This Moment in Corrution: Yet Another Misbehaving Home Health Agency

Thursday, August 22, 2019

In the latest announcement (Aug. 15) from Attorney General Maura Healey concerning the work of her department's Medicaid Fraud Division, we learn that a Boston-based home health company, Guardian Healthcare, will be paying $1.95 million "to resolve allegations that it filed claims for payment...that were not certified as medically necessary."

From April 2010 through July 2016, the AG's office said, Guardian "failed to obtain and/or maintain plans of care authorized by a physician for certain patients."

In order for a home health agency to bill MassHealth (the name we give to Medicaid in Massachusetts), a MassHealth patient's physician must review and sign a plan of care certifying that home health services are medically necessary.  Further, home health agencies are required to maintain good records for at least six years after care has been provided and claims for payment have been made.

In addition to laying nearly $2 million on the Commonwealth of Massachusetts, Guardian has agreed to implement "a multi-year, independent compliance program which will involve updating its policies and procedures, training its staff, and conducting annual audits to ensure compliance with federal and state regulations."

The AG's office said the Guardian settlement "is part of a larger effort to combat fraud in the home health program," and cited these other cases:
  • The conviction of the owner of a home health company in May on charges related to fraudulent billing to the tune of $2.5 million.
  • The payment in April of more than $10 million by two home health companies to resolve allegations of billing for unauthorized services.
  • The conviction of the owner of a Boston home health company in August of 2018 on charges stemming from a scheme "to steal millions from MassHealth."
At roughly $17 billion in total spending, MassHealth will account for more than 40 percent of the entire state budget during the current fiscal year, 2020.  (It's important to note that the federal government will reimburse the state for more than half of all that spending.)  The program covers 1.8 million Massachusetts residents, one in every four.

The latest available figures indicate that, in FY 2018, Healey's Medicaid Fraud Division recovered over $45 million for MassHealth.

Spending tax proceeds on the Medicaid Fraud Division is a good investment.  For every dollar earmarked by the legislature for this purpose in FY 18, the Division recovered $11 from the program's bad actors. 

If Former Gaming Chair's a Little Worried, Maybe We All Should Be

Friday, August 9, 2019

The Boston Globe's Shirley Leung had a great idea for a column this past week: invite Steve Crosby, the original (now former) chair of the Massachusetts Gaming Commission, to lunch at the newly opened Encore Boston Harbor casino in Everett and get his reactions to the Wynn Corporation's lavish gambling mecca on the Mystic, ("Ex-chief of gaming panel is wowed by new casino," 8-8-2019). It was Crosby's first visit to the completed casino.

Now, Crosby did a superb job as founding chief executive of the government entity that had the tall order of bringing casino gambling appropriately to life -- of actualizing the will and the vision of the legislature when, in 2011, it legalized gambling at one slots parlor and as many as three casinos in Massachusetts.

He has not yet received the credit due for his model service as commission chair. Over time, I hope what Crosby did in that high-pressure/high-stakes role will be seen in a proper light and he will be esteemed accordingly.

The best part of Leung's column, I felt, was its conclusion, where Crosby expressed concern that Encore Boston Harbor might not generate sufficient revenue to justify the Wynn Corporation's multi-billion-dollar investment -- that is, to make it sufficiently profitable in the eyes of those who make big investments in publicly traded companies. 

My long-lingering, oft-expressed fear that, one day in the not-too-distant future, we will see a casino rescue bill filed in the Massachusetts legislature seemed all of a sudden reasonable.

Excerpt from Leung:

"...then there's the question of whether Wynn Resorts can make a return on its investment.  When the company won the license in 2014, it planned to spend only $1.6 billion, not a billion dollars beyond that.

" 'It's got to cause everyone to pause,' Crosby said. 'Now we all just hold our breath and hope it works.'

"As for his role in shaping the state's casino industry, here's a bit of self reflection: 'Even with many years of experience in high level politics and public life, I underestimated the PR, political and legal maelstrom that establishing casinos would engender.  On top of it, I made my share of mistakes.  So how has it worked out?  I would say so far, so good.  But the truth is we will not know the long-term cost/benefit trade-offs of destination resort casinos for years or even decades.' "

We can thank Crosby for his honesty and candor. 

How's this whole thing with casinos going to work out for Massachusetts?  Who really knows?  Time will tell.

In the meantime, I'd say the odds of a bill being filed to reduce the level of taxation on gambling establishment proceeds from 25%, where it now stands, to somewhere between 15% and 20%, are better than even. 

If the rate isn't cut, gambling chiefs will say, many hundreds of casino and slots parlor jobs will have to be eliminated.

Consider that, in April, revenue at the MGM casino in downtown Springfield was $4 million lower than it had been in March, and that, in no month since it opened (in August, 2018), has MGM Springfield reached its pre-opening projections of $34.8 million in monthly gross revenues.    In April, for example, it grossed $21.8 million.

MGM Springfield officials say they are pleased with its overall performance.  How long will their patience last?

Pledge Dukakis Made 31 Years Ago this Summer Still Challenges the Nation

Thursday, August 8, 2019

More than 30 years have passed since Mike Dukakis was nominated for president by the Democratic Party.  He was in his third term as Massachusetts governor when he accepted the nomination on the final night of the Democratic national convention, July 31, 1988. 

The day after his acceptance speech, Dukakis had a lead in the polls of 17 percentage points over his Republican opponent, Vice President George H.W. Bush.
I remember very well watching that speech on television.  It was a hot night, an exciting night: The Duke was on a path that few ever get to tread.  My extended family and I were vacationing on Cape Cod, staying in a rented house in Harwich, not far from Red River Beach.  I especially remember the pledge given at the conclusion of the speech. 

On the most prominent stage he had ever stood upon, here is what our governor told the world:
“…as I accept your nomination tonight, I can’t help recalling that the first marathon was run in ancient Greece, and that on important occasions like this one, the people of Athens would complete their ceremonies by taking a pledge.

“That pledge – that covenant – is as eloquent and as timely today as it was 2,000 years ago:
‘We will never bring disgrace to this, our country.  We will never bring disgrace to this our country by acts of dishonesty or of cowardice.  We will fight for the ideals of this, our country.  We will revere and obey the law.  We will strive to quicken our sense of civic duty.  Thus, in all these ways, we will transmit this country greater, stronger, prouder and more beautiful than it was transmitted to us.’

“That is my pledge to you, my fellow Democrats.
“And that is my pledge to you, my fellow Americans.”

After that convention, Lee Atwater, the Bush family retainer then serving as chairman of the Republican National Committee, infamously said he was going “to strip the bark off the little bastard (Dukakis)” and “make Willie Horton his running mate.”
Horton was an African American who, while on furlough from a prison in Massachusetts in the time of Dukakis’s governorship, raped a woman in Maryland. 

Team Atwater made a TV ad for Bush on the Horton case that stoked white-vs-black fears and biases.  It was a racist, dishonest piece of propaganda for which Atwater kind of apologized later, shortly before his death at 40 from brain cancer.
“I am sorry for both statements,” Atwater said, meaning his desire to (a) strip the bark off Dukakis, and (b) make Horton his running mate.  He added that he was sorry for the first part because of its “naked cruelty,” and for the second because it made him “sound racist, which I am not.”

He owned up only to doing something that multitudes – mistakenly, in his view -- experienced as racist; he was sorry he had made them feel that way because he himself, of course, was not a racist.  We hear similar things today.
By the end of September 1988, Dukakis’s lead over Bush evaporated.  Five weeks later, Dukakis lost to Bush by more than seven million votes and carried only 10 states and the District of Columbia in the electoral college.

If our country, as transmitted to us down to this moment, is greater, stronger, prouder and more beautiful than it was in 1988, and if dishonesty (on racism, for example) and cowardice (on gun control, for example) have diminished over the past 31 years, I’m having a hard time this week seeing it.




Dem Congressional Primary Choice: Budget Prizes or Progressive Wish List

Saturday, July 27, 2019

I cannot predict who will be voting for Alex Morse in the Democratic primary election for the U.S. House in the First Massachusetts District in September of 2020, but I can tell you who will be voting against Morse in droves: elected and appointed officials in Springfield, Pittsfield, North Adams and many other cities and towns in western Massachusetts.  They won't want to lose the juice of longtime First District incumbent Richard Neal, Morse's primary opponent.  (Nor would I if I lived or held office in that district.)

Neal has been in the Congress as long as Morse has been alive, 30 years.  Now, at the pinnacle of his political career, Neal is at last chairing the Ways & Means Committee, meaning he influences every major budgetary decision at the federal level, including which local, in-state projects get funds from Uncle Sam.

Springfield Mayor Domenic Sarno is one of many office holders in western Massachusetts who are dreaming big because of Neal's newly acquired power.

During a meeting this past Tuesday of the East-West Passenger Rail Advisory Committee, which is reviewing options for binding Springfield to Boston via high-speed rail, Sarno mused on how this could actually be the moment when the people Massachusetts might get the feds to write big checks for the rail link.  "With Neal there, if they (the Congress) do infrastructure (this session), it could happen," he said. 

Sarno was referring to a bill -- long talked about in D.C., supposedly supported by majorities in both parties, but not yet filed -- that would address major infrastructure needs around the nation.

Since 1993, when Neal was first appointed to Ways & Means, pundits and plainfolk have speculated on the positive implications for his district and the entire Commonwealth if he were to become Ways & Means chair one day.

Now that that day has arrived, it's hard to imagine -- but certainly not out of the question -- that the First District would kick Neal to the curb and hand his job to Morse.  After Ayanna Pressley soundly beat 20-year-incumbent Mike Capuano in the Seventh Massachusetts House District last September, we don't laugh at longshots any more.

By the way, Morse told the publication "Mother Jones" he'd "be thrilled to be welcomed into the Squad," the foursome of first-term women members of the House, including Pressley, who have been pushed to the center of the nation's political discourse by President Trump's strategy of endlessly vilifying them on Twitter and at rallies. 

Could Morse be hoping Trump will start assassinating his character, too, thereby eliciting support and donations for his insurgent campaign from Trump haters everywhere?  In the theater of politics, persecution is good box office.

For old line Democrats in the Congress, a new world seems to be taking shape.  They now have to fear being "primaried" from the left by progressives almost as much as Republicans have for 10 years feared Tea Partiers coming at them from the right.

Morse, a graduate of Brown University, achieved boy wonder status in politics on Nov. 8, 2011, when he was elected, at age 22, as the youngest-ever mayor of Holyoke.  He was an even bigger boy wonder than Neal in his day.  (The guy everyone knows as Richie was 30 when elected Springfield City Council president and 34 when elected mayor.) 

We have here a clash both of ideals and generations.  The passions unleashed in contests of this nature guarantee that the race for the Democratic nomination in the First House District will be fierce. 

Neal wins in the end, I say, because he's is more naturally genial and humble than Capuano was, the First District is inherently more conservative than the Seventh, the First District needs the largesse of the federal government more desperately than the Seventh, and a Ways & Means potentate can deliver the goods better than a Squad newbie.


Hats Off to (a) the Inspector General, and (b) the Secretary of State

Monday, July 8, 2019

Let's hope this is an idea whose time has come.

For the second legislative session in a row, Inspector General Glenn Cunha is advocating for a bill that would require trustees of public colleges and universities in Massachusetts to undergo oversight training.

The idea is that many (volunteer) trustees, through no fault of their own, don't understand or fully grasp their powers and responsibilities to police what goes on at their institutions and that they could be whiffing on opportunities to make (paid) administrators toe the line.

When Cunha testified on behalf of House Bill 8, An Act Relative to Higher Education Boards of Trustees, on June 11, he cited the case of former Westfield State University President Evan Dobelle. 

A former mayor of Pittsfield, Dobelle was found in 2014 to have "misused thousands of (state/university) dollars" on personal purchases and international travel, Cunha said in testimony before the Joint Committee on Higher Education.  At the time of the misspending, Westfield State trustees were "unaware" they had the ability to question Dobelle's conduct, Cunha explained.

Previously, Cunha has said Dobelle "set up a dynamic where the board (members) thought they worked for him, rather than the other way around."

If HB 8 were to become law, members of the boards at all public colleges and universities -- there are 29 of them -- would have to go through a day of training devoted to topics such as the state's open meeting law, procurement practices, fraud prevention, fiduciary responsibilities, conflicts of interest, and what constitutes a public record.  Roughly 250 trustees would be covered by the mandate.

During the 2017-18 session, the Joint Committee on Higher Education gave an earlier, identical iteration of the bill a favorable report and sent it to the House Committee on Steering, Policy and Scheduling in the hope that it could be put on the calendar for a vote in the lower branch.  But time ran out: the legislature adjourned on July 31, 2018, without giving it a vote.

Speaking of oversight (and ethics), I'd like to direct your attention to an excellent article by Michael Jonas, which appeared yesterday in the online version of CommonWealth Magazine, "Old friends now in Beacon Hill face-off,"

It concerns the Joe-Friday/by-the-book approach taken by Secretary of State Bill Galvin to the attempt by former House Speaker Sal DiMasi to register as a lobbyist.  When DiMasi tried to register with the Lobbyist Division in the Secretary of State's office, Galvin rejected his application on the ground that DiMasi had been convicted of federal corruption charges and would not be eligible to become a lobbyist, under state law, until 10 years had elapsed since the conviction.  The two have known each other for decades and often socialized during their early days together in the House.

"To longtime Beacon Hill observers, the clash of the two State House veterans is playing out as an awkward conflict between one-time friends," Jonas writes. Galvin, through a spokeswoman, dismisses such talk. 

"It isn't awkward," he bristles, "it's the law."

No matter what is ever said about Bill Galvin, he knows the law, he's honest, and he's got a backbone.

This Moment in Corruption: Fare Collection Boxes Were T Employee's Piggy Bank

Tuesday, July 2, 2019

As a daily rider, I find myself drawn to the bad news emanating from the MBTA with morbid fascination.  There's nearly always something to be fascinated by.

Take the fare hikes that went into effect on July 1, which beaten-down commuters have been yipping about for weeks.  The heat is on every Boston politician to condemn the higher fares and the thinking that led to them.

Or take the scary shortfall in the taxpayer-subsidized T employees pension fund, which provides the unavailable-in-private-sector option of a very early retirement, with lifetime pensions.

The Boston Globe reported on June 29 that the fund is in "the danger zone" because, for the first time in at least three decades, it is less than 50% funded.  "At the close of last year," the Globe article said, "the MBTA Retirement Fund's liabilities climbed past $2.91 billion, more than double the $1.45 billion it reported in assets..."  The fund is under water.

Fact: In 2018, one in three MBTA retirees was younger than 55.

Not all the discouraging T news gets the attention it deserves.  If you have seen anything in the last few days, for example, about the former T employee who pleaded guilty to stealing more than $450,000 from fare collection boxes he was responsible for repairing, you haven't seen (or heard) much. 

One solitary employee-thief was closing in on half a mill in ill-gotten gains when someone finally suspected something funny and ran a sting to bring him down!

According to a press release from the office of MA Attorney General Maura Healey, Stephen P. Fagerberg, age 54, of Dedham, pleaded guilty in Suffolk Superior Court on June 28 to two counts of Larceny Over $1,200 in a Continuous Scheme. 

Judge Linda Giles sentenced Fagerberg to a two-year split sentence, with six months to serve in prison and the balance suspended for two years.  Fagerberg will also have to serve two years of probation on conditions that include his paying $458,694 in restitution and forfeiting all contributions he made to the MBTA Retirement Fund.

As an automated fare technician, Fagerberg repaired fare collection boxes on T buses parked in South Boston.  Healey's office began investigating him in April, 2018.

"Following an undercover operation that included planting marked bills in fare collection boxes that Fagerberg services," the press release said, "authorities found that the defendant deposited the marked bills into his personal bank account via a drive-up ATM."

Fagerberg was indicted in September, 2018.

Let's hope he makes good on the commitment to full restitution.

It Happens in Massachusetts Politics That...

Tuesday, June 25, 2019

-It is just a matter of time before a casino rescue bill is filed in the Massachusetts legislature now that the Encore Boston Harbor resort casino has opened for business in Everett.  Within five years, I predict, Encore owners, likely joined by owners of the MGM casino in Springfield, will be asking their hometown legislators to file a bill to reduce the percentage of their gross receipts taxable by the state from 25 percent, its current limit, to somewhere between 15 and 20 percent.  Without that reduction, they'll be telling us, "Layoffs will begin."  Cue the march on the State House by several hundred vociferous, off-duty casino employees demanding enactment of casino rescue bill.

-The City of Revere is twisting in the wind, all leverage-less, asking in on the casino impacts mitigation game long after it declined to accept its game ticket.  Former Revere Mayor Dan Rizzo, you may recall, fully supported the company that proposed a resort casino for Suffolk Downs, the old racetrack on the East Boston-Revere line, and that was competing for the Eastern Massachusetts casino license against Wynn Resorts and its proposed site, the former locale of a Monsanto chemical factory in Everett.  After Wynn Resorts won the license, Rizzo refused to negotiate a mitigation package with the company to compensate Revere for hardships a casino in Everett might bring, such as increased traffic and smaller bottom lines at local restaurants.  He was holding out hope that the MA Gaming Commission would reverse its Wynn-favorable decision on appeal and grant the license to the Suffolk Downs group.  Today, communities as far away from Everett as Melrose have mitigation deals with Encore but next-door Revere has zip.  Encore execs say the ship sailed long ago for Revere, mitigation-wise.  Nevertheless, current Revere Mayor Brian Arrigo has formed a local Casino Advisory Commission "to track and review the impacts of the opening of Encore Boston Harbor on the local community and businesses."  Arrigo vows he won't stop looking for "alternative avenues to ensure impacts on Revere can be addressed and mitigated appropriately..." 

-U.S. Senator Edward J. Markey delivered a statement pulsing with strong words in response to President Trump's authorization of military strikes against Iran for having shot down a U.S. surveillance drone and for Trump's abrupt cancellation of strikes 10 minutes before they were to be executed.  "Pushed by warmonger John Bolton and Secretary Pompeo," Markey said, "President Trump has abandoned a functioning Iran deal, imposed unnecessary sanctions, re-deployed thousands of U.S. troops to the Middle East, threatened the 'official end of Iran,' and nearly executed an unconstitutional, over-reactive military strike early this morning." 

-True to form, President Trump did not hesitate to pick a fight with the hierarchy of the firefighters union after the union endorsed the presidential candidacy of former Vice President Joe Biden.  Trump dismissed the leaders of the International Association of Fire Fighters as "dues-sucking people" and predicted "the firefighters are going to be voting for me."  In reporting Trump's put-down, the State House News Service pointed out that Ed Kelly, the IAFF's secretary-treasurer, is from Dorchester. 

-Ultimate power broker Jack Connors, Jr., a friend to every deep-pocketed mover and shaker from Massachusetts and beyond, has tentatively climbed aboard the bandwagon of Mayor Pete Buttigieg of South Bend, Indiana, one of 22 Democrat -- or is it 24? -- candidates for President of the U.S.  There was a fundraiser for Buttigieg in Boston (6-20-19) hosted by Connors, Brian Rafanelli and Sharon McNally.  The trio wrote in an invitation email,  "We believe that Mayor Pete Buttigieg just might be the right person to turn the ship around."  And if Pete ain't, Jack, et al. will identify and align with the next right person.

-U.S. Senator Tom Cotton, R-Arkansas, a staunch supporter and defender of President Trump damned U.S. Senator Elizabeth Warren with faint praise when he was in Boston in May and sitting for a radio interview on his newly published book, "Sacred Duty: A Soldier's Tour at Arlington National Cemetery."  Said Cotton, "My history with Elizabeth Warren goes far beyond the U.S. Senate.  She was my very first professor on my first day of law school (at Harvard).  I think Liz was a better professor than she is a senator."  If Cotton wants to stay on the Trump varsity, he'll have to do better than that.

-Massachusetts Attorney General Maura Healey has a good way of deflecting a couple of questions on everyone's mind: one, will she run for governor in 2022, and, two, does she think she could beat Charlie Baker if he decided to seek a third term?  "I'm not in the business of punditry," Healey responded in an interview with WCVB's Ed Harding, adding, "You know, I say this in all seriousness.  I'll continue to say this because I'll probably continue to be asked.  I actually love my job.  I like doing my job.  And it may seem funny for folks to hear that somebody is in a job that they like doing, they're focused on that.  To me, even 2020 and the presidential (race) is just too far away.  We've got to stay focused on what is before us."

-Maura Healey, asked in that same interview how Charlie Baker is doing as governor, was the soul of magnanimity.  "I think he's doing a good job on a lot of fronts," she said.

-Maura Healey is in the thick of the lawsuit filed this week in D.C. against the proposed merger of T-Mobile and Sprint.  "Our year-long investigation," Healey said, referring to the work of the 13 state attorney generals who are party to this action, "found that the proposed merger would give the new company the power to raise prices, significantly reduce competition for customers, lower quality, and cost thousands of retail workers their jobs.  We are challenging this merger to protect a service that matters to everyone."

-A recent audit by the office of State Auditor Suzanne Bump revealed that the Massachusetts Office of Business Development, an agency within the Executive Office of Housing and Economic Development, has never implemented the Buy Massachusetts Program, which was mandated by the legislature 26 years ago.  The program aims to connect MA companies and encourage them to purchase needed goods and services from each other, rather than from out-of-state or foreign companies.  Talk about not getting the memo.