From US DOJ; 24 individuals and businesses charged with $1.2 billion in medicare/medicaid fraud

This is exactly the reason why we do not have universal health care. This fraud has got to go.

https://www.justice.gov/opa/pr/federal-indictments-and-law-enforcement-actions-one-largest-health-care-fraud-schemes?fbclid=IwAR0VaKqGgmLl3khIV9GElPJH5iYWuYJrCvnNZyha9Qu3PksPX5WZAFKIA3I

Federal Indictments & Law Enforcement Actions in One of the Largest Health Care Fraud Schemes Involving Telemedicine and Durable Medical Equipment Marketing Executives Results in Charges Against 24 Individuals Responsible for Over $1.2 Billion in Losses

Hundreds of Thousands of Elderly and/or Disabled Patients Nationwide and Abroad Lured into Criminal Scheme; Center for Program Integrity, Center for Medicare Services, Takes Administrative Action Against 130 DME Companies That Submitted Over $1.7 Billion

One of the largest health care fraud schemes investigated by the FBI and the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) and prosecuted by the Department of Justice resulted in charges against 24 defendants, including the CEOs, COOs and others associated with five telemedicine companies, the owners of dozens of durable medical equipment (DME) companies and three licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $1.2 billion in loss, as well as the execution of over 80 search warrants in 17 federal districts.  In addition, the Center for Medicare Services, Center for Program Integrity (CMS/CPI) announced today that it took adverse administrative action against 130 DME companies that had submitted over $1.7 billion in claims and were paid over $900 million.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Sherri A. Lydon of the District of South Carolina, U.S. Attorney Craig Carpenito of the District of New Jersey, U.S. Attorney Maria Chapa Lopez of the Middle District of Florida, Assistant Director Robert Johnson of the FBI’s Criminal Investigative Division, Deputy Inspector General for Investigations Gary Cantrell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Chief Don Fort of the IRS Criminal Investigation (CI) and Deputy Administrator and Director of CPI Alec Alexander of the CMS/CPI made the announcement.

Today’s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division’s Fraud Section in conjunction with its Medicare Fraud Strike Force (MFSF), as well as the U.S. Attorney’s Offices for the Districts of South Carolina, New Jersey and the Middle District of Florida.  The MFSF is a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG.  In addition, IRS-CI and other federal law enforcement agencies participated in the operation.

The charges announced today target an alleged scheme involving the payment of illegal kickbacks and bribes by DME companies in exchange for the referral of Medicare beneficiaries by medical professionals working with fraudulent telemedicine companies for back, shoulder, wrist and knee braces that are medically unnecessary.  Some of the defendants allegedly controlled an international telemarketing network that lured over hundreds of thousands of elderly and/or disabled patients into a criminal scheme that crossed borders, involving call centers in the Philippines and throughout Latin America.  The defendants allegedly paid doctors to prescribe DME either without any patient interaction or with only a brief telephonic conversation with patients they had never met or seen.  The proceeds of the fraudulent scheme were allegedly laundered through international shell corporations and used to purchase exotic automobiles, yachts and luxury real estate in the United States and abroad.

“These defendants — who range from corporate executives to medical professionals — allegedly participated in an expansive and sophisticated fraud to exploit telemedicine technology meant for patients otherwise unable to access health care,” said Assistant Attorney General Benczkowski.  “This Department of Justice will not tolerate medical professionals and executives who look to line their pockets by cheating our health care programs.  I commend the Criminal Division prosecutors and our partners from U.S. Attorney’s Offices and law enforcement agencies across the country for their unrelenting efforts to stop this alleged fraud before more money was stolen from American taxpayers.”

“Simply put, the law applies equally to all in South Carolina,” said U.S. Attorney Sherri Lydon.  “The same spoon that serves indictments on drug dealers, felons in possession of firearms, and corrupt officials will also feed those companies and individuals who engage in Medicare fraud.  White collar crime is not victimless.  All taxpayers will endure the rising cost of health care premiums and out-of-pocket costs as a result of fraud on our Medicare system.  I am honored to stand with our partners at the FBI, HHS-OIG, and IRS-CI, who led this outstanding and nationally significant investigation from right here in South Carolina.”

“The indictments we are unsealing today charge the defendants with running a complex, multilayered scheme to defraud our Medicare system and avoid detection by government regulators,” said U.S. Attorney Craig Carpenito.  “The defendants took advantage of unwitting patients who were simply trying to get relief from their health concerns.  Instead, the defendants preyed upon their weakened state and pushed millions of dollars’ worth of unnecessary medical devices, which Medicare paid for, and then set up an elaborate system for laundering their ill-gotten proceeds. We are proud to join our law enforcement partners in New Jersey and around the country to put a stop to this unscrupulous criminal activity.”

“Protecting the integrity of America’s health care programs is necessary to ensure that our citizens receive the care they have paid for and deserve,” said U.S. Attorney Chapa Lopez.  “The mammoth coordination and cooperation demonstrated among the various offices, districts, and agencies involved in this case leaves no doubt. We will leverage the full weight of our resources to combat fraud and abuse, wherever it is found.”

“Today, one of the largest health care fraud schemes in U.S. history came to an end thanks to close collaboration and coordination between the FBI and partners including HHS-OIG and IRS-CI,” said FBI Assistant Director Robert Johnson.  “Health care fraud causes billions of dollars in losses, it deprives real patients of the critical health care services they need, and it can endanger the lives of real patients so individuals like those arrested today can profit from their criminal activity.  Through today’s coordinated national effort, we put an end to this egregious and costly health care fraud scheme, and the public can rest assured the FBI will continue to make health care fraud investigations a top priority.”

“Our law enforcement officers are focused on preventing and uprooting health care fraud schemes like those alleged today,” said Deputy Inspector General for Investigations Gary Cantrell.  “These schemes divert money from taxpayer-funded federal health care programs into the hands of criminals.  Working closely with our law enforcement partners, our agency will continue to investigate and disrupt attempts to undermine Medicare and target beneficiaries.”

“The breadth of this nationwide conspiracy should be frightening to all who rely on some form of healthcare,” said IRS-CI Chief Don Fort.  “The conspiracy described in this indictment was not perpetrated by one individual.  Rather, it details broad corruption, massive amounts of greed, and systemic flaws in our healthcare system that were exploited by the defendants.  We all suffer when schemes like this go undiscovered and I’m proud of the work our agents did in working with our partners to uncover this complex scheme.”

“The Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity (CPI) is proud to work very closely everyday with our law enforcement partners to stop exploitation of vulnerable patients and misuse of taxpayer dollars,” said Deputy Administrator and CPI Director Alec Alexander.  “In this case CMS has taken swift administrative action and has suspended payments to 130 distinct providers thereby likely preventing billions of additional dollars in losses.  CMS remains committed to protecting the millions of beneficiaries we are honored to serve and to preventing fraud of all sorts in the Medicare and Medicaid programs.”

According to allegations in court documents, some of the defendants obtained patients for the scheme by using an international call center that advertised to Medicare beneficiaries and “up-sold” the beneficiaries to get them to accept numerous “free or low-cost” DME braces, regardless of medical necessity.  The international call center allegedly paid illegal kickbacks and bribes to telemedicine companies to obtain DME orders for these Medicare beneficiaries.  The telemedicine companies then allegedly paid physicians to write medically unnecessary DME orders.  Finally, the international call center sold the DME orders that it obtained from the telemedicine companies to DME companies, which fraudulently billed Medicare.  Collectively, the CEOs, COOs, executives, business owners and medical professionals involved in the conspiracy are accused of causing over $1 billion in loss.

The Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

*********

Amongst those charged by Strike Force attorneys include:

In the District of New Jersey, charges were brought against Creaghan Harry, 51, of Highland Beach, Florida; Lester Stockett, 51, of Deefield Beach, Florida; and Elliot Loewenstern, 56, of Boca Raton, Florida; the owner, CEO and VP of marketing, respectively, of purported call centers and telemedicine companies, for their alleged participation in a $424 million illegal health care kickback and international money laundering scheme related to the solicitation of illegal kickbacks and bribes in exchange for the referral of DME orders to DME providers.  In addition, Joseph DeCoroso, M.D., 62, of Toms River, New Jersey, was charged in a $13 million conspiracy to commit health care fraud and separate charges of health care fraud for writing medically unnecessary orders for DME, in many instances without ever speaking to the patients, while working for two telemedicine companies.  The cases are being prosecuted by Fraud Section Acting Assistant Chief Jacob Foster and Trial Attorney Darren Halverson.

In the Middle District of Florida, charges were brought against Willie McNeal, 42, of Spring Hill, Florida, the owner and CEO of two purported telemedicine companies, for his alleged participation in a $250 million scheme related to the solicitation of illegal kickbacks and bribes in exchange for the referral of DME orders to DME providers.  The case is being prosecuted by Fraud Section Acting Assistant Chief Jacob Foster and Trial Attorneys John Michelich, Catherine Wagner and Sara Clingan.

In the Northern District of Texas, charges were brought against Leah Hagen, 48, and Michael Hagen, 51, of Dalworthington Gardens, Texas, owners and operators of two DME companies, for their alleged participation in a $17 million illegal health care kickback scheme related to the payment of kickbacks in exchange for the referral of medically unnecessary DME orders.  The case is being prosecuted by Fraud Section Trial Attorneys Brynn Schiess and Carlos Lopez.

In the Western District of Texas, Christopher O’Hara, 54, of Kingsbury, Texas, the owner of a purported telemedicine company, was charged in an $40 million scheme related to the alleged solicitation of illegal kickbacks and bribes in exchange for the referral of DME orders to DME providers.  The case is being prosecuted by Fraud Section Trial Attorney Kevin Lowell.

In the Eastern District of Pennsylvania, Randy Swackhammer, M.D., 60, of Goldsboro, North Carolina, was charged for an alleged $5 million conspiracy to commit health care fraud that involved writing medically unnecessary orders for DME while working for a telemedicine company, in many instances with only a brief telephonic conversation with the patients.  The case is being prosecuted by Fraud Section Trial Attorney Adam Yoffie.

In the Central District of California, charges were brought against Darin Flashberg, 41, of Glendora, California, and Najib Jabbour, 47, of Glendora, California, owners of seven DME companies, for their alleged participation in a $34 million scheme related to their payment of kickbacks and bribes in exchange for medically unnecessary DME orders.  The case is being prosecuted by Fraud Section Trial Attorney Robyn Pullio.

*********

In addition to the Strike Force prosecutions, other enforcement actions were taken, including the execution of search warrants to support related investigative efforts in seven additional U.S. Attorney’s Offices to include in various investigations conducted by the District of New Jersey, District of South Carolina, Southern District of California, District of Nebraska, Middle District of Florida, Eastern District of Missouri and Western District of Washington.
In the District of South Carolina, charges were brought against Andrew Chmiel, 43, of Mt. Pleasant, South Carolina, owner of over a dozen companies involved in the scheme, for his alleged participation in a $200 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary DME orders.  The cases are being prosecuted by Assistant U.S. Attorneys Jim May and Will Lewis of the District of South Carolina.

In the District of New Jersey, charges were brought against Neal Williamsky 59, of Marlboro, New Jersey, and Nadia Levit, 39, of Englishtown, New Jersey, owners of approximately 25 DME companies, for their alleged participation in a $150 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary DME orders.  Albert Davydov, 26, of Rego Park, New York, was also charged for his alleged participation in a $35 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary DME orders.  The cases are being prosecuted by Assistant U.S. Attorneys Brian Urbano and Stephen Ferketic of the District of New Jersey.

In the Middle District of Florida, search and seizure warrants are being executed at 20 different business locations, including numerous DME companies and a fraudulent telemarketing company. The search and seizures are being executed by over 100 law-enforcement officers from six federal agencies, including HHS-OIG, FBI, IRS-CI, VA-OIG, SSA-OIG, and USPS-OIG.  In addition to the 20 search warrants, millions of dollars and other assets tied to the conspiracy are being seized and/or frozen, including through a civil injunction naming 13 defendants as authorized under 18 U.S.C. § 1345.

The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with MFSF teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices in the District of New Jersey, District of South Carolina, Southern District of California, District of Nebraska, Middle District of Florida, Eastern District of Missouri and Western District of Washington; and agents from the FBI, HHS-OIG, IRS-CI and other federal law enforcement agencies.

A complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Any doctors or medical professionals who have been involved with alleged fraudulent telemedicine and DME marketing schemes – including Video Doctor USA, AffordADoc, Web Doctors Plus, Integrated Support Plus and First Care MD – should call to report this conduct to the FBI hotline at 1-800-CALL-FBI.

Additional documents related to this announcement will shortly be available here: https://www.justice.gov/opa/documents-and-resources-april-9-2019-press-release-health-care-fraud.

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From FB: Many prescription and non prescription drugs linked to dementia

Common Prescriptions Linked to Increased Dementia Risk

there are a ton of drugs to avoid, but the real problem I am seeing is:

  1. grandma has money AND greedy children.
  2.  grandma is drugged with psychotropic drugs from an unethical MD
  3.   grandma is kidnapped away from her home and drugged.
  4.   grandma is taken to a psychiatrist and he fills out a form she is incompetent (but in reality she is drugged)
  5.   the form is taken to probate
  6.   one of the greedy relatives is appointed Guardian
  7.   Grandma’s home is sold, she is placed in a series of nursing homes and then narcotized to death when the money runs out.

What safeguards are in place to prevent all of this?

 

Answer:  absolutely none. Sykes case, Alan Frake case,  Dolores Bedin case, and many, many others.

We wish it wasn’t the case but, unfortunately, memory loss is a hot topic. People have countless questions about brain diseases such as Alzheimer’s and dementia. What really causes it? Will there ever be a cure? Are there any natural preventatives? How do my other medications that I’m taking affect my risk of such problems?

Many prescriptions have been linked to memory loss! We hope to answer these questions and more below. So, if you or a loved one is worried about or currently living with this problem, please keep reading…

 

How Common Is Alzheimer’s Disease?

Most people associate Alzheimer’s with memory loss, one of first and most common symptoms of the disease. On average, the progressive (and currently) irreversible brain disorder starts affecting people after 60 years of age. [1] However, there are many factors that contribute to an individual’s experience such as their genes, diet, lifestyle habits, and more.

According to Alzheimers.net, there are 44 million people who have Alzheimer’s or a related dementia, approximately 5,700,000 of whom are American. Health officials expect that number to rise to 16 million by 2050. And because it’s the sixth leading cause of death in America – the only one in the top 10 that cannot be cured, prevented, or slowed – it demands everyone’s attention. [1,2]

 

10 Early Warning Signs and Symptoms of Alzheimer’s

  • Memory loss
  • Inability to plan things or solve problems
  • Difficulty completing simple tasks
  • Getting confused about times, dates, and places
  • Inability to understand spatial relationships and visuals
  • New problems when it comes to speaking or writing
  • Forgetting where you put stuff and being unable to retrace steps
  • Increasingly poor judgement
  • Growing less and less social
  • Uncharacteristic changes in mood and personality

How About Dementia?

Not unlike Alzheimer’s disease, the most common form of dementia, general dementia is also a progressive syndrome that impairs your cognitive function. That is, your ability to think, reason, remember, and behave properly (if at all). Many of the symptoms actually overlap with those of Alzheimer’s disease. [1]

Growing by 10 million new cases per year, there are around 50 million people worldwide currently living with dementia… According to the World Health Organization, that’s a figure that we expect to hit 82,000,000 by 2030 and 152,000,000. [4]

Although these numbers are alarming, there are numerous ways to decrease your risk of development Alzheimer’s disease or other forms of dementia – naturally and otherwise. But the possibility of keeping the number of dementia cases to a minimum seems unlikely when so many people are on medications that can increase the likelihood of getting it.

 

Common Drugs Like Benadryl Linked to Increased Dementia Risk

In March 2015, researchers published a prospective cohort study in JAMA Internal Medicine called “Cumulative Use of Strong Anticholinergics and Incident Dementia.” The University of Washington and Seattle healthcare system, Group Health, conducted the long-term study which tracked 3,434 men and women who were aged 65 and up, and had no dementia when the study began. [5]

The team accessed every participant’s history of drug use for the previous decade, including both over-the-counter and prescription drugs. Over a 7-year timeline, they followed up with all the participants every two years, during which 797 participants developed dementia (637 of whom developed Alzheimer’s disease).

As researchers looked back on what those 797 individuals took, anticholinergic drugsbecame the main suspect. The most common anticholinergics participants used were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics. Compared to those who didn’t take anticholinergic drugs, people who did for as little as three years were 54% more likely to develop dementia.

What Are Anticholinergics?

Usually, these types of drugs are prescribed to treat problems including urinary incontinence, Parkinson’s disease, and chronic obstructive pulmonary disorder (COPD). Anticholinergic drugs’ main purpose is to block the actions and effects of acetylcholine, a neurotransmitter which causes muscles to contract, activates pain responses and regulates endocrine and REM sleep functions. [6]

It’s just a natural fact of life – as we age, our bodies’ ability to produce acetylcholine decreases. [7] Since the brain actually contains many acetylcholine-producing cells, as Harvard editor Beverly Merz highlights, “blocking its effects can deliver a double whammy to older people.” [8]

If you want to keep your head clear and brain functioning as highly as possible, steering clear of anticholinergic drugs seems ideal. However, it is important to recognize that the long-term study revealed only a small portion of drugs was interfering with cognitive function. So, please discuss with your doctor if you’re thinking of getting off any prescribed medications.

 

Experiencing Memory Loss? It’s Not Necessarily Alzheimer’s

There are reversible dementias that, although worrisome, people can treat and even overcome. Some of these problems might surprise you: [9]

1) Delirium

Although this condition seems similar to dementia, the mental changes that occur in delirium happen within days in comparison to months or years. Another key distinction between these two problems is that with dementia, you maintain consciousness; with delirium, you don’t.

2) Depression

People with depression have likely experienced moments of forgetfulness and disorientation. A simple way to tell the difference between depression and dementia is looking at the timeline. Depressed people become depressed first and experience memory-related symptoms later, whereas people with dementia become depressed as a result of their declining cognitive function.

3) Vitamin B12 Deficiency

This crucial deficiency can lead to pernicious anemia, a rare condition associated with confusion, slowness, apathy, and irritability.

4) Thyroid Disease

Individuals with hypothyroidism will likely exhibit dementia-like symptoms.

5) Alcoholism

People who are alcoholics can suffer bouts of confusion and amnesia which can mimic the same experiences as someone with Alzheimer’s disease. Although alcoholism can deteriorate the ability to remember and orientate oneself, abstinence and overcoming addiction can help reverse side effects.

 

Sources: 
theheartysoul.com

[2] Alzheimer’s Statistics. (n.d.). Retrieved from https://www.alzheimers.net/resources/alzheimers-statistics/

[3] 10 Early Signs and Symptoms of Alzheimer’s. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/10_signs

[4] Dementia. (n.d.). Retrieved from http://www.who.int/news-room/fact-sheets/detail/dementia

[5] Gray, S. L. (2015, March 01). Strong Anticholinergics and Incident Dementia. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2091745

[6] Anticholinergics: List, Side Effects, and More. (n.d.). Retrieved from https://www.healthline.com/health/anticholinergics

[7] Acetylcholine (ACh). (n.d.). Retrieved from http://memorylossonline.com/glossary/acetylcholine.html

[8] Merz, B. (2017, May 23). Common anticholinergic drugs like Benadryl linked to increased dementia risk. Retrieved from https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667

[9] What’s Causing Your Memory Loss? (n.d.). Retrieved from https://www.helpguide.org/harvard/whats-causing-your-memory-loss.htm#top

[1] Alzheimer’s Disease Fact Sheet. (n.d.). Retrieved from https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet

From FB: New Hamp. is the leader in human rights and civil rights violations. What a goal?

http://www.peteearley.com/2019/04/09/new-hampshire-puts-mentally-ill-in-prison-because-it-lacks-treatment-beds-disability-group-applauds-decision-to-not-built-new-hospital/?fbclid=IwAR2JpczCIAcV0Fy53y9jdUXfvIiKRYvnj5c7pNClOX3MNjPNEHy2dTZQDlc

Therapy cages at state prison

(4-9-19) New Hampshire’s abhorrent practice of housing its seriously mentally ill citizens, who have not been charged with crimes, inside a state prison rather than treating them in a hospital is again making headlines.

Governor Chris Sununu sought to stop this horrific practice by requesting $26 million in funding to build a 60-bed state hospital that would be opened by June 2021 with its own secure unit.

But Democrats on the state’s finance committee rejected Sununu’s plan, opting instead to spend $5 million to renovate rooms in an existing state hospital for a limited number of higher-need patients.

What makes this dispute newsworthy is it has pitted two groups, both created to help patients, against each other.

Disability Rights Center-NH opposed building a new state hospital. In a statement, it agreed that civilly committed patients should not be housed in a state prison, but it argued that building a new state hospital would “divert precious funds and workforce from where they are most needed: community-based mental health services.”

 “Spending millions of dollars to significantly expand the state’s mental health health institutional bed capacity undermines the state’s ability to invest in much needed sustainable changes to the state’s community mental health system.” 

It called for more spending on assertive community treatment, supportive housing, supported employment and mobile crisis response teams.

The CEO of the New Hampshire (state) Hospital, Lori Shibinette, issued a sharply-worded rebuttal. The need for a 60-bed facility was documented through a “thorough, public and collaborative process” during a two year period, she noted. The Disability Center’s preferred alternatives, she said, “would do absolutely nothing to help people in hospital emergency departments (needing) a bed in a psychiatric facility…”

For the most seriously mentally ill patients, she wrote, such programs as housing first, assertive community treatment, job help and other supports simply are “stop gap measures at best.”

Sadly, while this debate is going on, there are no immediate plans to stop sending patients, who have been involuntarily committed, to the state prison. Although their only crime is that they got sick, they are housed behind barbed wire fences and relegated to solitary confinement.

Republicans could try to restore the governor’s plan when the finance committee’s recommendations are voted on April 11th, but that is judged unlikely.

The underlying issue here is a never ending argument about whether or not all individuals with serious mental illnesses can have their needs met in a community or if some need longer term care.

This is not a new debate nor are the two sides newcomers to it.

The Disability Rights Center – NH is part of a national network of what commonly are known as Protection and Advocacy [ P&A] organizations. Here’s their roots.

The Protection and Advocacy concept was initially triggered by a series of local television news broadcasts that Geraldo Rivera did for the ABC News affiliate in New York City in 1972. Rivera’s investigative reporting exposed abuse, neglect and lack of services and supports at Willowbrook, a state institution for people with intellectual and other disabilities on Staten Island. These broadcasts galvanized the state’s senior senator, Jacob Javits, to action, incorporating the first P&A program – PADD (Protection and Advocacy for People with Developmental Disabilities) – in 1975 in the renewal of the Developmental Disabilities Assistance and Bill of Rights (DD) Act.

The DD Act provided for the governor of each state to designate an agency to be the P&A and to assure that the P&A was, and would remain, independent of any service provider… The initial focus of PADD and subsequent P&A statutes was to safeguard the well-being of individuals living in institutions…

While P&As were created to monitor and protect persons in institutions, over time, most have expanded their mission to become advocates for all disability issues.  In this role, P&As have fought against the construction of any new institutions.

I will yield to legislative experts here, but my reading of Sen. Javits’ legislation finds no language stating that P&A’s should block construction of hospitals. Rather, this thinking appears based on the argument that institutions, by their nature, are dehumanizing and destructive to mental health.

While this proved true in our past, there are mental hospitals that are humane and help patients. A prime example is McLean Hospital. But these hospitals are only available to those with big checkbooks. They have managed to avoid the horrors of the old state hospital system because they are well-funded.

So what is the answer?

The solution for both sides would be to stop fighting over scraps and demand that individuals with mental illnesses have a full array of services available to meet their individual needs – whether that be longer term care, crisis care or community assistance. Persons with mental illnesses are not cogs.

The New Hampshire legislature would be wise to listen to what CEO Lori Shibinette wrote in her statement about the most seriously mentally ill: “We need to stop trying to fit this population into a system of care that does not meet their needs.”

from FB: UK Supreme Court rules foster children can sue for sexual and physical abuse–no excuses; local authorities do have a duty to keep kids safe from abuse

here is the decision:

https://www.supremecourt.uk/cases/docs/uksc-2016-0004-judgment.pdf

here is the press release:

 

18 October 2017
PRESS SUMMARY
Armes (Appellant) v Nottinghamshire County Council (Respondent) [2017] UKSC 60
On appeal from [2015] EWCA Civ 1139
JUSTICES: Lady Hale, Lord Kerr, Lord Clarke, Lord Reed, Lord Hughes
BACKGROUND TO THE APPEAL
The appellant was in the care of the respondent local authority from the ages of seven to eighteen. The local authority placed her into foster care with Mr and Mrs A between March 1985 and March 1986, and with Mr and Mrs B between October 1987 and February 1988. She was physically and emotionally abused by Mrs A, and sexually abused by Mr B.
The case proceeded on the basis that the local authority were not negligent in the selection or supervision of the foster parents, but that they were nevertheless liable for the abuse perpetrated by her foster carers.
She claimed that the local authority were liable for the abuse, either on the basis that they were in breach of a non-delegable duty, or on the basis that they were vicariously liable for the wrongdoing of the foster parents. Her claim was dismissed by the High Court and the Court of Appeal.
JUDGMENT
The Supreme Court allows the appeal by a majority of 4-1, finding the local authority vicariously liable for the abuse committed by the foster parents, but rejecting the argument that the local authority were liable on the basis of a non-delegable duty. Lord Reed gives the lead judgment, with which Lady Hale, Lord Kerr and Lord Clarke agree. Lord Hughes gives a dissenting judgment.
REASONS FOR THE JUDGMENT
References in square brackets are to paragraphs in the judgment
Non-delegable duty of care
A local authority are not under a non-delegable duty to ensure that reasonable care is taken for the safety of children in care while they are in the care and control of foster parents. Such a proposition is too broad, and fixes local authorities with too demanding a responsibility [49]. The following reasons are given:
• The Child Care Act 1980 (“the 1980 Act”) permits a local authority to arrange for children in care to spend time staying with their parents or grandparents, or other relatives or friends.
Imposing a strict liability on local authorities for the lack of care of those relatives or friends would risk creating a conflict between the local authority’s duty, under section 18(1) of the 1980 Act, to give first consideration to the need to safeguard and promote the welfare of the child, and their interests in avoiding exposure to such liability. It would also risk creating a form of state insurance in situations where the local authority place the child with the child’s own parents [45].
• The 1980 Act required the local authority to “discharge” the duty to provide accommodation and maintenance for a child, including by placing the child with foster parents. This implies that, although the local authority have numerous duties towards the child, their duty is not to provide the child with day to day care, but rather to arrange for, and monitor, the performance of that function by the foster parents [46-47].
• The Secretary of State makes regulations under section 22 of the 1980 Act imposing duties on local authorities in relation to the boarding out of children. The implication of section 22 is that the local authority’s continuing responsibility for the child is discharged by boarding-out the child in accordance with those regulations, including by prior approval of the household, and subsequent inspection, supervision and removal. The statutory regime does not impose any responsibility for the day to day care of the child [48].
Vicarious liability
Applying the principles set out in Cox v Ministry of Justice [2016] UKSC 10 on the imposition of vicarious liability, the local authority are vicariously liable for the acts of the foster parents in the present case for the following reasons:
• Integration and business activity: The local authority carried out the recruitment, selection and training of foster parents, paid their expenses, and supervised the fostering. In those circumstances, the foster parents were not carrying on an independent business of their own, and it is impossible to draw a sharp distinction between the activity of the local authority and that of the foster parents. Thus the abuse committed by the foster parents against the claimant was committed by the foster parents in the course of an activity carried on for the benefit of the local authority [59-60].
• Creation of risk: The placement of children with foster parents creates a relationship of authority and trust between the foster parents and children in circumstances where close control cannot be exercised by the local authority. This renders the children particularly vulnerable to abuse [61].
• Control: The local authority exercised a significant degree of control over the foster parents: it exercised powers of approval, inspection, supervision and removal [62]. Micro-management, or a high degree of control, are not necessary for the imposition of vicarious liability [65].
• Ability to pay damages: Most foster parents have insufficient means to meet a substantial award of damages, whilst local authorities can more easily compensate the victims of abuse [63].
• There was no evidence to suggest that imposing vicarious liability would discourage local authorities from placing children in care with foster parents, and encourage them instead to place them in residential homes, at much greater cost. [68].
In response to the concerns raised by Lord Hughes: (1) The approach adopted would not have resulted in the imposition of vicarious liability if the appellant had been placed with her own parents. (2) This decision is concerned only with the legislation and practice that was in force at the relevant time, not with the current regime. (3) The courts’ care not to impose unduly exacting standards in the context of
family life applies equally to life in foster families [71-73].
Lord Hughes gives a dissenting judgment on the vicarious liability issue. He considers that the majority’s approach would extend vicarious liability to family and friend placements under the current statutory regime, and consequently inhibit local authorities’ practice of making such placements. Finally, he considers that it may result in undesirable litigation of family activity in the courts [87-90].
NOTE
This summary is provided to assist in understanding the Court’s decision. It does not form part of the reasons for the decision. The full judgment of the Court is the only authoritative document. Judgments are public documents and are available at:
http://supremecourt.uk/decided-cases/index.html

 

 

 

 

From KD: Media blackout on Esformes Case $1 Billion hidden from the public in health care fraud.

It is interesting to see the almost total media blackout on the case of the Century.    Philip Esformes was being tried in the Southern District of Florida (Miami) for stealing a billion dollars in Medicare funds.   (Yes – 9 zeroes! one thousand million dollars).
The case is a smorgasbord as to steal a billion dollars Philip had to have alliances with the POLITICAL ELITE, the Judicial elite, and every corruptible segment of society.   Indeed, the Esformes empire included nursing homes in Florida, Illinois, Missouri etc and corruption that was almost unbelievable.
Previously in the Alice Gore case and others we noted the relationship between GUARDIANSHIP and the HUMAN TRAFFICKING in the Elderly, but, in this criminal proceeding an opportunity was presented for exposing all the felonies of ELDER CLEANSING and the entire corruption required to foster the criminal enterprise.
Here in Illinois ‘guardianship’ is a key element in the Elder Cleansing – human trafficking in the elderly movement.   755 ILCS 5/11a – 3 sets the criteria and 755 ILCS 5/11a – 10 sets the jurisdictional limitations and procedure.   The Mary Sykes case 09 P 4585 on its face demonstrates the corruption of the system.    For instance, in every lawsuit the matter starts with the service of summons.   The Sheriff has denied summons being served.   The statute requires the summons to be unique and specifies how it is unique.   The clerks’ office was not distributing such a summons, and the file indicates that not only was such a summons not tendered to the sheriff to serve, but the petitioner seeking to be appointed guardian made certain that Mary was not served – she attempted to serve summons at an address she knew Mary did not reside at.
The Petitioner knew, because she had Mary isolated in her (the Petitioner’s) home.   The Judge was also aware of this corruption – she appointed a 2nd GAL because GAL number 1 did not want to go out to DuPage County to interview Mary.   There are other substantial corruptions connoted such as the fact that the Judge never held a hearing required by 755 ILCS 5/11a – 3, or the Fifth and 14th Amendment and thus there was no prior notice to the next of Kin (also required by statute and jurisdictional).    (It was believed that the Esformes machine was also involved in this case).
The blogs AAAPG (Dr. Sam Sugar), NASGA, Probate Sharks, and MaryGSykes all detail the scandal.    The New Yorker, the NY Times and even the Wall Street Journal have detailed this horrific amorality and scandal, BUT in a manner characterized as benign neglect and reasonably calculated to not disturb the status quo.
A docket entry appears to indicate that Mr. Esformes is changing his plea and the case is terminating.   If Mr. Esformes is going to co-operate with the United States of America it would behoove the 2nd oldest profession to lead in the HONEST INVESTIGATION and give meaning to the oath that every lawyer takes as a condition to be admitted to the bar.
Currently,  the public is aware that when Lawyer JoAnne Denison disclosed the corruption that is essential to ELDER CLEANSING and the human trafficking in the elderly, the Attorney Registration and Disciplinary Commission sought an emergency suspension of her law license.   The IARDC characterized the disclosure of corruption on the bench to be akin to “yelling fire in a crowded theater.”   The Illinois Supreme Court infamously agreed.    Of course there was no hue and cry from the profession!
However, a second chance is being made available.   The profession can accept its position of benign neglect of its oath and responsibility or it can redeem itself.    The first act, in my opinion, would be to broadcast the revelations of this trial to the profession so that IT can ferret out HEALTH CARE FELONIES and those who are robbing our government.
NB.  I do not expect much from the Political elite – but, as we all get old and infirm – and thus potential victims – we have personal interests to consider.    An Esformes co-conspirator made it clear – the miscreants consider us to be a commodity!

Ken Ditkowsky

From KD: $1 Billion health care fraud scheme ends today with plea deal

I have no idea why major news media isn’t covering this story,  but you all know from my blog and FB page that Ken Ditkowsky and I have been following the Philip Esformes Trial.

Apparently, he has made a plea deal to a life sentence and to refund $1 Billion to Medicare/Medicaid.

Others were involved in this scheme and entered into plea deals.

Phillip Esformes and his family and friends operated nursing homes in the Mimi Dade area and over billed, double billed, submitted false and fraudulent bills.

The Larkin Hospital was involved, but I don’t know if the owner/operators are related to Jerome Larkin, head of the ARDC, which would explain a whole lot of why Jerome Larkin (together with Melissa Smart and Sharon Opryszek) went after me and Ken for publishing about the Mary Sykes case (a woman stripped of all her assets, forced into a nursing home and who was murdered in the end, with food and water being withdrawn while under heavy sedation).

It probably all does tie together, but the FBI/DOJ has this information and they’re not sharing.

Also, Phillip and Morris Esformes ran these fraudulent operations in Chicago and in many other areas, so don’t feel sorry PE was charged with $1 B in fraud and had to pay $1 B in fraud, because this case was only about one limited area for about 5 years.  News articles indicate this has been going on for decades in numerous areas by the Esformes fraud friends and family program.

here is one article on the trial:

https://www.miamiherald.com/news/local/article225176275.html

here is another case on how dirty Esformes fraud money was laundered to getting some dumb kid into an Ivy League school (not surprised)

https://www.miamiherald.com/news/local/crime/article219602620.html

(aren’t we tired of stupid kids getting a mass money fraud pass into Ivy League schools?)

Here is yet another article describing how patients were discharged from Larkin hospital in Miami, shuffled off to nursing home and assisted living for bribes (often described as escort services or charitable donations), and then never received the care they needed, but of course Medicare/Medicaid was billed for it.

https://www.mcknights.com/news/former-hospital-director-physicians-assistant-plead-guilty-in-1-billion-esformes-fraud-scheme/

I understand that numerous others have pled in this $1 Billion Esformes scandal.  The worst part about all of this is that it victimized the elderly and disabled, the most vulnerable of US citizens–and they were either denied services they desperately needed, or they received services they did not need, including false amputations for diabetes they never had and heart procedures when they had no heart disease, etc.

I am most gratefule that the DOJ/FBI and HHS is cleaning up this mess.

This is the major and no. 1 reason why we don’t have Universal Health Care–it’s because of this type of massive fraud.

The FBI/DOJ – HHS fraud team recovers $8 for every $1 spent on prosecutions. This needs to be expanded.  Clearly health care payments via Medicare and Medicaid need a whole lot more oversight.

Videos actually exist on youtube explaining how one person can easily bilk the US govt for fake Medicare/Medicaid claims of $1 to $2 million in a month or two and the leave the US without a trace.  (No, I will not publish the URLs to these videos, they’re shameful but a good example of what is going on in US healthcare today).

Here is yet another article on the schemes:

https://www.mahanyertl.com/2019/esformes-medicare-fraud-whistleblower/

you can google Esforme and trial or plea deal or a number of phrases to find mostly micro media and blogs on this issue, but the real question is why is the mega media silent on $1 Billion + in fraud?