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Corruption

Opinion | New name, same (alleged) corruption at HealthSouth

Josh Moon

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The name might be different but the corruption is the same for HealthSouth/Encompass. 

Last week, the Department of Justice announced that it had reached an agreement with Encompass — which was used to be named HealthSouth before it changed its name to shirk off the stink of massive fraud under former CEO Richard Scrushy — to settle three lawsuits brought by whistleblowers who alleged massive Medicare/Medicaid fraud. 

The final bill: $48 million. 

Encompass CEO Mark Tarr, of course, called this all a money saving move, proclaimed that the company did nothing wrong and chastised the federal government for a prolonged investigation that ultimately revealed no wrongdoing. 

Mmmmhmmm. 

I suppose that argument works for all of the people who won’t bother to check on the origin of this case and the three lawsuits which brought it about. Because those whistleblower lawsuits weren’t filed by rubes who thought something might be amiss. 

They were filed by two doctors working in Encompass facilities in Sarasota, Fla., and Richmond, Va., and the director of therapy operations at an Encompass facility in Arlington, Tx. 

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And the three tell remarkably similar stories of how HealthSouth/Encompass executives pressured them and other employees to break the law, violate Medicare/Medicaid rules, lie about patients’ diagnoses and fabricate patient charts. 

These practices, the three estimated, cost taxpayers hundreds of millions of dollars in bogus fees paid out to HealthSouth/Encompass facilities over the span of a few years. 

And if you think this alleged fraud was carried out simply through sly accounting tricks, oh no. There were some of those, but the majority of the fraud spanned from the obvious to the downright comically obvious. 

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For example, in his complaint, Dr. Emese Simon, who was a contract physician at the Encompass facility in Sarasota, said he witnessed such things as the kitchen staff at the facility providing group therapy sessions — for which Encompass billed Medicare the full cost of “individual therapy sessions.” 

Simon also described in detail how patients who clearly failed to meet the basic admission standards were admitted anyway. In one case, a man paralyzed from the waist down due to an inoperable cancerous tumor on his spine was admitted for therapy for his lower extremities that he obviously couldn’t participate in.     

At any given time, Simon said in his complaint, more than two-thirds of the patients in the Sarasota facility didn’t meet the standards for care under Medicare guidelines. 

But we paid out $1,000 per day per patient for them. A conservative estimate during the years Simon worked for the facility: $84 million. 

That was one facility. 

In Richmond, where Dr. Darius Clarke was the medical director at an Encompass Facility, the higher-ups within the company had to get more involved, according to Clarke’s lawsuit, because the director refused to go along with their schemes. 

That left HealthSouth/Encompass execs seeking “second opinions” in order to admit patients who failed to meet Medicare standards. 

Clarke said he witnessed HealthSouth/Encompass execs exert pressure on staff and others to admit patients and to also keep patients in the facilities for longer than necessary, often overriding his and other doctors’ recommendations. 

The goal was twofold for Encompass executives — they obviously enjoyed raking in $1,000 per patient per day, but by falsifying the reasons for admissions, as was claimed in the lawsuits, they also maintained a desired rating as an inpatient rehabilitation facility within Medicare. Such a qualification meant they could charge top dollar for their services. 

This, of course, is where the true fraud in Medicare/Medicaid disbursements is. It would take a thousand fake-claim individuals working a lifetime to rack up a few million in improper payouts. But one company at just a few of its facilities — that we know about — can haul in millions of dollars per week. 

All of it paid for by the American taxpayer. All of it feeding the bottom line and a bloated stock price. 

And even when they get caught, they just fork over $48 million — about half of the alleged fraud that occurred at ONE facility — change the name and move right along. 

Only one thing remains constant, it seems: The corruption.

 

Josh Moon is an investigative reporter and featured columnist at the Alabama Political Reporter with years of political reporting experience in Alabama. You can email him at [email protected] or follow him on Twitter.

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Corruption

Lake View mayor pleads guilty to ethics violation, resigns from office

Eddie Burkhalter

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Former Lake View Mayor Paul Calhoun

Alabama Attorney General Steve Marshall on Wednesday announced the conviction of former Lake View Mayor Paul Calhoun after he voted on a matter that benefited him personally, a violation of the state’s ethics law.

Calhoun, 45, pleaded guilty in Tuscaloosa County district court to voting on a matter in which he had a financial interest, according to a press release from Marshall’s office. 

The crime is a Class A misdemeanor, and as part of the guilty plea, Calhoun agreed to resign from office and not run again in the upcoming municipal election, according to the release.  

Calhoun was appointed mayor of Lake View in 2016, and was later elected to a four-year term. 

Calhoun, who was a voting member of the town’s council, voted “no” on a motion to order himself to repay the town for travel expenses incurred for unauthorized out-of-state travel expenses, according to the release.

His vote against the measure resulted in a tie that led to the failure of the motion’s passage. 

“Former Mayor Calhoun crossed the line when he violated state ethics laws for his personal benefit,” said Marshall. “We expect public officials to conduct themselves with integrity and when they do not, they will be held to account.”

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Calhoun’s sentencing date has not yet been set, and the conviction is punishable by up to a year in prison, a fine of up to $6,000 or both.

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Corruption

Birmingham building inspector arrested, charged with abusing office for personal gain

Eddie Burkhalter

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(STOCK PHOTO)

Alabama Attorney General Steve Marshall on Tuesday announced the arrest of a city of Birmingham building inspector charged in connection with soliciting and accepting a bribe in 2016, to approve a building inspection.

Thomas Edward Stoves surrendered to the Jefferson County Sheriff’s Office on Monday and was released on bond, according to a press release from Marshall’s office.

Stoves, 41, was working as a building inspector for the city’s Planning, Engineering and Permits office when in August 2016, he allegedly solicited and accepted $1,200 in exchange for approving a building inspection, Marshall’s office said in the release.

Stoves is charged with violating the state’s ethics laws by using his public position for personal gain, which is a class B felony and punishable by up to 20 years in prison.

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Congress

Voting rights activist calls for federal Department of Democracy

LaTosha Brown, a Selma native who co-founded Black Voters Matter, issued a statement saying that it is time to reimagine American democracy.

Micah Danney

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(VIA BLACK VOTERS MATTER)

The co-founder of an organization that is working to mobilize Black voters in Alabama and elsewhere used the 55th anniversary of the Voting Rights Act on Thursday to call for a new federal agency to protect voting rights nationwide.

LaTosha Brown, a Selma native who co-founded Black Voters Matter, issued a statement saying that it is time to reimagine American democracy.

“The Voting Rights Act should be reinstated, but only as a temporary measure. I want and deserve better, as do more than 300 million of my fellow Americans,” Brown said.

The U.S. Supreme Court invalidated a key provision of the law in a 5-4 ruling in 2013, eliminating federal oversight that required jurisdictions with a history of discrimination to get approval before they changed voting rules.

“To ensure that the Voter’s Bill of Rights is enforced, we need a federal agency at the cabinet level, just like the Department of Defense,” Brown said. “A Department of Democracy would actively look at the patchwork of election systems across the 50 states and territories. With federal oversight, our nation can finally fix the lack of state accountability that currently prevails for failure to ensure our democratic right to vote.”

She cited excessively long lines, poll site closings and voter ID laws in the recent primaries in Wisconsin, Georgia, Kentucky and Texas as voter suppression techniques that disproportionately affect Black and other communities of color.

Brown said that the July 17 passing of Rep. John Lewis, who was nearly killed marching for voting rights in Selma in 1965, has amplified calls for the Voting Rights Act to be strengthened. That’s the right direction, she said, but it isn’t enough.

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“History happens in cycles, and we are in a particularly intense one. We have been fighting for the soul of democracy, kicking and screaming and marching and protesting its erosion for decades,” Brown said.

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Corruption

Arrest warrant issued for Rep. Will Dismukes for felony theft

Dismukes is charged with first-degree theft of property in connection with a theft that occurred at his place of employment between the years 2016 to 2018.

Eddie Burkhalter

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Alabama State Rep. Will Dismukes, R-Prattville, has been accused of theft of property, a Class B felony. (WSFA)

An arrest warrant has been issued for Alabama State Rep. Will Dismukes, R-Prattville, for felony theft from a business where he worked, Montgomery County District Attorney Daryl Bailey said Thursday.

Dismukes is charged with first-degree theft of property in connection with a theft that occurred at his place of employment between the years 2016 to 2018, Bailey said during a press conference.

Bailey said the charge is a Class B felony and levied when a person steals in excess of $2,500 and that “I will tell you that the alleged amount is a lot more than that.” 

“The warrant has just been signed, his attorney has been notified and we are giving him until late this afternoon to turn himself in,” Bailey said.

Bailey said the employer contacted the district attorney’s office with a complaint about the theft on May 20, and after reviewing bank records and interviewing witnesses, the decision was made to charge Dismukes with the theft. 

WSFA reported Thursday that the theft occurred at Dismukes’ former employer, Weiss Commercial Flooring Inc. in East Montgomery. Bailey did not provide any more specifics on the charge but said the employer signed the arrest warrant after countless hours of investigation on the part of the DA’s office.

While the charge stems from a complaint filed months ago, Dismukes been in the headlines recently and faced a torrent of calls for his resignation in recent weeks after posting to Facebook an image of himself attending a birthday celebration for the first grand wizard of the Ku Klux Klan, Nathan Bedford Forrest.

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The event was hosted by an individual with close ties to the League of the South, a hate group, according to the Southern Poverty Law Center.

In response, Dismukes stepped down from his post as a pastor at an Autauga County Baptist church but defiantly refused to step down from the Legislature.

If convicted of the felony, Dismukes would be immediately removed from his seat in the Alabama House, to which he was elected in 2018.

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In June, the Alabama Democratic Party called for his resignation over previous social media posts glorifying the Confederacy.

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