This publication is from the Michigan’s Independent Source of News & Information, and can be found here.
Published: Wednesday, Dec. 12, 2018
A New York-based whistleblower is claiming the Michigan Department of Health and Human Services (DHHS) committed “three acts of fraud” in connection to a West Bloomfield Township home-health care service.
Everett STERN, CEO of Tactical Rabbit, a “private intelligence agency” offering “expertise in identifying financial wrongdoing” said he was hired by M&Y Care to look into DHHS. His report findings should “prompt” Gov.-elect Gretchen WHITMER and the U.S. DHHS Inspector General “to open a formal investigation.”
“I quickly realized that this was a bigger problem than any one home health care company, and could have an impact on any elderly, low-income or disabled person needing health care services at home in Michigan,” Stern said. “That’s why, today, we released our Intelligence Report looking broadly at the failings of the Michigan Department of Health and Human Services.”
When asked for comment, DHHS spokesperson Lynn SUTFIN issued this statement: “The Michigan Department of Health and Human Services Office of Inspector General (OIG) confirms there is an active and ongoing case involving Medicaid provider M&Y Care. The case is pending a formal administrative appeal at the Michigan Administrative Hearing System.”
Stern’s 15-page report alleges DHHS “personnel disabled a federal-approved computer program,” called Edit 1221, designed to monitor home health programs. The program, he noted, was “intentionally disabled in 2010 by MDHHS insiders to ‘ease the burden on claims processing staff,'” Stern’s report reads, quoting documents he says he received under the Freedom of Information Act.
In one March 2017 email Stern obtained, DHHS staffer noted: “The edit has been off since 2011, so we were not checking for the presence of therapies before approving home care aide services.”
Stern’s report notes that the OIG demanded an audit of nine years of payments to M&Y Health Care, alleging that the home health care service “received more than $600,000 of questionable payments,” but without including details about “why the bills might have been deficient.”
Stern’s report also alleges DHHS is using “outdated requirements” as it relates to home services for patients.
According to his web site, Stern is credited for exposing HSBC Bank’s policies allowing laundering of drug trafficking proceeds.