bring into public light the pilfering of the Social Security system under the guise of the child.



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With serenity and sincerity,

Beverly Tran
http://beverlytran.com

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