January 15, 2019 / For Immediate Release
Everett Stern, the whistleblower who uncovered major financial crimes at one of the world’s largest banks, today released confidential emails, obtained through the Freedom of Information Act, from senior officials at the troubled Michigan Department of Health & Human Services (MDHHS).
The emails, from 2017, expose incompetence, mismanagement, and confusion on the part of Michigan officials running the state’s multi-million-dollar programs designed to deliver non-medical Medicaid-paid services to sick and elderly Michigan residents in need of crucial at-home care.
The emails make clear that:
- MDHHS employees disabled a federally-approved computer program (called “Edit 1221”) designed to monitor home health services and prevent fraud
- When it was first deployed in 2010, MDHHS workers said “Edit 1221” was creating a burdensome number of false positives. Instead of simply fixing the glitch, a bureaucrat decided to disable the software in June 2010
- This allowed home health aide payments to be made without review, with checks automatically created and sent out while the case files slipped down a dark hole without a determination if appropriate care had been provided
- As the emails state, the state officials disabled the software program to “to ease the burden on claims processing staff”
- As a result, thousands of claims filed by Michigan home health agencies were incorrectly reimbursed
- The edit function software was turned off for more than six years before MDHHS managers discovered there was a problem
- Even after the problem was identified, it took weeks before state workers turned the software function back on
- Senior MDHHS managers were deeply concerned about the reaction of home health providers, once they were notified of the claim payment errors (which totaled more than $1 million)
Additionally, a separate MDHHS email “reminder” sent to Michigan home-health providers in May of 2017 states that all claims paid in error as a result of the software program glitch would be voided. The state informed health providers that it was going to recover ALL of the overpayments they received after January 2011. In essence, the providers were punished for a computer glitch that wasn’t addressed by MDHHS bureaucrats for more than six years.
Tactical Rabbit has turned over all of the emails here, as well as a detailed intelligence report, to the FBI’s Detroit field office. The FBI has acknowledged receipt of these documents, and Tactical Rabbit is hopeful that the FBI has launched an investigation into this troubling matter.
MDHHS FOIA Emails