Capacities for Medicaid Regulation to Improve the Well-being of Children
Child Welfare Exclusionary Database
Even though there is a comprehensive plan for Medicaid program integrity
with the exclusionary program, it does not includethe Targeted Case Management,
the largest component of child welfare services.Revenue-maximizing schemes in child welfare manifest in a multitude of complex shapesand forms, yet continue to go undocumented.The heaviest weighted reason there is no background for Medicaid provider eligibility or exclusionary database reporting for child welfare providers is, under Freedom Of Information Act (FOIA) exclusions and exemptions, any information dealingwith a child is protected, under seal, including the management and quality of services provided. Furthermore, child welfare agencies are, for the most part, non-profit and privatized
, meaning they are automatically accredited by Quasi-GovernmentalOrganizations
which advocate for further exclusions of external audit and qualityimprovements in the delivery of services as a charitable organization.In the event a child welfare agency was found to be ineligible as a child welfareservices provider, the remedy is to reorganize under a different name, for there is limitedto no competition in local regions, allowing rates to be set without comparability toquality and delivery of services with other regions. These actions and inactions set thestage for fraud, waste and abuse in child welfare services which artificially generatenational statistics presenting a false façade for the current well-being of children.
2. Electronic Health Record Technology
Currently, data reporting andwarehousing incidences of child abuse and neglect
should be considered suspect asstudies continuously “mimic”
previous methodologies, lacking in identification of errors,obstacles and barriers to reliability and validity. There has never been anyacknowledgement of kickbacks, false claims and other classifications of unallowable or questionable cost reimbursements of the States.
Electronic Health Record (EHR)
The Centers for Medicare and Medicaid (CMS), Medical Integrity Group (MIG) published the May 19,2010 memorandum report:
Excluded Medicaid Providers: Analysis of Enrollment
, OEI 09-08-00330, providing information on States' enrollment procedures for eligible Medicaid providers.
Child Welfare League of America,
Targeted Case Management (TCM) and Rehabilitative Services For Children in Foster Care, May 2007.
Compliance Guide for Tax-Exempt Organizations (other than 501(c)(3) Public Charities and Private Foundations
Council on Accreditation Standards for Private Organizations and Public Agencies,
Sedlak, A.J., Mettenburg, J., Gasena, M., Petta, I., McPherson, K., Greene, A., and Li, S.. (2010)
Fourth National Incidence Study of Child Abuse and Neglect (NIS-4): Report to Congress.
Washington, DC: U.S.Department of Health and Human Services, Administration for Children and Families.
, p. A-24, referring to the replication of methodologies of previous NIS publications.
Michigan Auditor General,
Financial Audit Including the Provisions for the Single Audit Act of the Department of Human Services,
October 1, 2002 through September 30, 2004, documenting the first in aseries of escalating child welfare services program questionable and unallowable costs in foster careservices.
The Center for Medicaid and State Operations letter to States Medicaid Director dated September 1, 2009,SMD # 09-006 ARRA HIT #1, providing initial guidance on section 4201 of the American Recovery and