Kristina Cooke http://blogs.reuters.com/kristina-cooke Sat, 10 Oct 2015 15:45:08 +0000 en-US hourly 1 http://wordpress.org/?v=4.2.5 California governor approves bill to help immigrant crime victims http://www.reuters.com/article/2015/10/10/us-immigration-california-idUSKCN0S40N920151010?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/10/10/california-governor-approves-bill-to-help-immigrant-crime-victims/#comments Sat, 10 Oct 2015 14:44:27 +0000 http://blogs.reuters.com/kristina-cooke/?p=1299 SAN FRANCISCO (Reuters) – California Governor Jerry Brown signed a bill designed to help undocumented immigrants who are victims of violent crime, by introducing time limits on law enforcement’s response to their U.S. visa applications in an attempt to standardize police forces’ uneven treatment of applicants.

The federal government grants visas to undocumented immigrants who help law enforcement try to catch criminals. The so-called U visa allows the recipient to live and work in the United States for four years, but to apply, a victim must first ask local law enforcement to verify their cooperation.

A Reuters investigation last year found vast geographic disparities in law enforcement approaches to this visa, with some agencies readily verifying cooperation and others stonewalling.

California legislators unanimously passed the bill this year, and Brown announced on Friday that he had signed it.

The bill comes as immigration features heavily in the early stages of the November 2016 presidential election, particularly among Republican candidates, where Donald Trump has made opposition to illegal immigration a hallmark of his campaign.

California, the nation’s most populous state, becomes the first to mandate that law enforcement sign U visa certifications in a particular time frame.

It requires California law enforcement to verify a victim’s cooperation within 90 days, unless the agency can demonstrate that the victim was uncooperative.

If the victim is in the process of being deported, the time frame shrinks to 14 days.

The Reuters report last year made public federal data on U visa certifications. It found, for example, that law enforcement in Oakland, California had verified 2,992 immigrants between January 2009 and May 2014 compared to just 300 in Sacramento, California, which has a slightly higher population.

Congress has limited the number of U visas to 10,000 a year, and the program is heavily oversubscribed. In fiscal 2012, U.S. Citizenship and Immigration Services received 24,768 applications from crime victims certified by local law enforcement.

If the agency determines an immigrant is eligible for the visa but the yearly cap has been reached, that person can still obtain protection against deportation – and work authorization – while joining the U visa queue.

(Reporting by Dan Levine, editing by David Evans)

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Special Report: Elected judges more likely to affirm death sentences, analysis finds http://www.reuters.com/article/2015/09/22/us-usa-deathpenalty-judges-specialreport-idUSKCN0RM1P420150922?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/09/22/special-report-elected-judges-more-likely-to-affirm-death-sentences-analysis-finds/#comments Tue, 22 Sep 2015 14:22:18 +0000 http://blogs.reuters.com/kristina-cooke/?p=1297 By Dan Levine and Kristina Cooke

(Reuters) – SAN FRANCISCO – When Ohio’s Supreme Court last October backed the death penalty for Ashford Thompson, the ruling was close. Three of the seven justices felt that Thompson, convicted of killing a cop during a traffic stop, should have received life without parole. One called the shooting a tragic misunderstanding.

Two of the four judges who voted to uphold the death penalty were also in the middle of an election campaign to keep their seats. The same month the ruling was published, television ads lauded one of them, Justice Judith French, for one of her previous votes in favor of death.

Ohio is one of the states where high court judges are directly elected – and that, a Reuters analysis found, makes a big difference in death penalty appeals.

A review of 2,102 state supreme court rulings on death penalty appeals from the 37 states that heard such cases over the past 15 years found a strong correlation between the results in those cases and the way each state chooses its justices. In the 15 states where high court judges are directly elected, justices rejected the death sentence in 11 percent of appeals, less than half the 26 percent reversal rate in the seven states where justices are appointed.

Justices who are initially appointed but then must appear on the ballot in “retention” elections fell in the middle, reversing 15 percent of death penalty decisions in those 15 states, according to opinions retrieved from online legal research service Westlaw, a unit of Thomson Reuters.

Some academic studies over the past 20 years have mirrored the Reuters analysis, showing a relationship between the result in death penalty appeals and how state supreme courts are selected. The U.S. Supreme Court has not addressed these findings in its rulings.

Now, however, at least three current justices are sympathetic to the idea that political pressure on judges is a factor that leads to arbitrary, and perhaps unconstitutional, application of the death penalty.

The findings, several legal experts said, support the argument that the death penalty is arbitrary and unconstitutional because politics – in addition to the facts – influence the outcome of an appeal.

Courts have a responsibility to protect a defendant’s constitutional rights without political pressure, especially when the person’s life is at stake, said Stephen Bright, a Yale Law School lecturer who has worked on hundreds of death defenses. “It’s the difference between the rule of law and the rule of the mob,” Bright said.

In an interview, French said she and her colleagues cast their votes months before the Thompson opinion was published.

Justice Sharon Kennedy, the other Ohio Supreme Court judge running for re-election last year, said facing voters helps ensure that judges apply the law regardless of personal views on the death penalty.

“If you’re not answerable to the people, you have a wider slide to become what I would call an activist,” she said.

EXTERNAL FACTORS

State supreme courts automatically review every death penalty verdict. Apart from examining whether any legal errors were made, judges must also weigh different factors to decide whether the death sentence is an appropriate punishment. Was it the defendant’s first offense or do they have a history of violent behavior? When a death sentence is reversed, the offender usually gets life in prison instead.

But as the Reuters analysis suggests, external factors may come into play. The election effect was a far stronger variable in determining outcomes of death penalty cases than state politics and even race.

Justices in states that supported Democratic President Barack Obama in the 2012 election reversed death sentences at roughly the same rate as those that went for Republican candidate Mitt Romney, at around 14 percent.

African-American defendants had lower reversal rates in both elected and appointed states. Nationally, death sentences were reversed 15 percent of the time for whites, compared with 12 percent for African-Americans, according to the Reuters findings.

Reuters did not analyze the possible impact of the race of the victim on death penalty appeals. The analysis also excluded a category of death penalty appeals known as habeas challenges, because state supreme courts are not required to hear them and overwhelmingly refuse to do so.

Thompson’s attorneys are asking the U.S. Supreme Court to take up the case and throw out the Ohio ruling, arguing that prosecutors improperly dismissed a potential African-American juror. They also argue that it was “basically impossible” for French to vote against capital punishment while she was being praised during her election campaign for supporting death sentences.

Ohio prosecutors say Thompson only complained about political influence after he lost.

The Supreme Court is scheduled to review Thompson’s appeal at the end of September. His arguments could meet a difficult audience.

A SKEPTICAL COURT

The U.S. Supreme Court suspended the death penalty in 1972, finding that the punishment was often applied arbitrarily. After several states rewrote their laws to codify specific guidelines that could lead to death, like a violent criminal history, the Supreme Court in 1976 found those approaches constitutional.

Since then, majorities on the high court have taken a skeptical view of data used to argue that the death penalty is applied arbitrarily. In 1987, for instance, the court voted 5-4 that an academic study that showed a “racially disproportionate impact” of capital punishment in Georgia wasn’t enough to overturn a death sentence there.

In 2013, however, Justice Sonia Sotomayor cited a study showing that Alabama judges are more likely to impose the death penalty in election years, part of a failed effort to persuade her colleagues to review an Alabama capital case.

Last June, in Glossip vs. Gross, the high court voted 5-4 that the method of execution in Oklahoma is constitutional. In dissent, Justices Stephen Breyer and Ruth Bader Ginsburg cited studies showing capital punishment is arbitrary because of racial bias, as well as political pressure, “including pressures on judges who must stand for election.”

Retired U.S. Supreme Court Justice John Paul Stevens, who has said he believes the death penalty to be unconstitutional, said in an interview that the Reuters findings “definitely lend support” to his side of the debate because they show how arbitrary capital punishment can be.

Yet in the Glossip case, Justice Clarence Thomas wrote that arbitrariness was “an imaginary constitutional rule.” And Justice Antonin Scalia wrote that Breyer and Ginsburg cited “abolitionist” academic studies “as though they have discovered the lost folios of Shakespeare,” despite the fact that the death penalty is clearly constitutional.

Beyond the Supreme Court, capital punishment is under attack in several states. Among the 31 states that have the death penalty, the punishment is on hold in at least nine due to legal challenges, according to the Death Penalty Information Center. (The 37 states in the Reuters analysis included seven that abolished the death penalty during the 15-year period covered; Montana did not have any direct appeals during the period, according to Westlaw.)

In Nebraska earlier this year, conservatives joined progressives to secure its repeal, calling it inefficient, costly and morally wrong. The Connecticut Supreme Court recently declared the punishment unconstitutional, citing a determination by the state legislature that it is arbitrarily applied.

But other death penalty states are holding fast where public opinion favors it as a valuable law enforcement tool. Ohio, which had an 8.7 percent reversal rate in the Reuters analysis, has scheduled 11 executions for 2016. Ohio prison officials, citing “victim sensitivity” and other issues, denied a request to interview Thompson, who could have years of court appeals ahead of him.

In California, where Supreme Court justices run in retention elections, fifty-six percent of voters support the death penalty, a 2014 Field Poll showed. The court reversed 4.6 percent of death penalties in the Reuters analysis.

In South Carolina, where justices never appear on the ballot, the state Supreme Court reversed death sentences 20.7 percent of the time. Justice Costa Pleicones, a former defense lawyer who has voted to reverse several death sentences, said judges’ capital punishment voting records never come up in the legislature. “We don’t really fear public outcry or reaction,” he said.

In 1996, Tennessee Supreme Court Justice Penny J. White became the first and only Tennessee appellate judge to lose a retention election. The Tennessee Conservative Union and the Republican Party put out ads urging voters to support capital punishment by removing her.

White, now a professor at the University of Tennessee College of Law, said people she knew refused to look at her or shake her hand during the campaign. After the election, then-Tennessee Gov. Don Sundquist said: “Should a judge look over his shoulder about whether they’re going to be thrown out of office? I hope so.”

Last year, three Tennessee justices faced an organized campaign to oust them from the court. In campaign ads, a Tennessee group backed by the pro-business Republican State Leadership Committee called the court “liberal on crime,” citing a death sentence it reversed.

The justices fought back with a television ad reminding voters that the bench “affirmed nearly 90 percent” of death sentences, a statistic which matches the Reuters data. In an interview, Justice Gary Wade said his campaign conducted polling showing that more than 70 percent of Tennessee voters supported capital punishment.

“Those who were employed to run the campaign believed that it was important for this court to have a demonstrated record, or willingness, to impose the death penalty,” said Wade.

Wade and the two other Tennessee judges kept their seats. Wade retired in early September.

The RSLC, which backs Republican candidates for state office, chooses which judicial elections to get involved in based on “which ones we have an opportunity to flip a court to Republican, or to help maintain a Republican majority on a court,” said Matt Walter, the group’s president.

DEADLY ENCOUNTER

In the Ohio case that the U.S. Supreme Court will decide whether to review in late September, there is no doubt that Ashford Thompson is a cop killer.

A little after midnight on July 13, 2008, Thompson and his girlfriend, Danielle Roberson, went for a drink at the Rav’s Creekside Tap & Grill in Twinsburg, Ohio. The bartender served him a single Budweiser draft.

A witness who had been at the bar testified that he heard Thompson make angry comments including, “I will kill any one f***r that threatens me,” and, “There’s demons in me.”

At about 1:55 a.m, Twinsburg police officer Joshua Miktarian called dispatch to report a traffic stop. Thompson had pulled into his driveway, and Miktarian pulled in behind him, according to Roberson. It’s not clear why the officer stopped Thompson, but a witness testified that Thompson’s car was playing loud music.

According to Roberson’s testimony, Miktarian asked Thompson: “[W]hy are you running through my city with all that boom, boom, boom. I ought to rip all this s*** out of your car.” Miktarian said he had been following Thompson for two and a half miles and asked Thompson why he had not stopped, and whether he had been drinking.

According to Roberson’s testimony, the officer “slammed” Thompson onto the hood of the cruiser and reached for his belt. Roberson said she then saw Thompson, who had a license to carry a concealed firearm, turn and shoot Miktarian.

When other officers arrived at the scene, they found Miktarian dead, with four gunshot wounds to the head. Thompson was arrested less than half an hour later, the handcuffs marked with Miktarian’s badge number still hanging off his right wrist.

After a five-day trial, a jury convicted Thompson of aggravated murder, escape, resisting arrest, tampering with evidence and carrying a concealed weapon. He was sentenced to death.

The Ohio Supreme Court heard Thompson’s appeal on April 8, 2014, and French was chosen to write the majority opinion affirming the death sentence.

As she was writing, French was in the midst of a hard-fought campaign to keep her seat on the bench. In her campaign literature, French used the tagline “Judge Judi” and touted her conservative credentials.

Introducing Ohio Gov. John Kasich at a campaign event, French described the Ohio Supreme Court as a “backstop” for laws passed in the Republican-dominated legislature. None of the votes, for governor, for state senator, would matter if the Ohio Supreme Court didn’t stay conservative, she said. “We are the ones that will decide whether it is constitutional,” she said.

That month, American Freedom Builders, a Washington-based nonprofit that advocates for small government, bought about $600,000 in ads for French, according to the Brennan Center for Justice at New York University School of Law. An ad reminded voters that French is “tough” and upheld a death sentence “for a murderer who shot his girlfriend in front of her three year old daughter.”

In the opinion on Thompson’s appeal, French wrote that the death penalty was appropriate compared to similar cases. “We have previously upheld death sentences for killing a law-enforcement officer who is engaged in official duties,” she wrote.

One of three dissenting judges, William O’Neill, wrote that the evidence depicted a routine traffic stop gone tragically wrong. He said the majority did not seriously take mitigating factors into account: Thompson went to college, was a licensed practical nurse with a steady job who was involved in his community and church, and was a law-abiding citizen. He carried a concealed weapon, O’Neill wrote, for his own protection because he often treated patients who lived in dangerous neighborhoods.

“The majority’s failure to seriously engage in the weighing process provides yet another reason why, in my opinion, Ohio’s system of imposing and reviewing death sentences is unconstitutional,” he wrote.

Thompson’s attorney said the problem is broader. “There are men all over the U.S. who are going to die because of politics. That’s a basic component of the death penalty,” said Tim Young, director of the Office of the Ohio Public Defender.

The opinion in Thompson’s case was issued on Oct. 29, 2014. Six days later, French was re-elected with 56 percent of the vote, and Kennedy with 73 percent of the vote.

(Edited by Amy Stevens and John Blanton)

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California passes bill to help immigrant crime victim visa applicants http://www.reuters.com/article/2015/09/04/us-immigration-california-idUSKCN0R42AW20150904?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/09/04/california-passes-bill-to-help-immigrant-crime-victim-visa-applicants/#comments Fri, 04 Sep 2015 20:42:05 +0000 http://blogs.reuters.com/kristina-cooke/?p=1295 SAN FRANCISCO (Reuters) – California legislators have voted to help undocumented immigrants who are victims of violent crime by introducing time limits on law enforcement’s response to their U.S. visa applications, in an attempt to standardize police forces’ uneven treatment of applicants.

The federal government grants visas to undocumented immigrants who help law enforcement try to catch criminals. The so-called U visa allows the recipient to live and work in the United States for four years, but to apply, a victim must first ask local law enforcement to verify their cooperation.

A Reuters investigation last year found vast geographic disparities in law enforcement approaches to this visa, with some agencies readily verifying cooperation and others stonewalling.

The California bill was passed unanimously by the state Assembly on Thursday. Twenty-seven Republicans voted for the California crime victim bill, joined by 51 Democrats. A representative for Governor Jerry Brown on Friday declined to comment on whether Brown would sign it.

The vote comes as immigration features heavily in the early stages of the November 2016 presidential election, particularly among Republican candidates, where Donald Trump has made opposition to illegal immigration a hallmark of his campaign.

“Right now is such an important time,” said Angie Junck, supervising attorney at the Immigrant Legal Resource Center in San Francisco. “Immigrant communities are increasingly living in fear.”

If enacted, California would be the first state to mandate that law enforcement sign U visa certifications in a particular time frame.

It would require California law enforcement to verify a victim’s cooperation within 90 days, unless the agency can demonstrate that the victim was uncooperative.

If the victim is in the process of being deported, the time frame shrinks to 14 days.

The Reuters report last year made public federal data on U visa certifications. It found, for example, that law enforcement in Oakland, California had verified 2,992 immigrants between January 2009 and May 2014 compared to just 300 in Sacramento, California, which has a slightly higher population.

Congress has limited the number of U visas to 10,000 a year, and the program is heavily oversubscribed. In fiscal 2012, U.S. Citizenship and Immigration Services received 24,768 applications from crime victims certified by local law enforcement.

If the agency determines an immigrant is eligible for the visa but the yearly cap has been reached, that person can still obtain protection against deportation – and work authorization – while joining the U visa queue.

(Reporting by Dan Levine)

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Special Report: Renowned U.S. drug-rehab program spun out of control http://www.reuters.com/article/2015/09/02/us-usa-rehab-phoenixhouse-specialreport-idUSKCN0R21PY20150902?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/09/02/special-report-renowned-u-s-drug-rehab-program-spun-out-of-control/#comments Wed, 02 Sep 2015 15:46:10 +0000 http://blogs.reuters.com/kristina-cooke/?p=1293 NEW YORK (Reuters) – Martin Szczupak had already been in and out of rehab when, for a misdemeanor possession charge, a judge sent the 21-year-old heroin addict to a century-old estate in the wooded hills of upstate New York for another chance to clean up.

Belle Terre, the former home of a 19th-century copper baron, housed the 168-bed Phoenix House Delaware County Center, a private, nonprofit residential drug treatment facility. When Szczupak arrived in June 2012, all was not well behind Belle Terre’s stately walls.

In the two years prior to Szczupak’s arrival, New York’s Office of Alcoholism and Substance Abuse Services (OASAS) had twice closed Belle Terre to new admissions after inspectors discovered illegal drug use, insufficient treatment and bad record-keeping, among many other regulatory violations. In each case, Belle Terre resumed admissions after Phoenix House submitted a “corrective action plan” to regulators.

Even so, residents and a counselor at Belle Terre when Szczupak was there said little had changed. Residents trafficked in drugs, cigarettes and other contraband. Nor were residents receiving the 40 hours a week of therapeutic services OASAS required.

“This place is basically a super minimum security prison camp,” Szczupak wrote in an Aug. 29, 2012, letter to a friend. “We do nothing all day.” Still, Szczupak was hopeful. “I’m gonna be out … before I even know it,” he wrote.

By December 2012, he had given up on the treatment program. He felt he would be stuck going from “dead end job and rehab and jail until I eventually drop dead,” he wrote in a letter to his fiancée. “You deserve better than that.” He didn’t want to use drugs anymore, he wrote, “but realistically the odds are against me.”

Szczupak never sent the letter. Three weeks later, he walked out of Belle Terre without permission. One day after that, police visited Szczupak’s mother, Inez, at her Brooklyn home to tell her that her son had been found dead from a drug overdose.

POLITICAL TRACTION

Sending addicts to treatment rather than jail or prison for nonviolent offenses has become increasingly popular across the U.S. political spectrum. In the 2016 presidential campaign, candidates from Democrat Hillary Clinton to Republican Chris Christie have hailed drug treatment as a smart way to tackle the problems of prison overcrowding and excessive sentencing.

Facilities like Belle Terre are part of that solution. Underwritten by taxpayers, they work with the courts and probation departments to rehabilitate offenders. In 2012, the U.S. criminal justice system sent 580,000 people to drug treatment.

There’s little doubt that quality care in a controlled setting can help. Multiple studies have shown that people who complete drug treatment court, a special court for drug addicted offenders, are less likely to reoffend in the first year or two after their release.

At Belle Terre, criminal-justice referrals account for the majority of residents. The facility is run by Phoenix Houses of New York, whose parent foundation is one of the nation’s largest drug treatment nonprofits, operating in 10 states and the District of Columbia. In the year ended June 20, 2014, the Phoenix House Foundation and its affiliates reported operating revenue of $141 million.

Phoenix Houses of New York is 95 percent publicly funded and enjoys star-studded endorsements. Beyonce donated a cosmetology center at a Brooklyn facility. Financier Pete Peterson chaired a summer fundraiser in 2013 in the posh Hamptons on New York’s Long Island.

But as the case of Martin Szczupak suggests, the system as practiced doesn’t always deliver on the promise in principle. A review of Szczupak’s journal and letters and of state regulators’ reports, as well as interviews with dozens of current and former Phoenix House employees and residents, reveal a respected institution that in recent years has consistently failed to provide the quality of care necessary to help addicts kick the habit.

“PERSISTENT REGULATORY VIOLATIONS”

The closures that preceded Szczupak’s arrival weren’t the last. And nor is Belle Terre an anomaly. In November last year, OASAS suspended admissions to Belle Terre and four other Phoenix Houses of New York facilities. In a letter to Phoenix House’s then-chief executive in November 2014, OASAS said Phoenix House had “persistent regulatory violations and resident/patient care concerns dating back several years.”

An OASAS site report on the five facilities went into graphic detail. The regulator’s findings at some or all of the facilities included use of marijuana, cocaine, heroin and other illegal drugs; sexual activity among residents; reports of violence and sexual assault; insufficient, inadequately trained or abusive staff; dirty premises; and lax security, with residents coming and going as they wished.

In each case, OASAS allowed admissions to resume “based upon sustained systemic improvements,” the agency said in a written response to questions from Reuters.

On Aug. 19, Phoenix House said it would be closing Belle Terre and its 185th Street facility in New York City. In an open letter to staff, Phoenix Houses of New York’s president and regional director, Peter Scaminaci, cited a changing environment, “particularly as a result of health care and criminal justice reform,” as a reason for the closures. “These facilities do not lend themselves to our vision for a transformed Phoenix House,” he wrote.

In a statement to Reuters, Scaminaci said his organization was “engaged in a strategic effort to re-allocate our resources to locations where we can achieve the greatest impact.” Phoenix House, he said, is “collaborating closely with OASAS on designing better treatment programs, improving our standard of care and offering increased options for those suffering from substance abuse.”

“RAMPANT DRUG USE”

Belle Terre’s recent run-ins with regulators date back to at least May 2010. That’s when Albany City Court Judge Thomas Keefe, who had sent three addicts there, became concerned by stories of “rampant” drug use and high staff turnover at the facility.

Keefe, long a proponent of drug treatment as a way to stop addicts from cycling in and out of jail, called the facility’s director, Jerome Pryor. He was surprised by what he described as Pryor’s cavalier attitude and “virtual non-action to address the problem,” Keefe told state regulators in a subsequent 2010 complaint to OASAS. Believing his “addicts were in danger,” the judge had them reassigned to other facilities.

Later that year, Jessica Deagan, now 26, started a court-ordered 9-month stay at Belle Terre to treat her heroin addiction. “It was like the street inside of a building,” she said. “There was a great amount of access to drugs. I used heroin, angel dust, Xanax, whatever was in there for the week.”

Former residents said dealers would throw drugs over the stone wall around the property or hide them along nearby hiking trails for residents to retrieve.

On Aug. 11, 2010, three months after the judge’s initial complaint, a team of OASAS inspectors descended on Belle Terre unannounced. As the inspectors introduced themselves to a staff member, who was leading a house meeting, residents began shouting, “Shut this place down,” and “Get us out of here,” according to the regulator’s report, a copy of which Reuters obtained New York’s Freedom of Information Law.

“THERE WAS NO STAFF”

OASAS recommended halting new admissions, citing widely available illegal drugs, unsupervised outings, sexual activity among residents, diversion of medications, unavailability of staff members, and lack of group counseling.

Belle Terre Director Pryor, according to the OASAS report, attributed most of the problems to the recent loss of five staff members. Four new employees, he told the regulators, lacked experience in treating chemical dependency.

Pryor declined to comment.

A month after admissions were stopped, OASAS conducted a follow-up visit and determined that the facility had stabilized. Admissions resumed.

Two weeks after that, Jordan Nedlik, a resident on kitchen duty, was stabbed in the back by another resident unhappy with the size of his meatball supper. “There was no staff,” Nedlik said. Nedlik returned to Belle Terre after a brief hospital stay. He was sent back to Belle Terre in 2012, after failing a urine test, and later spent time in prison for his initial grand larceny charge. He said that as of August 2015, he has been clean for 14 months.

In September 2011, inadequate staffing prompted counselor Mary Moynahan to quit. In her resignation letter, a copy of which she sent to OASAS, she complained that nonviolent, often very young offenders were mixed with residents who were “not addicts, but rather, hardened criminals avoiding jail time.” She added: “The bottom line is the understaffing.”

SUSPICIOUS RECORDS

Some former counselors told Reuters they lacked the training required to provide the individualized, holistic drug and alcohol addiction treatment Phoenix House promised on its website. Group sessions were haphazard, often pieced together from information gathered through Google searches the night before, they said.

Treatment records were suspect. “There were times when I would say, ‘I didn’t write this. That’s not my handwriting,’ ” said Glenn Williamson, a former counselor and military veteran.

Another counselor, who asked not to be identified for fear of losing her license, recalled chasing a young man high on the synthetic opioid fentanyl around the grounds to keep him out of sight during an OASAS inspection.

In November 2011, OASAS again halted admissions. The agency cited insufficient clinical and mental health services, strip searches conducted without consent, and failure to file incident reports. Residents drove program vans and stayed up all night as “night watchman,” which kept them from participating in group therapy.

OASAS also found that Belle Terre’s new director, Henry Bennett, obstructed their request for records in an attempt to modify them before handing them over. Phoenix House fired Bennett. Bennett, who went on to work for various treatment providers before retiring in Georgia, said he had not been aware that the records were being altered.

Bennett said Phoenix House “took their eye off the prize” by emphasizing business considerations over “things they need such as clinical functions and a good medical records system.”

TOOL OF ABUSE

About 75 percent of Belle Terre residents at the time were on psychotropic medications, state records show, but the only psychiatric care for residents was a four-hour drive away in New York City. A van took seven residents there twice a week.

Myke Champlin, a 2011 resident with borderline personality disorder, said he stayed clean for his first four months at Belle Terre, but by the time he graduated, “I was smoking more K2 [synthetic marijuana] and everything than you could imagine.”

Courts rely on treatment providers for updates on offenders’ performance. If offenders don’t comply with a treatment provider’s rules, the court can use sanctions such as short jail stints or can extend their time in treatment. In some cases, offenders end up spending more time incarcerated than if they had eschewed drug treatment.

At Belle Terre, the threat of reporting infractions could become a tool of abuse. As is common practice in many rehab programs, residents were assigned jobs in a hierarchy, from the lowest cleaning crew to managing other residents’ schedules. This system, which counselors and residents called “the Structure,” was meant to help residents break bad habits and prepare for working life.

Former residents said the system became a means of settling personal scores. Higher-ranking residents could punish others for minor infractions, such as talking in the medication line. Infractions could result in cancellation of family visits, or could be reported to the courts.

PARTNERS IN ADDICTION

This was the milieu Martin Szczupak entered in the summer of 2012.

Szczupak grew up in the New York City boroughs of Brooklyn and Staten Island. In middle school, he met Priscilla Pardo, with whom he shared a love of punk rock. “Punk rock is angry and abrasive, and for several years, so was I,” Szczupak wrote in his journal.

Szczupak was addicted to heroin by age 15, Pardo said. She was hooked at 18. Still, they managed to start college. He studied biology. She studied mortuary science. They missed a lot of classes, mostly to get high, Pardo said.

They didn’t know it, but they were part of a resurgence of heroin abuse in the U.S. In 2013, 517,000 Americans abused or were dependent on heroin, more than twice as many as in 2007, according to the National Survey on Drug Use and Health. Staten Island had the highest rate of heroin-related deaths among all New York City boroughs in 2012. Local officials have called it an “epidemic.”

Pardo nearly died from an overdose in 2011. That “scared the crap out of Martin,” Pardo said. He persuaded his girlfriend to admit to their parents that they had a problem.

Szczupak finished a stint in rehab in March 2011. On his way home, according to the account he gave to his mother and Pardo, the rehab facility van he was riding in made a stop. Szczupak, woozy and disoriented from prescribed medications, stepped out of the van. When he returned, he told Pardo and his mother, he mistook another vehicle for the rehab facility van.

According to the police report on the incident, Szczupak was pulling on the vehicle’s door handle and shouting, “open the door.” Inside the Ford Explorer sat a woman and her 3-year-old son. She called the police. Szczupak was charged with attempted grand larceny and resisting arrest. Records show Szczupak told the police that he “wanted to take the car home.”

“DOWN THE DRAIN”

Szczupak later told police he had no recollection of the incident. He pleaded guilty and agreed to go to treatment. A year later, he relapsed. He was arrested for possession on Staten Island, a probation violation. In court, the judge agreed to give him another chance at treatment.

When Szczupak arrived at Belle Terre in June 2012, the facility was still short-staffed. Residents at the time described the lack of counseling and widespread use of illegal drugs that OASAS staff had cited over the prior two years.

Brian Moody, 33, a former Bank of America contractor who had been remanded to Belle Terre after violating probation on a drug-sales charge, said the place was in chaos. “There were people who were high,” he said. “It was a circus show.”

Moody said he befriended Szczupak, whom he described as smart and determined. “He wanted to change,” but felt he was getting no help, said Moody, now working as a debt-collection agent.

Szczupak at first rose within the Structure. He was assigned to computer work, where he spent days listening to music, according to a letter to a friend.

“I hoped this one would work, mentally he wanted it to work, he was pretty optimistic,” said his mother, Inez. “And then all of a sudden everything went down the drain, and every phone call that I got was, ‘I can’t stand this place, this is bullshit, they don’t treat me fair.’ But I never understood what happened.”

In December 2012, Szczupak was demoted within the Structure for disrespecting a staff member, his treatment records show. The details are unclear.

Szczupak told friends that the time already spent in treatment was worthless and that he would end up going to jail anyway.

According to treatment records, Szczupak was given the option of starting over again in drug court, but he refused, saying he had heard “nightmare stories” from others.

“HE SEEMED LIKE A SHELL”

“This whole episode here has pushed back my completion of this shit,” he wrote in an undated entry that ends his journal. “This whole drug court thing has got me frustrated.”

When Pardo spoke with Szczupak on Thursday, Jan. 3, 2013, six months after his arrival at Belle Terre, he seemed “really mad at the world, very dark, not making any jokes,” she said. “He seemed like a shell.”

The next day, Moody said, Szczupak told him he would rather be in jail, with a clear end-date. He packed his belongings and walked out without approval.

That Saturday, police were called to a Brooklyn house where they found Szczupak, dead from a heroin overdose.

In November 2014, regulators again suspended admissions at Belle Terre, as well as four other Phoenix House facilities. State regulators noted high staff turnover and need for improved clinical practices at Belle Terre. They also warned the facility to let clients speak to their attorneys without staff present.

OASAS let Belle Terre reopen in January 2015. Three of the other centers were reopened with limited admissions in late 2014 and early 2015. The Shrub Oak teen residential treatment facility was closed permanently in June 2015.

In March, OASAS inspected Belle Terre again, prompted by unspecified complaints against director Alan Hargrove, OASAS reported. Phoenix House then fired Hargrove, based on OASAS’s feedback.

Hargrove declined to comment.

Phoenix House announced on Aug. 19 it would be closing Belle Terre and the 185th Street facility.

Pardo, now 24, lives with her parents on Staten Island and works the night shift at a convention center. She has been sober for three years after receiving treatment at Mount Sinai Beth Israel Medical Center in New York City.

(Reporting by Kristina Cooke and Robin Respaut; Edited by John Blanton)

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Banned Medicaid providers still participate in some states, report says http://www.reuters.com/article/2015/08/05/us-usa-medicaid-providers-idUSKCN0QA0AS20150805?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/08/05/banned-medicaid-providers-still-participate-in-some-states-report-says/#comments Wed, 05 Aug 2015 04:05:53 +0000 http://blogs.reuters.com/kristina-cooke/?p=1291 By Kristina Cooke and M.B. Pell

(Reuters) – Hundreds of medical providers banned from a Medicaid program in one state are able to take part in another state’s program despite regulations designed to stop them, according to a report by an independent federal auditor to be released on Wednesday.

The continued participation of banned providers leaves state Medicaid programs for the poor and disabled vulnerable to fraud, waste and abuse, according to the study, which says the problem reflects a struggle by states to communicate with one another.

The study, conducted by the U.S. Department of Health and Human Services Office of the Inspector General (OIG), also found that about half of the states were unable to terminate providers enrolled in privately run Medicaid managed care programs. Some refuse to terminate providers still licensed by a medical board, it found.

“If a provider has been terminated by a state, that is a red flag, because it would indicate there was a problem either in billing or the way they handle patients,” said Deborah Cosimo, team leader for the report. “Do states really want to trust beneficiary care to someone who has problems like that?”

The report follows a Reuters investigation published in April that found 1,800 providers banned by the federal Medicare program for the elderly or a state’s Medicaid program were still able to bill elsewhere in 2014. here

Under the Affordable Care Act, which was implemented in 2011, all states are required to terminate providers banned by another state for reasons related to fraud, integrity or quality. Prior to 2011, a provider terminated in one state could enroll in another state’s program.

But the Centers for Medicare and Medicaid Services (CMS), the agency that administers Medicare, does not require states to report terminated providers to a federal database that shares the information and would not say if it planned to do so, the auditor wrote.

“The government hasn’t done what it is expected to do to keep providers who shouldn’t be in the program out of the program,” said Kevin Golladay, OIG regional inspector general for Region VI.

Reuters obtained a copy of the report in advance of its release. OIG was working on the report before Reuters published its investigation in April.

The auditor examined 2,539 providers terminated by a state in 2011 and found 295, or 12 percent, still participated in another state’s Medicaid programs. It found Medicaid programs paid $7.4 million to 94 providers for services performed after the providers were terminated.

The auditor identified only individual providers, not companies. New Mexico had the most terminated providers still participating in its program, with 33, and Massachusetts had the second-most, with 30.

California paid terminated providers the most, $1.7 million, followed by Mississippi, $1.2 million, and Wyoming, $919,000.

One state Medicaid program paid a single provider more than $1 million for services performed after the provider’s termination.

The latest report may underestimate the number of providers who continue to participate in Medicaid after termination and the amount they were paid due to poor record keeping by the states, the auditor wrote.

Seventy-five percent of the terminated providers still approved to bill in other states were doctors and 11 percent were mental health workers.

CMS, in a June 19 letter to OIG, agreed with the report’s recommendation that it work with states to develop uniform language to identify providers terminated for cause.

It said it also supports a requirement for states to screen providers in privately run managed care programs in Medicaid and a recommendation that the CMS tell states to terminate providers banned by other states even if the provider still has a medical license.

(Reporting by M.B. Pell; Editing by Frank McGurty and Dan Grebler)

]]>
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Special Report: How Sony sanitized Adam Sandler movie to please Chinese censors http://www.reuters.com/article/2015/07/24/us-china-fil-specialreport-idUSKCN0PY1OJ20150724?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/07/24/special-report-how-sony-sanitized-adam-sandler-movie-to-please-chinese-censors/#comments Fri, 24 Jul 2015 14:06:07 +0000 http://blogs.reuters.com/kristina-cooke/?p=1287 HONG KONG/LOS ANGELES (Reuters) – In a 2013 script for the movie “Pixels,” intergalactic aliens blast a hole in one of China’s national treasures – the Great Wall.

That scene is gone from the final version of the sci-fi comedy, starring Adam Sandler and released by Sony Pictures Entertainment this week in the United States. The aliens strike iconic sites elsewhere, smashing the Taj Mahal in India, the Washington Monument and parts of Manhattan.

Sony executives spared the Great Wall because they were anxious to get the movie approved for release in China, a review of internal Sony Pictures emails shows. It is just one of a series of changes aimed at stripping the movie of content that, Sony managers feared, Chinese authorities might have construed as casting their country in a negative light.

Along with the Great Wall scene, out went a scene in which China was mentioned as a potential culprit behind an attack, as well as a reference to a “Communist-conspiracy brother” hacking a mail server – all to increase the chances of getting “Pixels” access to the world’s second-biggest box office.

“Even though breaking a hole on the Great Wall may not be a problem as long as it is part of a worldwide phenomenon, it is actually unnecessary because it will not benefit the China release at all. I would then, recommend not to do it,” Li Chow, chief representative of Sony Pictures in China, wrote in a December 2013 email to senior Sony executives.

Li’s message is one of tens of thousands of confidential Sony emails and documents that were hacked and publicly released late last year. The U.S. government blamed North Korea for the breach. In April, WikiLeaks published the trove of emails, memos and presentations from the Sony hack in an online searchable archive.

“We are not going to comment on stolen emails or internal discussions about specific content decisions,” said a spokesman for Sony Pictures, a unit of Tokyo-based Sony Corp. “There are myriad factors that go into determining what is best for a film’s release, and creating content that has wide global appeal without compromising creative integrity is top among them.”

Chinese government and film-industry officials didn’t respond to requests for comment for this story.

A PALATABLE ‘ROBOCOP’

“Pixels” wasn’t the only Sony movie in which the China content was carefully scrutinized. The emails reveal how studio executives discussed ways to make other productions, including the 2014 remake of “RoboCop,” more palatable to Chinese authorities.

In a 2013 email about “RoboCop,” the senior vice president at Sony Pictures Releasing International at the time, Steve Bruno, proposed relocating a multinational weapons conglomerate from China. His solution: Put it in a Southeast Asian country like Vietnam or Cambodia. Ultimately, that change wasn’t made, a viewing of the movie shows. Bruno has since left Sony.

The Sony emails provide a behind-the-scenes picture of the extent to which one of the world’s leading movie studios exercised self-censorship as its executives tried to anticipate how authorities in Beijing might react to their productions. The internal message traffic also illustrates the deepening dependence of Hollywood on audiences in China, where box office receipts jumped by almost a third last year to $4.8 billion, as revenues in the United States and Canada shrank.

Other studios have made changes to movies in a bid to get them approved by Beijing, altering the version that is screened in China. A scene showing a Chinese doctor who helps the main character in “Iron Man 3,” for example, was lengthened in the Chinese version and included popular Chinese actress Fan Bingbing, a comparison of the Chinese and international versions shows. Produced by Marvel Studios, “Iron Man 3” was the second top grossing movie in China in 2013. Marvel declined to comment.

THE LOGIC OF SELF-CENSORSHIP

In the case of “Pixels,” in which the aliens attack Earth in the form of popular video game characters, the Sony emails point to the creation of a single version for all audiences – a China-friendly one. The logic behind Sony’s thinking was explained by Steven O’Dell, president of Sony Pictures Releasing International, in a September 12, 2013 email about “RoboCop.”

“Changing the China elements to another country should be a relatively easy fix,” O’Dell wrote. “There is only downside to leaving the film as it is. Recommendation is to change all versions as if we only change the China version, we set ourselves up for the press to call us out for this when bloggers invariably compare the versions and realize we changed the China setting just to pacify that market.”

Efforts by the U.S. motion-picture industry to woo China come as the ruling Communist Party under President Xi Jinping is engaged in the biggest crackdown on civil society in more than two decades. About a dozen human rights lawyers were taken into police custody this month, and hundreds of dissidents have been detained since Xi took power in late 2012.

As China rises, its efforts to contain civil liberties at home are radiating outward. The removal of scenes from “Pixels” thought to be offensive to Beijing shows how global audiences are effectively being subjected to standards set by China, whose government rejects the kinds of freedoms that have allowed Hollywood to flourish.

“I think the studios have grown pretty savvy,” said Peter Shiao, founder and CEO of Orb Media Group, an independent film studio focused on Hollywood-Chinese co-productions. “For a type of movie, particularly the global blockbusters, they are not going to go and make something that the Chinese would reject for social or political reasons. That is already a truism.”

Sony’s emails were hacked ahead of the release of “The Interview,” a comedy depicting the assassination of North Korean leader Kim Jong-un. When Sony halted the film’s release in response to threats made against movie theaters, U.S. President Barack Obama warned of the dangers of self-censorship. Ultimately, Sony released the movie.

“If somebody is able to intimidate folks out of releasing a satirical movie, imagine what they start doing when they see a documentary that they don’t like, or news reports that they don’t like,” Obama said at his year-end White House press briefing. “Or even worse, imagine if producers and distributors and others start engaging in self-censorship because they don’t want to offend the sensibilities of somebody whose sensibilities probably need to be offended. That’s not who we are. That’s not what America is about.”

FAST & FURIOUS GROWTH

For Hollywood studios, the allure of the Chinese box office has become increasingly difficult to resist. While box office receipts in the United States and Canada combined fell five percent last year to $10.4 billion compared with 2013, box office receipts in China jumped 34 percent to $4.8 billion in the same period, according to the Motion Picture Association of America Inc.

China is on course to set a new record this year: Box office receipts were $3.3 billion in the first half of 2015, China’s state-run media reported. Action movie “Fast & Furious 7” was the best ticket seller in China by early June 2015, grossing $383 million – higher than the $351 million in the United States and Canada combined. It was followed by “Avengers: Age of Ultron” and “Jurassic World.”

Last November, the vice president of the China Film Producers’ Association, Wang Fenglin, said the Chinese film market would overtake the United States to become the largest in the world within three years.

The importance of the China market appears to have informed decisions taken by Metro-Goldwyn-Mayer Studios Inc in its 2012 remake of the action movie “Red Dawn.” MGM changed the nationality of the soldiers who invade the United States from Chinese to North Korean in post-production, according to Red Dawn producer Tripp Vinson. MGM did not respond to requests for comment.

APPARATUS OF CONTROL

To get on the circuit in China, a movie must win the approval of the Film Bureau, which is headed by Zhang Hongsen, a domestic television screenwriter and senior Communist Party member. “Foreign films come to China one after another like aircraft carriers; we are facing great pressure and challenges,” Zhang said last year. “We must make the Chinese film industry bigger and stronger.”

The Film Bureau is part of the State Administration of Press, Publication, Radio, Film and Television (SAPPRFT), which reports directly to China’s cabinet, the State Council. The administration controls state-owned enterprises in the communications field, including China Central Television and China Radio International.

Censorship guidelines are included in a 2001 order issued by the State Council. The order bans content that endangers the unity, sovereignty and territorial integrity of China, harms national honor and disrupts social stability. Harming public morality and national traditions is forbidden.

SAPPRFT guidelines also include bans on material seen as “disparaging of the government” and political figures. The broadening scope of these guidelines can be seen in an email sent last November by Sanford Panitch, who has since joined Sony as President of International Film and Television, to Sony Entertainment CEO Michael Lynton.

The email outlines new measures that were being implemented by SAPPRFT officials: “What is different is now they are clearly making an attempt to try to address other areas not been specified before, decadence, fortune telling, hunting, and most dramatically, sexuality,” Panitch wrote.

Studios also have to work with China Film Group Corp, a state-owned conglomerate that imports and distributes foreign movies. In some cases China Film also acts as an investor. In the emails, Sony executives discussed a co-financing arrangement whereby China Film will cover 10 percent of the budget of “Pixels.” China Film is run by La Peikang, a Communist Party member and the former deputy head of the Film Bureau.

“TOO MUCH MONEY ON THE LINE”

A total of 34 foreign films are allowed into China each year under a revenue-sharing model that gives 25 percent of box office receipts to foreign movie studios. Fourteen of those films must be in “high-tech” formats such as 3D or IMAX.

The censorship process in China can be unpredictable, the Sony emails show. In early 2014, the studio was faced with a demand to remove for Chinese audiences a key but disturbing scene from “RoboCop,” the story of a part-man, part-machine police officer.

“Censorship really hassling us on Robocop…trying to cut out the best and most vital scene where they open up his suit and expose what is left of him as a person,” reads a January 28, 2014 email written by international executive Steven O’Dell. “Hope to get through it with only shortening up the scene a bit. Don’t think we can make a stand on it either way, too much money on the line, cross fingers we don’t have to cut the scene out.”

The political climate under President Xi may also be playing a role, one email indicates. “As to greater flexibility, I am not so sure about that,” Sony China executive Li Chow wrote in early 2014, commenting on a media report that Beijing was mulling an increase in its foreign film quota. “The present government seems more conservative in all aspects and this is reflected by the repeated cuts to Robocop. Lately, members of the censorship board seem uncertain, fearful and overly careful.”

In the messages in which “Pixels” is discussed, Sony executives grapple with how to gauge the sensitivities of the Chinese authorities.

In a November 1, 2013 email, Li Chow suggested making a number of changes to the script, including the scene in which a hole is smashed in the Great Wall. “This is fine as long as this is shown as part of a big scale world-wide destruction, meaning that it would be good to show several recognizable historical sites in different parts of the world being destroyed,” she wrote.

She also advised altering a scene in which the President of the United States, an ambassador and the head of the CIA speculate that China could be behind an attack using an unknown technology. In the final version, which moviegoers are now getting to see, the officials speculate that Russia, Iran or Google could be to blame.

“China can be mentioned alongside other super powers but they may not like ‘Russia and China don’t have this kind of technology’,” Li wrote in the email. “And in view of recent news on China hacking into government servers, they may object to ‘a communist-conspiracy brother hacked into the mail server…’”

“THE UNWRITTEN RULE”

In mid-December 2013, Li suggested doing away with the Great Wall scene altogether, saying it was “unnecessary.”

Around the same time, the emails show Sony executives also discussed relocating a car-chase scene involving the video-game character Pac-Man from Tokyo to Shanghai, and whether that might help with the release date in China.

Li Chow advised against the change. “As to relocating the Pac-Man action from Tokyo to Shanghai, this is not a good idea because it will involve destruction all over the city and may likely cause some sensitivity,” she wrote in a December 18, 2013 email. “In other words, it is rather hard to say whether it would be a problem because the unwritten rule is that it is acceptable if there is no real intention in destroying a certain building or street and if it is just collateral damage. But where would you draw the line?”

Ultimately, all references to China in the movie were scrubbed. That decision appears to have been made in early 2014. “It looks like Doug is going to heed Li’s advice and get all China references out of Pixels (including not using the Great Wall as one of the set pieces),” international executive O’Dell wrote, referring to then-Columbia Pictures President Doug Belgrad.

The cost of not winning approval to distribute a movie in China is also evident in the Sony emails. In February 2014, a Sony marketing executive circulated an email: “Please note that CAPTAIN PHILLIPS will not be released theatrically in China” – a reference to the movie in which Tom Hanks stars as Captain Richard Phillips, who was taken hostage by Somali pirates in 2009.

Budget discussions about “Captain Phillips,” contained in the emails, show Sony executives had expected to earn $120 million globally from the movie, but that changed when they didn’t get approval for it to be screened in China. “We are short $9M and we won’t be getting into China,” emailed notes from a conference call read. “We need to grab every dollar we can to meet our objectives. It is incumbent on all of us to try to figure out how we can get more money from this picture.”

In a December 2013 email, Rory Bruer, president of worldwide distribution at Sony Pictures, had speculated that “Captain Phillips” was unlikely to be approved by China’s censors. In the film, the U.S. military rescues the ship’s captain. That plot element, Bruer noted, might make Chinese officials squirm.

“The reality of the situation is that China will probably never clear the film for censorship,” wrote Bruer. “Reasons being the big Military machine of the U.S. saving one U.S. citizen. China would never do the same and in no way would want to promote this idea. Also just the political tone of the film is something that they would not feel comfortable with.”

Beijing shows every sign of being comfortable with “Pixels.” This week, Sony had some good news: “Pixels” has been approved for release in China. It opens there on September 15.

(Additional reporting by Viola Zhou in Hong Kong, Megha Rajagopalan in Beijing and Piya Sinha-Roy in Los Angeles. Edited by Peter Hirschberg)

]]>
http://blogs.reuters.com/kristina-cooke/2015/07/24/special-report-how-sony-sanitized-adam-sandler-movie-to-please-chinese-censors/feed/ 0
How Sony sanitized Adam Sandler movie to please Chinese censors http://www.reuters.com/article/2015/07/24/china-film-idUSL1N1040TO20150724?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/07/24/how-sony-sanitized-adam-sandler-movie-to-please-chinese-censors/#comments Fri, 24 Jul 2015 13:56:50 +0000 http://blogs.reuters.com/kristina-cooke/?p=1289 HONG KONG/LOS ANGELES, July 24 (Reuters) – In a 2013 script
for the movie “Pixels,” intergalactic aliens blast a hole in one
of China’s national treasures – the Great Wall.

That scene is gone from the final version of the sci-fi
comedy, starring Adam Sandler and released by Sony Pictures
Entertainment this week in the United States. The aliens strike
iconic sites elsewhere, smashing the Taj Mahal in India, the
Washington Monument and parts of Manhattan.

Sony executives spared the Great Wall because they were
anxious to get the movie approved for release in China, a review
of internal Sony Pictures emails shows. It is just one of a
series of changes aimed at stripping the movie of content that,
Sony managers feared, Chinese authorities might have construed
as casting their country in a negative light.

Along with the Great Wall scene, out went a scene in which
China was mentioned as a potential culprit behind an attack, as
well as a reference to a “Communist-conspiracy brother” hacking
a mail server – all to increase the chances of getting “Pixels”
access to the world’s second-biggest box office.

“Even though breaking a hole on the Great Wall may not be a
problem as long as it is part of a worldwide phenomenon, it is
actually unnecessary because it will not benefit the China
release at all. I would then, recommend not to do it,” Li Chow,
chief representative of Sony Pictures in China, wrote in a
December 2013 email to senior Sony executives.

Li’s message is one of tens of thousands of confidential
Sony emails and documents that were hacked and publicly released
late last year. The U.S. government blamed North Korea for the
breach. In April, WikiLeaks published the trove of emails, memos
and presentations from the Sony hack in an online searchable
archive.

“We are not going to comment on stolen emails or internal
discussions about specific content decisions,” said a spokesman
for Sony Pictures, a unit of Tokyo-based Sony Corp. “There are
myriad factors that go into determining what is best for a
film’s release, and creating content that has wide global appeal
without compromising creative integrity is top among them.”

Chinese government and film-industry officials didn’t
respond to requests for comment for this story.

A PALATABLE ‘ROBOCOP’

“Pixels” wasn’t the only Sony movie in which the China
content was carefully scrutinized. The emails reveal how studio
executives discussed ways to make other productions, including
the 2014 remake of “RoboCop,” more palatable to Chinese
authorities.

In a 2013 email about “RoboCop,” the senior vice president
at Sony Pictures Releasing International at the time, Steve
Bruno, proposed relocating a multinational weapons conglomerate
from China. His solution: Put it in a Southeast Asian country
like Vietnam or Cambodia. Ultimately, that change wasn’t made, a
viewing of the movie shows. Bruno has since left Sony.

The Sony emails provide a behind-the-scenes picture of the
extent to which one of the world’s leading movie studios
exercised self-censorship as its executives tried to anticipate
how authorities in Beijing might react to their productions. The
internal message traffic also illustrates the deepening
dependence of Hollywood on audiences in China, where box office
receipts jumped by almost a third last year to $4.8 billion, as
revenues in the United States and Canada shrank.

Other studios have made changes to movies in a bid to get
them approved by Beijing, altering the version that is screened
in China. A scene showing a Chinese doctor who helps the main
character in “Iron Man 3,” for example, was lengthened in the
Chinese version and included popular Chinese actress Fan
Bingbing, a comparison of the Chinese and international versions
shows. Produced by Marvel Studios, “Iron Man 3″ was the second
top grossing movie in China in 2013. Marvel declined to comment.

THE LOGIC OF SELF-CENSORSHIP

In the case of “Pixels,” in which the aliens attack Earth in
the form of popular video game characters, the Sony emails point
to the creation of a single version for all audiences – a
China-friendly one. The logic behind Sony’s thinking was
explained by Steven O’Dell, president of Sony Pictures Releasing
International, in a September 12, 2013 email about “RoboCop.”

“Changing the China elements to another country should be a
relatively easy fix,” O’Dell wrote. “There is only downside to
leaving the film as it is. Recommendation is to change all
versions as if we only change the China version, we set
ourselves up for the press to call us out for this when bloggers
invariably compare the versions and realize we changed the China
setting just to pacify that market.”

Efforts by the U.S. motion-picture industry to woo China
come as the ruling Communist Party under President Xi Jinping is
engaged in the biggest crackdown on civil society in more than
two decades. About a dozen human rights lawyers were taken into
police custody this month, and hundreds of dissidents have been
detained since Xi took power in late 2012.

As China rises, its efforts to contain civil liberties at
home are radiating outward. The removal of scenes from “Pixels”
thought to be offensive to Beijing shows how global audiences
are effectively being subjected to standards set by China, whose
government rejects the kinds of freedoms that have allowed
Hollywood to flourish.

“I think the studios have grown pretty savvy,” said Peter
Shiao, founder and CEO of Orb Media Group, an independent film
studio focused on Hollywood-Chinese co-productions. “For a type
of movie, particularly the global blockbusters, they are not
going to go and make something that the Chinese would reject for
social or political reasons. That is already a truism.”

Sony’s emails were hacked ahead of the release of “The
Interview,” a comedy depicting the assassination of North Korean
leader Kim Jong-un. When Sony halted the film’s release in
response to threats made against movie theaters, U.S. President
Barack Obama warned of the dangers of self-censorship.
Ultimately, Sony released the movie.

“If somebody is able to intimidate folks out of releasing a
satirical movie, imagine what they start doing when they see a
documentary that they don’t like, or news reports that they
don’t like,” Obama said at his year-end White House press
briefing. “Or even worse, imagine if producers and distributors
and others start engaging in self-censorship because they don’t
want to offend the sensibilities of somebody whose sensibilities
probably need to be offended. That’s not who we are. That’s not
what America is about.”

FAST & FURIOUS GROWTH

For Hollywood studios, the allure of the Chinese box office
has become increasingly difficult to resist. While box office
receipts in the United States and Canada combined fell five
percent last year to $10.4 billion compared with 2013, box
office receipts in China jumped 34 percent to $4.8 billion in
the same period, according to the Motion Picture Association of
America Inc.

China is on course to set a new record this year: Box office
receipts were $3.3 billion in the first half of 2015, China’s
state-run media reported. Action movie “Fast & Furious 7″ was
the best ticket seller in China by early June 2015, grossing
$383 million – higher than the $351 million in the United States
and Canada combined. It was followed by “Avengers: Age of
Ultron” and “Jurassic World.”

Last November, the vice president of the China Film
Producers’ Association, Wang Fenglin, said the Chinese film
market would overtake the United States to become the largest in
the world within three years.

The importance of the China market appears to have informed
decisions taken by Metro-Goldwyn-Mayer Studios Inc in its 2012
remake of the action movie “Red Dawn.” MGM changed the
nationality of the soldiers who invade the United States from
Chinese to North Korean in post-production, according to Red
Dawn producer Tripp Vinson. MGM did not respond to requests for
comment.

APPARATUS OF CONTROL

To get on the circuit in China, a movie must win the
approval of the Film Bureau, which is headed by Zhang Hongsen, a
domestic television screenwriter and senior Communist Party
member. “Foreign films come to China one after another like
aircraft carriers; we are facing great pressure and challenges,”
Zhang said last year. “We must make the Chinese film industry
bigger and stronger.”

The Film Bureau is part of the State Administration of
Press, Publication, Radio, Film and Television (SAPPRFT), which
reports directly to China’s cabinet, the State Council. The
administration controls state-owned enterprises in the
communications field, including China Central Television and
China Radio International.

Censorship guidelines are included in a 2001 order issued by
the State Council. The order bans content that endangers the
unity, sovereignty and territorial integrity of China, harms
national honor and disrupts social stability. Harming public
morality and national traditions is forbidden.

SAPPRFT guidelines also include bans on material seen as
“disparaging of the government” and political figures. The
broadening scope of these guidelines can be seen in an email
sent last November by Sanford Panitch, who has since joined Sony
as President of International Film and Television, to Sony
Entertainment CEO Michael Lynton.

The email outlines new measures that were being implemented
by SAPPRFT officials: “What is different is now they are clearly
making an attempt to try to address other areas not been
specified before, decadence, fortune telling, hunting, and most
dramatically, sexuality,” Panitch wrote.

Studios also have to work with China Film Group Corp, a
state-owned conglomerate that imports and distributes foreign
movies. In some cases China Film also acts as an investor. In
the emails, Sony executives discussed a co-financing arrangement
whereby China Film will cover 10 percent of the budget of
“Pixels.” China Film is run by La Peikang, a Communist Party
member and the former deputy head of the Film Bureau.

“TOO MUCH MONEY ON THE LINE”

A total of 34 foreign films are allowed into China each year
under a revenue-sharing model that gives 25 percent of box
office receipts to foreign movie studios. Fourteen of those
films must be in “high-tech” formats such as 3D or IMAX.

The censorship process in China can be unpredictable, the
Sony emails show. In early 2014, the studio was faced with a
demand to remove for Chinese audiences a key but disturbing
scene from “RoboCop,” the story of a part-man, part-machine
police officer.

“Censorship really hassling us on Robocoptrying to cut out
the best and most vital scene where they open up his suit and
expose what is left of him as a person,” reads a January 28,
2014 email written by international executive Steven O’Dell.
“Hope to get through it with only shortening up the scene a bit.
Don’t think we can make a stand on it either way, too much money
on the line, cross fingers we don’t have to cut the scene out.”

The political climate under President Xi may also be playing
a role, one email indicates. “As to greater flexibility, I am
not so sure about that,” Sony China executive Li Chow wrote in
early 2014, commenting on a media report that Beijing was
mulling an increase in its foreign film quota. “The present
government seems more conservative in all aspects and this is
reflected by the repeated cuts to Robocop. Lately, members of
the censorship board seem uncertain, fearful and overly
careful.”

In the messages in which “Pixels” is discussed, Sony
executives grapple with how to gauge the sensitivities of the
Chinese authorities.

In a November 1, 2013 email, Li Chow suggested making a
number of changes to the script, including the scene in which a
hole is smashed in the Great Wall. “This is fine as long as this
is shown as part of a big scale world-wide destruction, meaning
that it would be good to show several recognizable historical
sites in different parts of the world being destroyed,” she
wrote.

She also advised altering a scene in which the President of
the United States, an ambassador and the head of the CIA
speculate that China could be behind an attack using an unknown
technology. In the final version, which moviegoers are now
getting to see, the officials speculate that Russia, Iran or
Google could be to blame.

“China can be mentioned alongside other super powers but
they may not like ‘Russia and China don’t have this kind of
technology’,” Li wrote in the email. “And in view of recent news
on China hacking into government servers, they may object to ‘a
communist-conspiracy brother hacked into the mail server…'”

“THE UNWRITTEN RULE”

In mid-December 2013, Li suggested doing away with the Great
Wall scene altogether, saying it was “unnecessary.”

Around the same time, the emails show Sony executives also
discussed relocating a car-chase scene involving the video-game
character Pac-Man from Tokyo to Shanghai, and whether that might
help with the release date in China.

Li Chow advised against the change. “As to relocating the
Pac-Man action from Tokyo to Shanghai, this is not a good idea
because it will involve destruction all over the city and may
likely cause some sensitivity,” she wrote in a December 18, 2013
email. “In other words, it is rather hard to say whether it
would be a problem because the unwritten rule is that it is
acceptable if there is no real intention in destroying a certain
building or street and if it is just collateral damage. But
where would you draw the line?”

Ultimately, all references to China in the movie were
scrubbed. That decision appears to have been made in early 2014.
“It looks like Doug is going to heed Li’s advice and get all
China references out of Pixels (including not using the Great
Wall as one of the set pieces),” international executive O’Dell
wrote, referring to then-Columbia Pictures President Doug
Belgrad.

The cost of not winning approval to distribute a movie in
China is also evident in the Sony emails. In February 2014, a
Sony marketing executive circulated an email: “Please note that
CAPTAIN PHILLIPS will not be released theatrically in China” – a
reference to the movie in which Tom Hanks stars as Captain
Richard Phillips, who was taken hostage by Somali pirates in
2009.

Budget discussions about “Captain Phillips,” contained in
the emails, show Sony executives had expected to earn $120
million globally from the movie, but that changed when they
didn’t get approval for it to be screened in China. “We are
short $9M and we won’t be getting into China,” emailed notes
from a conference call read. “We need to grab every dollar we
can to meet our objectives. It is incumbent on all of us to try
to figure out how we can get more money from this picture.”

In a December 2013 email, Rory Bruer, president of worldwide
distribution at Sony Pictures, had speculated that “Captain
Phillips” was unlikely to be approved by China’s censors. In the
film, the U.S. military rescues the ship’s captain. That plot
element, Bruer noted, might make Chinese officials squirm.

“The reality of the situation is that China will probably
never clear the film for censorship,” wrote Bruer. “Reasons
being the big Military machine of the U.S. saving one U.S.
citizen. China would never do the same and in no way would want
to promote this idea. Also just the political tone of the film
is something that they would not feel comfortable with.”

Beijing shows every sign of being comfortable with “Pixels.”
This week, Sony had some good news: “Pixels” has been approved
for release in China. It opens there on September 15.

(Additional reporting by Viola Zhou in Hong Kong, Megha
Rajagopalan in Beijing and Piya Sinha-Roy in Los Angeles. Edited
by Peter Hirschberg)

]]>
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Special Report: Banned from Medicare, still billing Medicaid http://www.reuters.com/article/2015/04/29/us-usa-medicaid-fraud-specialreport-idUSKBN0NK1ID20150429?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/04/29/special-report-banned-from-medicare-still-billing-medicaid/#comments Wed, 29 Apr 2015 13:32:47 +0000 http://blogs.reuters.com/kristina-cooke/?p=1281 NEW YORK/SAN FRANCISCO (Reuters) – A doctor who took kickbacks from a Pennsylvania hospice involved in a multimillion-dollar fraud. An Ohio psychiatrist who billed for treating no-show patients. A Georgia optometrist who claimed he conducted 177 eye exams in one day.

Their transgressions vary. What these doctors have in common is that each was paid by a state Medicaid health insurance program after being kicked out of another state’s Medicaid system or the federal Medicare program.

That’s not supposed to happen. The Affordable Care Act, or Obamacare as it is popularly known, explicitly requires that states suspend the billing privileges of most providers who have been “terminated” or “revoked” by another state or Medicare.

But in an exclusive analysis of state and federal data, Reuters found that more than one in five of the thousands of doctors and other healthcare providers in the U.S. prohibited from billing Medicare are still able to bill state Medicaid programs.

In all, Reuters found 1,800 banned providers that were still able to bill elsewhere on a given date in 2014. The figures almost certainly underestimate the phenomenon by thousands of providers because of inadequate state and federal data.

After reviewing Reuters’ list of revoked providers, 17 state Medicaid programs terminated, attempted to recoup money from or launched investigations of 67 of the providers. Based on incomplete data from most of those states, the providers had been paid a combined total of at least $874,000 while revoked.

More broadly, 32 states and the District of Columbia supplied data showing they paid at least $79 million to 269 of the 1,800 providers after their terminations elsewhere. But the data was incomplete. Extrapolating from what could be verified, Medicaid payments to banned providers could easily reach into the hundreds of millions of dollars.

“We spend a lot of resources to identify bad actors, so this should be low hanging fruit,” said Blaine Collins, a deputy regional inspector general for the U.S. Department of Health and Human Services, which investigates fraud, waste and abuse in Medicare.

The problem has taken on added urgency since the 2010 passage of the Affordable Care Act. That sweeping overhaul of the U.S. healthcare system is counting on a reduction in fraud and abuse to help pay for an $800 billion expansion of Medicaid – and to ensure that those additional dollars don’t go to the wrong people.

To that end, the act required the federal Centers for Medicare and Medicaid Services (CMS) to set up a data-sharing system that would allow states to identify providers terminated in other states or by Medicare. In the past, only a few states maintained such lists.

THROUGH THE CRACKS

But the data-sharing system is deeply flawed. Banned providers can slip through the cracks because of missing or erroneous data. Others remain unrecorded because of state laws that don’t square with federal requirements or because of different interpretations of language in the Affordable Care Act.

Responding to Reuters’ findings, CMS officials said the data on revoked providers could be misleading. They noted that under federal law, states aren’t required to terminate all revoked providers.

Still, CMS officials acknowledged that providers revoked under federal law “for cause” – for fraud or issues of quality and integrity – sometimes continue to bill state Medicaid programs when they shouldn’t. Deputy Administrator Shantanu Agrawal said the agency was working to improve the system.

“If there are bad actors who are not following the rules, we want these actors to be revoked across all Medicaid programs,” Agrawal said.

Officials in Minnesota, responding to the Reuters analysis, are attempting to retrieve $548,000 from five providers who were paid after their Medicare revocations. Nevada officials are attempting to recoup $250,000.

Georgia’s health department terminated optometrist Dr. Jeffrey Sponseller on Feb. 20, 2013, the same day he pleaded guilty to Medicare fraud. He claimed that in a single day, he conducted 177 eye exams that would have taken 132 hours to perform.

Sponseller remained on South Carolina’s Medicaid rolls for almost a year afterward, until Reuters asked about him.

“If you hadn’t brought this to our attention, we don’t know when we would have known about this,” said Kim Cox, director of communications for the South Carolina Department of Health and Human Services. South Carolina has not attempted to recoup the money.

Sponseller, now serving a 33-month sentence in federal prison, was unavailable for comment.

Data input errors allowed Yevgeniy Goldman, a Philadelphia doctor, to remain approved to bill Pennsylvania’s Medicaid program even while serving a 51-month prison sentence for taking $263,000 in illegal payments for patient referrals to a home hospice company.

CMS said he was able to do that because of a mistake in the report the agency provides to states. CMS fixed the error after Reuters inquired about Goldman in October 2014. Pennsylvania paid $17,000 for services provided by Goldman after his guilty verdict – but before he began serving time.

Goldman’s lawyer, Christopher Lewis, said that his client is appealing the conviction and that all the services he prescribed were medically necessary.

NOT HERE, BUT HERE

Muhammad Choudhry came to the attention of investigators for the Ohio Bureau of Workers’ Compensation in 2006 after a data analysis revealed suspicious billing patterns. Agents staked out his office in Columbus, Ohio, reviewed medical records and interviewed patients over the course of a three-year investigation.

They found, among other things, that Choudhry routinely billed for 20 hours of individual psychotherapy in a day and significantly over-reported the time he spent with patients. In some cases, he billed for 45 to 50 minutes of treatment for patients who popped in for less than five minutes or never showed up at all.

Choudhry pleaded no contest in a Franklin County, Ohio, court in June 2011 to felony workers’ compensation fraud and was ordered to pay restitution of $78,573 to the Ohio Bureau of Workers’ Compensation. CMS revoked his billing privileges from the date of his conviction. In an unsuccessful appeal to the Ohio medical board, Choudhry blamed his secretary for the fraudulent billing. Ohio permanently revoked his state license to practice medicine in 2012.

Two states over, Choudhry continued to work in the Illinois Medicaid program. Illinois first learned of Choudhry’s workers’ compensation fraud in February 2012 and suspended him from receiving payments. But the state’s nearly 40-year-old payment system failed to stop payments for services he provided through the company where he worked or prescriptions that he wrote.

In spring 2012, the inspector general of the U.S. Health and Human Services Department told Illinois that Choudhry was excluded from all government healthcare programs, including Medicaid, according to Brad Hart, inspector general for the Illinois Department for Healthcare and Family Services. At that point Illinois should have terminated Choudhry’s billing privileges, he said. “We probably made mistakes in this particular case.”

Illinois terminated Choudhry on April 30, 2013, nearly two years after the date of his Medicare revocation. The state’s Medicaid program paid $560,000 for services Choudhry provided or prescriptions he wrote after his Medicare revocation.

Yet investigators may have missed warning signs of further problems. Reuters analyzed Choudhry’s billing in Illinois from 2009 through mid-2013 and found claims that billing experts said were questionable. Choudhry provided group therapy sessions for more than 100 Illinois Medicaid patients almost every other day in 2010 and 2011.

On June 6, 2011, he saw 131 group therapy patients at his Illinois practice, according to Medicaid claims data. One problem: He was in Columbus, Ohio, that day, being sentenced for workers’ compensation fraud.

Beth Morgan, a medical billing consultant, said 131 patients would be a red flag even on a day he wasn’t traveling. “Something’s not kosher,” she said.

Choudhry also claimed that he saw 300 or more patients for group therapy on each of two days in August 2010 at Midwest Behavioral Center, the psychotherapy practice where he worked. Those sessions yielded as much as $8,000 a day.

Choudhry declined to comment.

A spokesman for the Illinois Department of Healthcare and Family Services said the department is investigating Choudhry and Midwest Behavioral Center and cannot comment on either provider’s billing practices.

“WHAT A MESS”

Attempts to improve data-sharing under the Affordable Care Act to help states catch unscrupulous providers got off to a rough start. In early 2014, CMS abandoned the rollout of a new system after several states were unable to access it for at least four months.

In an April 2, 2014, email to Medicaid officials in other states, Kelly Shropshire, director of the Oklahoma Health Care Authority’s program integrity division, complained that the team responsible for screening providers could not obtain a username or password from Medicare to access the system.

“What a mess,” Dawn Mock, North Dakota’s Medicaid integrity administrator, wrote in a March 26, 2014, email to Medicaid officials in other states. “Especially if we can’t access the site. (I thought it was just us).”

State Medicaid officials said the system CMS now has in place – an Excel file updated every two weeks – allows states to share more detailed information on providers, like Social Security numbers. But fortnightly updates mean state officials don’t always get the information as soon as they would like.

Another problem is that states have historically enjoyed wide latitude in how they administer Medicaid. An old joke in Medicaid circles is that if you’ve seen one Medicaid program, you’ve seen one Medicaid program.

One result is different sets of rules for each of the 50 states and Washington, D.C.

Federal regulations require that a provider terminated “for cause” in either Medicare or Medicaid be terminated by all states. But states have different interpretations of “for cause.” States aren’t required to ban providers terminated by Medicare when the reason doesn’t fall under the definition of “for cause.” One such case is when a doctor dies: Medicare removes them from its list of approved providers, while some states don’t, even though experts say a dead doctor with billing privileges is an invitation to fraud.

Such differences are evident in the case of Dynasplint Systems Inc. In 2012, the U.S. Department of Justice took over a whistleblower case alleging that the Severna Park, Maryland, company was improperly billing Medicare for durable medical equipment it provided to patients living in skilled nursing facilities.

The government argued that Dynasplint falsely claimed it sold this equipment to patients for use at home. Skilled nursing homes are paid a daily rate by Medicare that includes the cost of providing durable medical equipment to patients.

Dynasplint’s chief executive, George Hepburn, said the company “did not commit fraud or anything anywhere near it.” He said the patients in question were not receiving skilled care and thus weren’t covered by reimbursements the nursing facility received.

Some states considered the false claims lawsuit to be a “credible allegation of fraud,” requiring suspension of payments to Dynasplint under the law, while other states did not. Some didn’t know about the lawsuit.

At the request of the Justice Department, five states terminated or suspended payments to Dynasplint in August and September of 2013. Three other states followed suit over the next 18 months, including Arizona, which revoked Dynasplint after Reuters asked about the company. Dynasplint is still approved to bill in 24 states, however, and it has been paid at least $123,000 by state Medicaid programs since August 28, 2013. A trial is set for September 2015.

CMS Deputy Administrator Agrawal said that his agency is working to “harmonize” states’ interpretation of when a provider must be terminated after CMS or another state has done so, but that discrepancies persist.

(Edited by John Blanton)

]]>
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Figuring out who can bill Medicare and Medicaid, and who can’t http://www.reuters.com/article/2015/04/29/us-usa-medicaid-methodology-idUSKBN0NK1IX20150429?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/04/29/figuring-out-who-can-bill-medicare-and-medicaid-and-who-cant/#comments Wed, 29 Apr 2015 13:31:30 +0000 http://blogs.reuters.com/kristina-cooke/?p=1283 By M.B. Pell and Kristina Cooke

(Reuters) – To determine how many healthcare providers were banned from Medicare or a state Medicaid program while still allowed to bill Medicaid in another state, Reuters compared states’ lists of approved providers against lists of providers terminated by other states or Medicare on a specific date in 2014.

In response to open-records requests, all states and the District of Columbia supplied approved-provider lists. Only 23 states supplied terminated-provider lists, as did the Centers for Medicare and Medicaid Services, the federal agency that administers Medicare, and the U.S. Department of Health and Human Services Office of the Inspector General.

To avoid false matches, only providers with a National Provider Identifier number were included. About 55 percent of revoked or terminated providers were correctly coded with that identifier.

Reuters made every effort to include only those providers terminated “for cause” – the standard in the Affordable Care Act that requires states to follow suit and terminate a provider. CMS defines “for cause” as “terminations based upon fraud, integrity, or quality.”

Providers that were terminated, but not “for cause,” were removed from the analysis when: the termination resulted from a lapsed license while the provider continued to practice fully licensed in another state; the provider received a waiver because of a shortage of the services provided; or a providers’ revocation had been overturned on appeal.

Some providers were kept in the analysis even though they hadn’t been terminated for cause: dead doctors (because their provider numbers can still be used for fraudulent purposes by others); and providers revoked from one part of Medicare but still allowed to bill another.

In some cases, the data gave only a vague reason for the revocation. Reuters included those providers unless a state or another source provided a reason not to.

Ultimately, the analysis yielded 1,800 providers terminated for cause or falling under one of the exceptions Reuters established.

Only thirty-two states and Washington, D.C., provided billing information on the 1,800 providers. Most of the rest of the states asked for between $150 and $12,000 for the information.

(Edited by John Blanton)

]]>
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Banned from Medicare, still billing Medicaid http://www.reuters.com/article/2015/04/29/usa-medicaid-fraud-idUSL1N0XO0S520150429?feedType=RSS&feedName=everything&virtualBrandChannel=11563 http://blogs.reuters.com/kristina-cooke/2015/04/29/banned-from-medicare-still-billing-medicaid/#comments Wed, 29 Apr 2015 13:24:02 +0000 http://blogs.reuters.com/kristina-cooke/?p=1285 NEW YORK/SAN FRANCISCO, April 29 (Reuters) – A doctor who
took kickbacks from a Pennsylvania hospice involved in a
multimillion-dollar fraud. An Ohio psychiatrist who billed for
treating no-show patients. A Georgia optometrist who claimed he
conducted 177 eye exams in one day.

Their transgressions vary. What these doctors have in common
is that each was paid by a state Medicaid health insurance
program after being kicked out of another state’s Medicaid
system or the federal Medicare program.

That’s not supposed to happen. The Affordable Care Act, or
Obamacare as it is popularly known, explicitly requires that
states suspend the billing privileges of most providers who have
been “terminated” or “revoked” by another state or Medicare.

But in an exclusive analysis of state and federal data,
Reuters found that more than one in five of the thousands of
doctors and other healthcare providers in the U.S. prohibited
from billing Medicare are still able to bill state Medicaid
programs.

In all, Reuters found 1,800 banned providers that were still
able to bill elsewhere on a given date in 2014. The figures
almost certainly underestimate the phenomenon by thousands of
providers because of inadequate state and federal data.

After reviewing Reuters’ list of revoked providers, 17 state
Medicaid programs terminated, attempted to recoup money from or
launched investigations of 67 of the providers. Based on
incomplete data from most of those states, the providers had
been paid a combined total of at least $874,000 while revoked.

More broadly, 32 states and the District of Columbia
supplied data showing they paid at least $79 million to 269 of
the 1,800 providers after their terminations elsewhere. But the
data was incomplete. Extrapolating from what could be verified,
Medicaid payments to banned providers could easily reach into
the hundreds of millions of dollars.

“We spend a lot of resources to identify bad actors, so this
should be low hanging fruit,” said Blaine Collins, a deputy
regional inspector general for the U.S. Department of Health and
Human Services, which investigates fraud, waste and abuse in
Medicare.

The problem has taken on added urgency since the 2010
passage of the Affordable Care Act. That sweeping overhaul of
the U.S. healthcare system is counting on a reduction in fraud
and abuse to help pay for an $800 billion expansion of Medicaid
– and to ensure that those additional dollars don’t go to the
wrong people.

To that end, the act required the federal Centers for
Medicare and Medicaid Services (CMS) to set up a data-sharing
system that would allow states to identify providers terminated
in other states or by Medicare. In the past, only a few states
maintained such lists.

THROUGH THE CRACKS

But the data-sharing system is deeply flawed. Banned
providers can slip through the cracks because of missing or
erroneous data. Others remain unrecorded because of state laws
that don’t square with federal requirements or because of
different interpretations of language in the Affordable Care
Act.

Responding to Reuters’ findings, CMS officials said the data
on revoked providers could be misleading. They noted that under
federal law, states aren’t required to terminate all revoked
providers.

Still, CMS officials acknowledged that providers revoked
under federal law “for cause” – for fraud or issues of quality
and integrity – sometimes continue to bill state Medicaid
programs when they shouldn’t. Deputy Administrator Shantanu
Agrawal said the agency was working to improve the system.

“If there are bad actors who are not following the rules, we
want these actors to be revoked across all Medicaid programs,”
Agrawal said.

Officials in Minnesota, responding to the Reuters analysis,
are attempting to retrieve $548,000 from five providers who were
paid after their Medicare revocations. Nevada officials are
attempting to recoup $250,000.

Georgia’s health department terminated optometrist Dr.
Jeffrey Sponseller on Feb. 20, 2013, the same day he pleaded
guilty to Medicare fraud. He claimed that in a single day, he
conducted 177 eye exams that would have taken 132 hours to
perform.

Sponseller remained on South Carolina’s Medicaid rolls for
almost a year afterward, until Reuters asked about him.

“If you hadn’t brought this to our attention, we don’t know
when we would have known about this,” said Kim Cox, director of
communications for the South Carolina Department of Health and
Human Services. South Carolina has not attempted to recoup the
money.

Sponseller, now serving a 33-month sentence in federal
prison, was unavailable for comment.

Data input errors allowed Yevgeniy Goldman, a Philadelphia
doctor, to remain approved to bill Pennsylvania’s Medicaid
program even while serving a 51-month prison sentence for taking
$263,000 in illegal payments for patient referrals to a home
hospice company.

CMS said he was able to do that because of a mistake in the
report the agency provides to states. CMS fixed the error after
Reuters inquired about Goldman in October 2014. Pennsylvania
paid $17,000 for services provided by Goldman after his guilty
verdict – but before he began serving time.

Goldman’s lawyer, Christopher Lewis, said that his client is
appealing the conviction and that all the services he prescribed
were medically necessary.

NOT HERE, BUT HERE

Muhammad Choudhry came to the attention of investigators for
the Ohio Bureau of Workers’ Compensation in 2006 after a data
analysis revealed suspicious billing patterns. Agents staked out
his office in Columbus, Ohio, reviewed medical records and
interviewed patients over the course of a three-year
investigation.

They found, among other things, that Choudhry routinely
billed for 20 hours of individual psychotherapy in a day and
significantly over-reported the time he spent with patients. In
some cases, he billed for 45 to 50 minutes of treatment for
patients who popped in for less than five minutes or never
showed up at all.

Choudhry pleaded no contest in a Franklin County, Ohio,
court in June 2011 to felony workers’ compensation fraud and was
ordered to pay restitution of $78,573 to the Ohio Bureau of
Workers’ Compensation. CMS revoked his billing privileges from
the date of his conviction. In an unsuccessful appeal to the
Ohio medical board, Choudhry blamed his secretary for the
fraudulent billing. Ohio permanently revoked his state license
to practice medicine in 2012.

Two states over, Choudhry continued to work in the Illinois
Medicaid program. Illinois first learned of Choudhry’s workers’
compensation fraud in February 2012 and suspended him from
receiving payments. But the state’s nearly 40-year-old payment
system failed to stop payments for services he provided through
the company where he worked or prescriptions that he wrote.

In spring 2012, the inspector general of the U.S. Health and
Human Services Department told Illinois that Choudhry was
excluded from all government healthcare programs, including
Medicaid, according to Brad Hart, inspector general for the
Illinois Department for Healthcare and Family Services. At that
point Illinois should have terminated Choudhry’s billing
privileges, he said. “We probably made mistakes in this
particular case.”

Illinois terminated Choudhry on April 30, 2013, nearly two
years after the date of his Medicare revocation. The state’s
Medicaid program paid $560,000 for services Choudhry provided or
prescriptions he wrote after his Medicare revocation.

Yet investigators may have missed warning signs of further
problems. Reuters analyzed Choudhry’s billing in Illinois from
2009 through mid-2013 and found claims that billing experts said
were questionable. Choudhry provided group therapy sessions for
more than 100 Illinois Medicaid patients almost every other day
in 2010 and 2011.

On June 6, 2011, he saw 131 group therapy patients at his
Illinois practice, according to Medicaid claims data. One
problem: He was in Columbus, Ohio, that day, being sentenced for
workers’ compensation fraud.

Beth Morgan, a medical billing consultant, said 131 patients
would be a red flag even on a day he wasn’t traveling.
“Something’s not kosher,” she said.

Choudhry also claimed that he saw 300 or more patients for
group therapy on each of two days in August 2010 at Midwest
Behavioral Center, the psychotherapy practice where he worked.
Those sessions yielded as much as $8,000 a day.

Choudhry declined to comment.

A spokesman for the Illinois Department of Healthcare and
Family Services said the department is investigating Choudhry
and Midwest Behavioral Center and cannot comment on either
provider’s billing practices.

“WHAT A MESS”

Attempts to improve data-sharing under the Affordable Care
Act to help states catch unscrupulous providers got off to a
rough start. In early 2014, CMS abandoned the rollout of a new
system after several states were unable to access it for at
least four months.

In an April 2, 2014, email to Medicaid officials in other
states, Kelly Shropshire, director of the Oklahoma Health Care
Authority’s program integrity division, complained that the team
responsible for screening providers could not obtain a username
or password from Medicare to access the system.

“What a mess,” Dawn Mock, North Dakota’s Medicaid integrity
administrator, wrote in a March 26, 2014, email to Medicaid
officials in other states. “Especially if we can’t access the
site. (I thought it was just us).”

State Medicaid officials said the system CMS now has in
place – an Excel file updated every two weeks – allows states to
share more detailed information on providers, like Social
Security numbers. But fortnightly updates mean state officials
don’t always get the information as soon as they would like.

Another problem is that states have historically enjoyed
wide latitude in how they administer Medicaid. An old joke in
Medicaid circles is that if you’ve seen one Medicaid program,
you’ve seen one Medicaid program.

One result is different sets of rules for each of the 50
states and Washington, D.C.

Federal regulations require that a provider terminated “for
cause” in either Medicare or Medicaid be terminated by all
states. But states have different interpretations of “for
cause.” States aren’t required to ban providers terminated by
Medicare when the reason doesn’t fall under the definition of
“for cause.” One such case is when a doctor dies: Medicare
removes them from its list of approved providers, while some
states don’t, even though experts say a dead doctor with billing
privileges is an invitation to fraud.

Such differences are evident in the case of Dynasplint
Systems Inc. In 2012, the U.S. Department of Justice took over a
whistleblower case alleging that the Severna Park, Maryland,
company was improperly billing Medicare for durable medical
equipment it provided to patients living in skilled nursing
facilities.

The government argued that Dynasplint falsely claimed it
sold this equipment to patients for use at home. Skilled nursing
homes are paid a daily rate by Medicare that includes the cost
of providing durable medical equipment to patients.

Dynasplint’s chief executive, George Hepburn, said the
company “did not commit fraud or anything anywhere near it.” He
said the patients in question were not receiving skilled care
and thus weren’t covered by reimbursements the nursing facility
received.

Some states considered the false claims lawsuit to be a
“credible allegation of fraud,” requiring suspension of payments
to Dynasplint under the law, while other states did not. Some
didn’t know about the lawsuit.

At the request of the Justice Department, five states
terminated or suspended payments to Dynasplint in August and
September of 2013. Three other states followed suit over the
next 18 months, including Arizona, which revoked Dynasplint
after Reuters asked about the company. Dynasplint is still
approved to bill in 24 states, however, and it has been paid at
least $123,000 by state Medicaid programs since August 28, 2013.
A trial is set for September 2015.

CMS Deputy Administrator Agrawal said that his agency is
working to “harmonize” states’ interpretation of when a provider
must be terminated after CMS or another state has done so, but
that discrepancies persist.

(Edited by John Blanton)

]]>
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