This Month in Corruption: Short Rebates, Costly Supplies, Pricey Medicaid Services, etc.

Medicaid Shortchanged on Epi-Pen Rebates. Attorney General Maura Healey announced on Oct. 3 that Mylan, the pharmaceutical company, will pay $20.3 million to the Massachusetts Medicaid program (MassHealth) to resolve allegations that it knowingly underpaid rebates owed to the program for EpiPens dispensed to program members/recipients.  The payment is part of a “global settlement” with all of the 49 other states, the federal government, and the District of Columbia.  “Mylan knowingly misrepresented this drug to MassHealth in order to underpay on rebates and make a profit at the expense of our state,” said Healey.  “This settlement brings critical funds back to our MassHealth program.  Companies that receive payments from taxpayer-funded programs must be held accountable when they abuse this system.”

Massport Overcharged for Supplies.  Interline Brands, a New Jersey company, will pay a settlement of nearly $2 million to resolve allegations it overcharged the Massachusetts Port Authority hundreds of thousands of dollars for cleaning supplies, Attorney General Maura Healey announced on Oct. 10.  The investigation into Interline’s pricing methods began with a complaint from someone who walked into the office of the state’s Inspector General Glenn Cunha one day.  Under the terms of the settlement, Massport will receive $958,000 in damages, and other entities that were over-billed will receive more than $22,000.  Cunha’s office will receive $60,000 to defray the costs of the investigation, and the balance – roughly $960,000 – will go to the state’s general fund.

Arrest Made in Medicaid Overbilling. The owner of a home health agency, Hellen Kiago, 47, of Sturbridge, was arrested on the morning of Oct. 11 by Massachusetts State Police officers assigned to the office of Attorney General Maura Healey for allegedly stealing approximately $2.7 million from the state’s Medicaid program (MassHealth) by routinely overbilling and falsely billing for services that were not authorized, according to Healey’s office.  Kiago was identified by the authorities as the sole owner of Lifestream Healthcare Alliance, which has offices in Worcester and Dracut.  Kiago pleaded innocent at her subsequent arraignment.  Healey’s office began an investigation into Lifestream after receiving complaints from several former employees “alleging misconduct and fraudulent billing practices.”

Police Officer Indicted on Larceny, Money Laundering Charges. On Oct. 12, a Suffolk County grand jury indicted Joseph Nee, 44, a Boston police officer assigned to the department’s Evidence Management Unit in Hyde Park, on charges of larceny over $250 and money laundering (one count each).  Nee is accused of stealing money from the evidence room and attempting to launder it at the Plainridge Park Casino.  Authorities allege that Nee stole approximately $2,000 from the file of a closed bank robbery case.  The stolen money was identified by the traces of red dye left from an anti-theft dye pack that discharged during the robber, according to the Office of Attorney General Maura Healey.

Sheriff Employee Snared in Cash Smuggling Case. Jamie Melo, 45, of North Dartmouth, a captain with the Bristol County Sheriff’s Office, was indicted on Oct. 25 by a federal grand jury for allegedly helping Carlos Rafael, the owner of one of the largest commercial fishing businesses in the U.S., smuggle the profits from an illegal overfishing scheme to Portugal.  Melo was charged with one count each of bulk cash smuggling, structuring, and conspiracy, according to the Office of Acting U.S. Attorney for Massachusetts William D. Weinreb.    

Five Go Down in False ID Scheme. Five individuals charged in connection with a scheme to produce false identification documents through the Massachusetts Registry of Motor Vehicles (RMV) have agreed to plead guilty in federal court, according to an Oct. 2 announcement from Acting U.S. Attorney for Massachusetts William D. Weinreb.  The defendants in the case have been identified as: Evelyn Medina, 56; Annette Gracia, 37; Kimberly Jordan, 33; David Brimage, 46; and Bivian Yohanny Brea, 41.  All of the defendants reside in Boston, with the exception of Jordan, who is from Randolph.  Each has agreed to plead guilty to one count of producing without lawful authority an identification document or a false identification document, Weinreb announced.  At the time of their arrests, Medina, Gracia, Jordan and Brimage were all employed as clerks at the Haymarket RMV office in Boston.  The scheme involved the production, for cash, of Massachusetts driver’s licenses and identification cards for illegal aliens.

Falsifying Records? IRS Employee Says ‘Guilty.’ Erik Santiago-Then, 36, of Lawrence, pleaded guilty in federal court in Boston on Oct. 10 to ten counts of falsifying records in a federal investigation, the Office of Acting U.S. Attorney for Massachusetts William D. Weinreb reported.  Santiago-Then was working as a paid cooperator for the Internal Revenue Service’s Criminal Investigation (IRS-CI) unit when the falsifications occurred.  He is due to be sentenced on Jan. 3, 2018.  Here’s how Weinreb’s office described the crime:

“As part of his work uncovering evidence against the perpetrators of a stolen identity refund fraud scheme, Santiago-Then was given IRS-CI funds and authorized to set up a controlled meeting for the purpose of purchasing fraudulently-obtained tax refund checks.  However, Santiago-Then set up a sham meeting with a cohort during which time he obtained a list of personal identifying information, rather than tax refund checks.  Following the controlled meeting, and unbeknownst to IRS-CI, Santiago-Then split the IRS-CI funds with his cohort.  Santiago-Then subsequently engineered several recorded phone calls during which his cohort posed as someone else and purportedly gave Santiago-Then the run-around concerning the purported mix-up regarding the tax refund checks.”

Probe Requested by Senator Warren Reveals Losing Move by Trump Administration

On January 26, less than a week after President Trump had been inaugurated, his administration canceled key portions of a federal outreach campaign informing the public of the open enrollment for health coverage under the Affordable Care Act (Obamacare) then under way. 

The Trump administration stifled the outreach even though it would have ended anyway on January 31, the date the open enrollment was scheduled to close.

On January 31, two U.S. Senators, Elizabeth Warren, D-Massachusetts and Patty Murray, D-Washington, called upon the Inspector general of the U.S. Department of Health and Human Services (HHS), an independent authority, to investigate the impact of stopping Obamacare outreach and give a report to the Senate on what they found.  The study was done; the report was written.

This past Wednesday, October 25, Senators Warren and Murray released the IG’s report.  Among other things, it found that:

• The Trump administration first became aware of the outreach campaign on the evening of January 25.
• The administration gave the order to cancel key portions of the campaign on the morning of the next day.
• HHS staff members warned the administration that cancelling the outreach campaign when it was almost over “would have detrimental effects” on the risk pool for the individual insurance market and the administration cancelled it anyway.
• $1.1 million in taxpayer funds was lost when payments already made for cancelled open enrollment ads could not be recouped.

“The HHS IG report shows,” said Senator Warren, “that the Trump Administration came into office with one goal: to sabotage the Affordable Care Act.”

She added, “The cancellation of these ads was malicious and destructive, and wasted over $1 million in taxpayers’ money.  This was a blatantly political decision, with no regard for its impact on American families and their access to affordable health care.”

This report and the comments on it by Senators Warren and Murray did not make even a minuscule dent for one moment this week in the consciousness of the country.  Too many outrages emanate constantly from Trump and the persons around him.

Wasting a million bucks and trying to keep citizens from obtaining one of life’s necessities, health insurance, is but a single grain in The Donald’s sandbox.

 

Boston Municipal Research Bureau 'Update' Has Me Thinking Thoughts of PILOTS

I always thought that hospitals and universities owned most of the tax-exempt land in the City of Boston.  Boy was I mistaken.

The total area of Boston consists of 47.84 square miles.  Of that total, 49 percent, or 23.44 square miles is tax-exempt.  And of those 23.44 tax-exempt square miles, only 4.98 square miles are owned by institutions devoted to medicine and health care, higher education, cultural pursuits and worship (churches, synagogues, mosques), etc.  The rest is mainly owned by the government.

I got this information from the latest (10-3-17) “Bureau Update” from the Boston Municipal Research Bureau, an independent organization that’s been keeping tabs on Boston’s finances since 1932.  Thank you, BMRB.

Here are some other things I gleaned:

• The state government owns 48.5% of all the tax-exempt land in the city.
• The city and federal governments own, respectively, 28.6%  and 1.6% of all the tax-exempt land.
• The total assessed value of all the property in Boston is $190.3 billion.
• Of all the property in Boston, the value of the taxable property is $138.1 billion, whereas the value of all of the tax-exempt property is $52.2 billion. (That’s a 72.6 to 27.4 percentage split.)

Many large owners of tax-exempt property in Boston make annual payments in lieu of taxes (PILOTS) to the city.

Every once in a while, an elected official at the local or state level will complain that PILOTS to Boston are way too small.  They will demand that the largest non-profits, for example, Massachusetts General Hospital, increase their PILOTS substantially; or, they will call upon the legislature to pass a bill stripping them of their tax-exempt status altogether. 
After a bit of media coverage, the issue dies down without anything having changed.

The City of Boston is doing very well today, so much so that its bid to be the second headquarters of Amazon is seriously considered as one of the two or three strongest in a nationwide competition.

Boston’s economy is really cranking and the city today is a far wealthier place than it was 25 (never mind 50) years ago.  To those of us who grew up in this area during the Fifties and Sixties, there is an almost OZ-like quality to Boston’s current wealth, appeal, confidence and national standing. 

I’m no economist.  But given how well Boston is doing, and given how much its hospitals, medical research centers, universities and cultural institutions contribute to the city’s success and appeal, I’d say there’s no case for increasing PILOTS or eliminating anyone’s tax-exempt status. The whole mix of property uses and tax categories in Boston, as old and idiosyncratic as it may be, seems to be working just fine.

You can find the complete update at:

http://bmrb.org/government-owns-79-of-bostons-exempt-area/
 

Let's Hope Moulton's View on Gun Slaughter Moments of Silence Is Contagious

Seth Moulton has the right idea about those weak and perfunctory and unproductive moments of silence at the Capitol after mass shootings like the one Sunday night in Las Vegas.

“As after #Orlando, I will NOT be joining my colleagues in a moment of silence on the House Floor that just becomes an excuse for inaction.  Now is not the moment for silence; it’s a time for action.” Moulton tweeted earlier today.

The action he referred to is voting on new gun control measures.  I like what Moulton’s doing but have to say good luck with that voting thing.

After more than 20 first graders were mowed down by a deranged young loner in Sandy Hook, Connecticut, in 2012, many thought it would be the atrocity of atrocities that finally spurred Congress to ban the sale of assault weapons.  Of course, we all underestimated the ability of the Republicans running D.C. to take massacres in stride.

Moulton, an Iraq War hero who represents the Sixth Massachusetts District, also tweeted, “Thinking of everyone in #Las Vegas, and praying Congress will have the courage to do more than stand in silence to commemorate them.”

Amen.

Moulton has been a Congressman for only three years, but he has a smitten national following so large and a buzz about him so insistent that many Millenials (Americans born from the mid-1990s to the early-2000s) are talking seriously about him as a Democrat candidate for President of the United States.

In the Sunday New York Times yesterday, Moulton was mentioned in an article in the Opinion section headlined, “Who Can Beat Trump in 2020?”  Here’s what the Times said about him:

“Seth Moulton…is a charismatic, intelligent Iraq war veterans who isn’t afraid to call out party elders like Nancy Pelosi.  He’s only 38, and it’s almost certainly too soon for him to have much of a chance of winning the nomination, but it doesn’t hurt to put his name into the 2020 veepstakes.”

Wouldn’t it be something if this exceptional man from Salem made it to a national political ticket.

FOOTNOTE: The online satirical newspaper "The Onion" had the most apropos headline on the horror in Las Vegas: 'No way to Prevent This,' Says Only Nation Where This Regularly Happens.