$$ Foster Care in Alaska $$

Foster Care in Alaska
By Matt Jackson   May 09, 2009
Saturday

Today, I learned what really makes the "youth treatment system" go 'round in Alaska. It's not love, it is not about the kids, and no one cares about us. It is the money. I won't go into the many grievances Residential Youth Care and foster care have committed against me. Rather, today I will only talk about the numbers.
For the month of May, my foster parents will receive $3,900 in state money to care for one child. Me. I was never told this, I never knew, I only found out because they left their budget out on the computer desk. I never would have guessed. Admittedly, I eat and sleep in their house, but is that amount of money justified? When asking friends and teachers at school how much they thought foster parents received to care for one child for one month, the highest guess was 2,000, most were closer to 1,000. But even given generous estimates including food, utilities, gas and allowance ($15 a week), there is no way I cost them more than $1500 monthly. Where does the other $2400 go? I sure don't know.
Yesterday I bought a mother's day card for my real mother, $3. Last week I paid $150 in court fees for my emancipation case. Later today I will pay the enrollment fee to a prestigious college on the East Coast to the tune of $500. All $653 is coming out of my pocket. In about an hour I will be broke. Where did that extra $2400 for foster children go? I wish I knew.
When I asked Jack Duckworth, director of Residential Youth Care and the foster program, if he knew, he had an interesting point of view. "I'm not even putting this on the table. The state pays me to do them a service. I make shitloads of money." Mr. Duckworth, does indeed make lots of money, more than 1 million from Medicare and Medicaid alone. That doesn't include the money he makes of his four foster children. I've learned that he receives as much money for them as my foster parent's receive for me, about $130 per day. With four foster children that calculates out to $15,600 a month or $187,200 annually. I wish my mother, parent to four children, received half as much. Doesn't everyone wish they could get $3900 a month for having a kid?
Over the last 5 months I've been in treatment, (for one minor consuming alcohol) Mr. Duckworth, went a long way to convince me that it really was about the kids. However, yesterday he revealed what it is really all about. Mr. Duckworth, still remembers that he does a service to the State of Alaska. Unfortunately, he has forgotten that the State of Alaska is supposed to provide services to the People of Alaska. He is not supposed to be doing a service to the state, or to his budget. He is supposed to be doing a service to the children of Alaska.
But in a system which provides an extravagant amount of money for the control of children, there is only one eventual outcome. People, who care only about money, not kids, are being drawn into the system. I witness and experience it every day.
Matt Jackson
Ketchikan, AK

Received May 07, 2008 - Published May 09, 2009

Sitnews,Stories In The News, Ketchikan, Alaska


*The posts made in this blog are of our opinion only* Without Prejudice UCC 1-207

Medicating Children: A “Whistleblower’s” Lawsuit Raises a Novel Legal Question

 Published on Psychology Today (http://www.psychologytoday.com)

 Medicating Children: A “Whistleblower’s” Lawsuit Raises a Novel Legal Question

By Robert Whitaker

Created Jun 2 2010 - 12:08pm

In the past few years, a number of pharmaceutical companies have admitted to federal charges that they illegally marketed psychiatric medications for non-approved uses, with the companies paying large sums to settle the cases. Now, a legal complaint filed by the Law Project for Psychiatric Rights in an Alaskan federal court is raising a related question. When healthcare providers bill Medicaid for prescriptions of psychiatric drugs to children for non-approved uses, are they committing Medicaid fraud?
The case, United States ex-rel Law Project for Psychiatric Rights v. Matsutani, was unsealed earlier this year, and legal papers were recently filed that have brought this novel question -- which obviously has profound implications for the prescribing of psychiatric medications to poor children and adolescents -- into sharp focus.
The Law Project for Psychiatric Rights (PsychRights), which is headed by Alaskan attorney James Gottstein, filed its whistleblower complaint in April 2009. Known as a qui tam lawsuit, PsychRights sued on behalf of the federal government under the False Claims Act, which allows private individuals to pursue legal complaints against individuals or companies that are allegedly defrauding the government. In December, the federal government declined to join PsychRights in the case.
PsychRights named Alaskan state officials, hospitals, mental health agencies, psychiatrists, and pharmacies as defendants. In its complaint, PsychRights argues that the federal government has agreed to provide Medicaid reimbursement only for those outpatient drugs that are prescribed for an FDA-approved use or for a use supported by a medical compendium (such as the DRUGDEX Information System.) PsychRights maintains that the defendants defrauded the federal government when they billed Medicaid (or the federal Children's Health Insurance Program) for outpatient drugs that didn't meet this standard.
As part of its complaint, PsychRights identified 16 commonly prescribed psychiatric medications that have no "medically accepted indication" for youth under 18 years old, and it also identified the limited number of "medically accepted indications" that exist for 32 other psychiatric drugs. PsychRights compiled this list of "approved" uses by methodically going through the drug compendiums, and it serves as the evidential heart of the complaint, for it reveals that psychiatric medications are regularly prescribed to poor children for non-approved uses. PsychRights is asking the federal court to stop this practice (which it argues is harmful), and to pay hefty financial penalties for the fraudulent claims made to date.
In early April, the defendants petitioned the court to dismiss the complaint, arguing that it was "fatally flawed" for a number of reasons, including several technical ones. For example, the defendants maintain that PsychRights has not "disclosed" private information that is required of "whistleblowers" in qui tam suits. But the defendants also argued --and this goes to the core legal issue of interest to healthcare providers -- that PsychRights has misinterpreted the applicable Medicaid law. Medicaid is a joint state-federal program, with each state establishing a Medicaid plan that must be approved by the federal government, and the defendants argue that a state may in fact choose to provide Medicaid reimbursement for outpatient drugs that are not FDA approved or "medically indicated" by drug compendia. The defendants argue that Alaska implicitly made that choice in regard to off-label use of psychiatric medications in children, and thus no fraud was committed.
The U.S. District Court in Alaska will likely take months to rule on the defendants' motions to dismiss the complaints. If the court rules on the central issue, it will help define whether Medicaid law supports off-label, non-compendia-approved use of psychiatric medications in children, or deems this commonplace practice to be medically unjustified.

http://www.psychologytoday.com/blog/mad-in-america/201006/medicating-children-whistleblower-s-lawsuit-raises-novel-legal-question

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FRAUD UPON THE COURT PSYCHOLOGY WHISTLE BLOWER

 FRAUD UPON THE COURT PSYCHOLOGY WHISTLE BLOWER

This video describes the fraudulent use of indicators in psychology for the prosecution in government trafficking of children to strangers for Title IV and medicaid. From Jan Smith.

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Surprise! Audit uncovers rampant fraud in fed program.

WND EXCLUSIVE

 by Bob Unruh

Millions suspected stolen under Medicaid plan to help disabled

A federal audit of one part of the Medicaid system has uncovered hundreds of millions of dollars in suspected fraud, including payments to caregivers to provide home-care services to the disabled even when they are hospitalized or in nursing homes.
“It would seem inconceivable – even for today’s bloated government – if it wasn’t laid out in a report … by the offending agency’s inspector general,” noted Judicial Watch, which reported on the systemic failure.
Judicial Watch said the issue centers on personal care services provided by the federal and state-funded health insurance Medicaid, which have been provided to the disabled since the Supreme Court ruled in the 1990s that such care is a civil right.
“The idea is to allow the sick, disabled and those with chronic or temporary conditions [to] stay home and, in turn, avoid sticking Uncle Sam with a hefty hospitalization bill,” Judicial Watch said.
“Instead, Medicaid’s personal care services program is rife with corruption that was first exposed more than five years ago and continues to be documented annually by the agency’s watchdog. The budget has ballooned to more than $12 billion a year, just to send what amounts to a nanny to provide supportive ‘nonmedical services’ like meal preparation, housework, help with bathing and getting dressed, transportation and even money management.”
The IG report on the troubling loss of federal taxpayer dollars said Obamacare provisions that already have kicked in have contributed to the increasing number of dollars in the program.
“The Patient Protection and Affordable Care Act (ACA) of 2010 removed barriers to providing home and community-based services by allowing additional state plan amendment options, increasing states’ timeframes to elect and renew PCS as a care option, and streamlining processes for accessing home and community-based services,” the report said. “The ACA also provided additional funding for programs supporting home care goals, such as the Money Follows the Person demonstration and the Community First Choice Option programs.”
But the program has significant troubles, including error rates on documentation of costs as high as 40 percent in New Jersey, where more than $145 million in costs were questioned.
“Since 2009, seven of the eight completed audits have identified over $582 million in questioned costs,” the report said.
Also revealed was the fact that states don’t monitor the programs and payment circumstances, leading some caregivers to be able to collect payments even when the disabled person for whom they are supposed to be providing services is hospitalized or in a nursing home.
“[An] evaluation examining PCS in 20 states over a one-year period found that 18 percent of paid claims for Medicaid PCS in a universe totaling $724 million were inappropriate because the required qualifications for PCS attendants were undocumented,” the report said.
And,” it continued, “an audit examining paid PCS claims over a 30-month period in Nebraska identified 464 instances in which PCS providers billed and were improperly paid for PCS during the beneficiaries’ inpatient hospital stays.”
In many cases, neither the time frame for the provided service nor the attendant’s identification was included on a bill.
John Alemoh Momoh, owner and operator of Hopecare Service Inc., was sentenced to two years in jail and ordered to repay more than $656,000 after it was discovered he submitted claims inflating the number of hours and claiming payments for services not provided, the report said.
It noted that most fraud cases come to the attention of authorities through someone who knows the person committing the fraud because there are few checks and cross-checks to identify problems.
Among the steps that need to be taken, the report said, is the standardization of PCS attendant qualifications, improved billing monitors and a cut in the rules and regulations.
“For example, PCS attendants and agencies that commit fraud often bill for impossibly or improbably large volumes of services; for services that conflict with one another (e.g. a PCS attendant purports to provide many hours of services to multiple beneficiaries on the same dates); or for services that could not have been performed as claimed because of geographical distances between beneficiaries purportedly served by the same PCS attendant on the same day. If claims contained more specific details, including the exact dates of service and the identity of the PCS attendants, such irregular billings could be more easily and systematically discovered through claims analysis by state program integrity units,” the report said.
Judicial Watch noted that the billings for home care have risen 35 percent since 2005, and fraud also is on the rise.
Right now, under the system, “Medicaid recipients can hire practically anyone to help them and collect the money and providers undergo virtually no scrutiny.”
In fact, auditors list examples of Medicaid recipients hiring juveniles, relatives and girlfriends to provide services. One man was in jail while his girlfriend collected money from the government to supposedly provide him with home care,” the report said.

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Massive Dental Fraud Uncovered

 NORTH CAROLINA DENTAL SERVICES CHAIN PAYS $10 MILLION TO RESOLVE FALSE CLAIMS ALLEGATIONS
CHARLOTTE  – Medicaid Dental Center (MDC), a privately-owned chain of dental clinics in North Carolina previously known as Smile Starters and Carolina Dental Center, has reached a settlement with the United States and North Carolina to resolve False Claims Act allegations, the Justice Department announced today. Under the agreement, MDC agreed to pay
$10,050,000 to resolve allegations that it caused false or fraudulent claims for payment to be presented to the North Carolina Medicaid program by billing for medically unnecessary dental services performed on indigent children.

Massive Dental Fraud Uncovered

Part 1 -aired March 6, 2009. Report on dental treatment for the low income by FORBA/Small Smiles

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Whistleblower Lawsuit Against Psychiatrists Unsealed: Defendents Listed

Examiner.com
January 26, 2010 By: Deborah Dupre

 A major Medicaid Fraud lawsuit by Law Project for Psychiatric Rights (PsychRights®) against psychiatrists, their employers, pharmacies, state officials, and a medical education-publishing company for their roles in fraudulent claims to Medicaid to drug mainly disadvantaged children and youth was unsealed, revealing a long list of defendants.

The Law Project for Psychiatric Rights (PsychRights) is a non-profit, tax exempt 501(c)(3) public interest law firm whose mission is to mount a  strategic legal campaign against horrors of forced psychiatric drugging and electroshock in the U.S. akin to what Thurgood Marshall and the NAACP mounted in the 40's and 50's on behalf of African American civil rights. 

The public mental health system is creating a huge class of chronic mental patients through forcing them to take ineffective, yet extremely harmful drugs according to PsychRights.

"The massive psychiatric drugging of America's children, particularly poor, disadvantaged children & youth through Medicaid and in foster care is an unfolding public health catastrophe of massive proportions," states attorney Jim Gottstien, PsychRights director.

Defendants

The defendants in this case are:

* Osamu H. Matsutani, M.D.
* William Hogan, Commissioner Of the Alaska Department Of Health And Social Services
* Tammy Sandoval, Director Of The Alaska Office Of Children's, Services
* Steve McComb, Director Of The Alaska Division Of Juvenile Justice
* William Streur, Director Of The Alaska Division Of Health Care Services
* Juneau Youth Services, Inc.
* Providence Health & Services,
* Elizabeth Baisi, M.D.
* Ruth Dukoff, M.D.
* Charter North Star Behavioral Health System
* Kerry Ozer, M.D.
* Claudia Phillips, M.D.
* Southcentral Foundation
* Sheila Clark, M.D.
* Hugh Starks, M.D.
* Lina Judith Bautista, M.D.
* Heidi F. Lopez-Coonjohn, M.D.
* Robert D. Schults, M.D.
* Mark H. Stauffer, M.D.
* Ronald A. Martino, M.D.
* Irvin Rothrock, M.D.
* Jan Kiele, M.D.
* Alternatives Community Mental Health Services, D/B/A Denali Family Services
* Anchorage Community Mental Health Services
* Lucy Curtis, M.D.
* Fairbanks Psychiatric And Neurologic Clinic, Pc
* Peninsula Community Health Services Of Alaska, Inc.
* Bartlett Regional Hospital Foundation, Inc.
* Thomson Reuters (Healthcare), Inc.
* Wal-Mart Stores, Inc.
* Safeway, Inc.
* Fred Meyer Stores, Inc.
Law Project for Psychiatric Rights v. Matsutani, et al., United States District Court, District of Alaska, Case No. 3:09-cv-0080-TMB.
The lawsuit, filed on April 27, 2009 and required to be kept under seal (secret) until now, is brought under the federal False Claims Act, which authorizes private parties to bring fraud actions on behalf of the Government.

These cases are also called "whistleblower suits" or "qui tam," actions, and those who file them are entitled to a share in the recovery, if any.

Each offending prescription carries a minimum penalty of $5,500.

The Complaint walks through the lack of science supporting the practice and the methods used by the pharmaceutical industry to induce psychiatrists to improperly prescribe these drugs.

"Even though the drug companies have been using these methods to induce psychiatrists to prescribe these drugs, it is the psychiatrists' responsibility to base their decisions on the facts, not drug company marketing," said Mr. Gottstein, continuing, "the uncritical acceptance of pharmaceutical company hype represents a massive betrayal of trust by the psychiatrists prescribing these drugs to children and youth."

PsychRights has developed a streamlined model Qui Tam Complaint for use around the country. (See, PsychRights Launches Campaign Against Medicaid Fraud With Model Lawsuit, July 27, 2009)

The model Qui Tam Complaint is drafted for former foster youth to bring the lawsuits and receive the whistleblower's share of the recoverey, but anyone with knowledge of specific offending prescriptions, such as parents and mental health workers, can bring these suits.

Last fall, Mr. Gottstein gave talks at two national conferences, the National Association for Rights Protection and Advocacy (NARPA), and the International Center for the Study of Psychiatry and Psychology (ICSPP), where he presented how to bring and conduct these cases. Mr. Gottstein is also giving a presentation in New York City, February 2nd, following oral argument in Lilly v. Gottstein.
Mr. Gottstein indicates a number of these cases are percolating around the country. In one that is not as far along as some others, Ted Chabasinski, a Berkeley, California, lawyer, is seeking a former foster youth as a client to bring such a lawsuit in the Bay Area. Any former foster youth in the Bay Area who was given psychiatric drugs within the last 6 years can call Mr. Chabasinski at (510) 843-6372 to talk to him about bringing such a case.

"Foster children are singled out for psychiatric drugging because they and their foster parents have almost no legal protections and no way they can refuse these damaging drugs," says Mr. Chabasinski, who as a foster child, was electroshocked at the age of six as part of an experiment involving hundreds of foster children.

While PsychRights and Mr. Chabasinski are not bringing these cases for the money, such cases represent a tremendous financial opportunity for attorneys to do well by doing good.
"These are about as open and shut as cases can get," said Mr. Gottstein.

"It is Medicaid fraud to cause or submit prescriptions to Medicaid for reimbursement if they are not for a medically accepted indication. End of story."

PsychRights has developed a Medically Accepted Indications Chart showing what is allowable for common psychiatric drugs. Every other use of these drugs in children and youth and submitted to Medicaid is fraudulent. http://psychrights.org/Education/ModelQuiTam/PediatricPsychotropicMedicallyAcceptedIndications.pdf PsychRights conservatively estimates that at least half of psychotropic drug prescriptions to children and youth submitted to Medicaid are not for medically accepted indications and therefore fraudulent.

*The posts made in this blog are of our opinion only* Without Prejudice UCC 1-207