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Category Archives: Monetary Damages
$1.68 million. That's what company controlling millions in taxpayer dollars wants back from fired CEO
Article in the Winston Salem Journal today:
Cardinal Innovations filed a lawsuit Monday in Mecklenburg Superior Court against fired chief executive Richard Topping.
The state's largest managed care organization – which controls hundreds of millions in taxpayer dollars – is suing to recoup $1.68 million in severance from Topping, as well as prevent him from collecting any further payments approved by the former board that was disbanded Nov. 27.
The lawsuit says Topping's severance represents "excessive and unlawful payments."
Cardinal oversees providers of services for mental health, developmental disabilities and substance abuse for more than 850,000 Medicaid enrollees in 20 counties, including Forsyth and five others in the Triad. It handles more than $675 million in annual federal and state Medicaid money.
An investigation by McGuireWoods LLP was requested by a reconstituted board, formed in January and approved by state health Secretary Mandy Cohen, along with interim chief executive Trey Sutten. It was conducted by McGuireWoods partner Kurt Meyers, a former federal prosecutor.
The lawsuit represents a new action by Cardinal, and is not in response to the previous board's lawsuit against the state to allow for executive salaries, including for Topping, that exceeded those permitted by state law.
However, it does represent a follow-up on the temporary restraining order and then preliminary injunction won against Topping and the former board filed in the same court.
The injunction prevents Topping and the former board from interfering with N.C. Department of Health and Human Services' regulatory actions versus Cardinal that began when Cohen ordered the takeover of the organization on Nov. 27.
The former board took action against Topping's employment at its Nov. 17 meeting by terminating his contract without cause. The board, at Topping's request, would have been allowed to stay on through Dec. 1.
Cardinal said in the lawsuit that "Topping's motive in asking the board to allow him to remain CEO was so that he could use his position as CEO to ensure that Cardinal Innovations paid him the lump-sum severance before his departure."
Now to my opinion:
Disclosure: I have not read the Complaint and would love someone to send it to me. But, on the face of this article, my experience in the legal world, and my limited knowledge about the whole Topping debacle:
While we can all agree that Topping's salary, plus bonuses and perks, was absolutely repugnant and offensive to taxpayers (like me), Topping did not get there all by himself. The Board of Directors met, discussed Topping's salary, and voted to give him that salary. The Board of Directors, essentially, is the heart and the brain of Cardinal Innovations.
Is Cardinal Innovations going to sue itself for bestowing such an outrageous salary, plus benefits, to Topping?
Because if I am Topping and I get sued for having a high salary, I am going to point at the Board of Directors and say, "I couldn't have gotten paid without your votes, Board. So have fun and sue yourself."
BTW: Isn't this lawsuit a conflict of interest?? It was only last year that Cardinal filed a lawsuit asking the court to ALLOW TOPPING TO CONTINUE TO RECEIVE SUCH OUTRAGEOUS SALARY THAT NOW – SAME COMPANY – IS SUING BECAUSE IT GAVE THIS SALARY TO IT CEO…which is it, Cardinal? Or is it just a matter of following the wind of public opinion?
Not to mention – HOW IS CARDINAL FUNDING THE LAWSUIT (ATTORNEYS' FEES) – WITH OUR TAX DOLLARS!!!!!!! I mean, good for Womble Carlyle, the law firm hired with our tax dollars to spend more money on a losing case (my opinion) because Cardinal mismanaged our tax dollars! Winner, winner, chicken dinner! Last year it got paid to file a lawsuit to keep Topping's salary and perks. Five months later it's hired to sue for giving Topping's salary and perks. See blog.
Does anyone else not see how screwed up this is?????
Posted in Behavioral health, Cardinal Innovations, Health Care Providers and Services, Injunctions, Knicole Emanuel, Lawsuit, Legal Analysis, Managed Care, Medicaid, Medicaid Advocate, Medicaid Attorney, Medicaid Providers, Medicaid Recoupment, Medicaid Services, Medicare and Medicaid Provider Audits, Mental Health, Mental Health Problems, Mental Illness, Monetary Damages, NC, NC DHHS, North Carolina, Tax Dollars, Taxes, Taxpayers
Tags: Behavioral health, Behavioral Health Care Providers, Behavioral health Providers, Cardinal, Cardinal CEO, Cardinal Innovations, Injunctions, Knicole Emanuel, Managed care, Managed Care Organizations, Mandy Cohen, MCO and Tax dollars, Medicaid, Medicaid Attorney; Medicaid Lawyer; Medicare Attorney Medicare Lawyer, Medicaid Behavioral Health, Medicaid Tax Dollars, NC DHHS, Personal, Potomac Law, Potomac Law Group, Richard Topping
NCTracks Lawsuit Dismissed! Judge Finds Providers Failed to Exhaust Their Administrative Remedies!
Remember July 1, 2013? Providers across North Carolina probably still suffer PTSD at the mention of the "go-live" date for NCTracks. If you remember July 1, 2013, you probably also remember that my former firm filed a class action lawsuit on behalf of the physicians in NC who suffered losses from NCTracks' inception.
There was oral argument at the NC Business Court.
Judge McGuire, of the NC Business Court, dismissed the NCTracks class action lawsuit stating the providers failed to exhaust the administrative remedies. The Order reads, in part:
"Ultimately, the burden of proving that administrative remedies are inadequate in this action rests on Plaintiffs. Jackson, 131 N.C. App. at 186. Although sympathetic to the apparently difficult administrative process, the Court concludes that, particularly in light of the fact that not a single Plaintiff has attempted to use the available administrative procedures to resolve their Medicaid reimbursement claims, Plaintiffs have simply failed to satisfy this burden. Accordingly, Defendants' Motions to Dismiss pursuant to Rule 12(b)(1) should be GRANTED."
While I understand the logic applied to come to this decision, I do not necessarily agree with the outcome. There are exceptions to the exhaustion of administrative remedies, which, in my humble opinion, are present here.
(This blog contains my own opinions as to the NCTracks ruling and not those of my present or former firms. It is not intended to claim any ruling was incorrect or inconsistent with case law, rules, and statutes).
(Try to read the foregoing sentences in a fast-paced, tiny, whispery voice, like a pharmaceutical commercial).
Regardless, where does this decision leave the physicians in NC who suffered under an, admittedly, botched, beginning of NCTracks? (Even DHHS recognized the imperfections at the beginning).
First, what is the doctrine of failure of administrative remedies? (I was going to start with what is NCTracks, but you do not know what NCTracks is, you probably should begin reading some of my earlier blog posts: blog; and blog; and blog).
In a nutshell, the exhaustion doctrine dictates that if a party disagrees with an adverse action of a state agency that the party must exhaust its administrative remedies before asking for relief from a civil court judge.
Law 101: The Office of Administrative Hearings (OAH) has limited jurisdiction. It only has jurisdiction over those matters specifically granted to it by statute. If you have an issue with a final adverse decision of a state agency, you sue at OAH. In other words, if you want to sue a state agency, such as DHHS, or any of its agents, like an MCO, you sue at OAH, not Superior Court. An Administrative Law Judge, or ALJ, presides over the court. While OAH is more informal than Superior Court, OAH follows the rules of civil procedure unless an administrative rule exists.
If a Superior Court were to find that the party failed to exhaust its administrative remedies, then the court would find that the party lacked subject matter jurisdiction; i.e., the court is holding that it does not have the authority to determine the legal question at issue.
You would be back to square one, and, potentially, miss an appeal deadline.
In the Medicaid world this is similar to a managed care organization (MCO) having an informal review process internally which would be required prior to bringing a Petition for Judicial Review at OAH.
Were you to bring a Petition for Judicial Review at OAH prior to attending an informal reconsideration review at the MCO, the ALJ would, most likely, dismiss the case for failure to exhaust your administrative remedies.
But in the NCTracks case, the Plaintiffs sued DHHS and Computer Science Corporation (CSC). CSC is, arguably, not a state agency. The only way in which you could sue CSC at OAH would be for an ALJ to determine that CSC is an agent of a state agency. And, who knows? Maybe CSC is an agent of DHHS. Judge McGuire does not address this issue in his Order.
Many of you may wonder why I opine that CSC is not an agent of the state, yet surmise that the MCOs are agents of DHHS. Here is my reasoning: DHHS, in order to bestow or delegate its powers of administering behavioral health to the MCOs, was required to request a Waiver from the federal government. Unlike with CSC, DHHS merely contracted with CSC; no Waiver was required. That Waiver (two Waivers, really, the 1915(b) and 1915(c)) allow the MCOs to step into the shoes of DHHS….to a degree…and only as far as was requested and approved by CMS…no more. I view CSC as a contractor or vendor of DHHS, while the MCOs are limited agents.
Going back to NCTracks…
One can surmise that, because Judge McGuire dismissed the entire lawsuit and did not keep CSC as a party, Judge McGuire opined that CSC is an agent of DHHS. But there is a possibility that the providers sue in OAH and an ALJ determines that OAH is not a proper venue for CSC. Then what? Back to Superior Court and/or Business Court?
Why do you have to exhaust your administrative remedies? It does seem too burdensome to jump through all the hoops.
The rationale behind requiring parties to exhaust their administrative remedies is that those entities (such as OAH) that hear these specialized cases over and over and develop an expertise to decide the certain esoteric matters that arise under their jurisdiction. Also, the doctrine of separation of powers dictates that an agency created by Congress should be allowed to carry out its duties without undue interference from the judiciary.
For example, Judges Don Overby and Melissa Lassiter, ALJs at the NC OAH have, without question, presided over more Medicaid cases than any Superior Court Judge in the state (unless a Superior Court is a former ALJ, like Judge Beecher Gray). The thinking is that, since Overby and Lassiter, or, ALJs, generally, have presided over more Medicaid cases than the average judge, that the ALJs have formed expertise in area. Which is probably true. It cannot be helped. When you hear the same arguments over and over, you tend to research the answers and form an opinion.
So there is the "why," what about the exceptions?
There are exceptions to the general rule of having to exhaust your administrative remedies that may or may not be present in the NC tracks case. If you ask me, exceptions are present. If you ask Judge McGuire vis-à-vis his Order, there are no exceptions that were applicable.
One such exception to the general rule that you must exhaust your administrative remedies is if bringing a case at the informal administrative level would be futile. If you can prove futility, then you are not required to exhaust your administrative remedies. Another exception is if you are requesting monetary damages that cannot be awarded at the administrative law level.
Where the administrative remedy is inadequate, a plaintiff is not required to exhaust that remedy before turning to the courts. Shell Island, 134 N.C. App. at 222. The burden of establishing the inadequacy of an administrative remedy is on the party asserting inadequacy. Huang v. N.C. State Univ., 107 N.C. App. 110, 115 (1992).
What DHHS argued, in order to have the case dismissed for lack of subject matter jurisdiction, and Judge McGuire agreed with, is:
that adequate administrative remedies exist for all health care providers when NCTracks improperly denies claims.
This holding is not without questions.
Some providers re-bill denied claims over and over. There is a question as to when do you appeal? The first denial? The second? The Fourteenth? At which point do you accept the denial from NCTracks as a "final agency decision?" Do you use the "3 strikes and you're out" rule? Do you give NCTracks a mulligan? Or do you wait until NCTracks "fouls out" with a 6th denial?
Another question that remains hanging in the wake of the NCTracks dismissal is how will providers handle the sheer volume of denials. Some providers receive voluminous denials. Some RAs can be hundreds of pages long.
Let's contemplate this argument in a hypothetical. You run a nephrology practice. The bulk of your patients are Medicaid (90% Medicaid, although 50% are dual eligible with Medicaid/Medicare). You have approximately 500-700 patients, who come see your doctors because they are in need of dialysis. You know that if a person does not receive dialysis that there is a chance that the person can enter Stage 5 (end stage renal disease) and die quickly. However, upon July 1, 2013, when NCTracks went live, you stopped receiving Medicaid payments completely. Do you stop accepting and treating your Medicaid patients? Obviously you do not stop accepting Medicaid patients? But your practice cannot sustain itself. Even if you continue to treat Medicaid patients, at some point, you will be out of business, failing to meet payroll, and being forced to involuntarily not treat your patients.
Your patients in need of dialysis come to the office 3x per week. A single hemodialysis treatment typically costs up to $500 or more — or, about $72,000 or more per year for the typical three treatments per week.
Let's approximate with 500 patients. 500 patients multiplied by 3x per week is 1,500 per week. That is 1,500 denials per week. What Judge McGuire is saying is that your office is burdened with appealing 1,500 denials per week. Or 6,000 denials per month. Or 72,000 appeals per year.
Which of your office staff will be charged with appealing at OAH 72,000 denials per year? The physicians? You, the office manager (because you obviously have nothing else to do)? The receptionist? Hire someone new? For how much? How will you recoup the cost of appealing 72,000 denials per year? How many hours does it cost to appeal one? Hire an attorney?
Obviously, my example is one of an extreme case with 100% denials. But the sentiment holds true even for 30%, 40%, or 50% of denials. The sheer volume would be overwhelming.
And you can imagine the backlog that would be created at OAH.
Judge McGuire's decision that plaintiffs failed to exhaust their administrative remedies issue appears to be based, in part, that because no plaintiff had tried to go to OAH, plaintiffs could not convince him that the administrative remedy was non-functional.
"Significantly, none of the Plaintiffs even attempted to use the administrative procedures to address the failure to pay claims and other issues they allegedly encountered in attempting to use NCTracks. Instead, Plaintiffs allege that the administrative process would have been futile and inadequate to provide the relief they seek." See Abrons Family Practice v. DHHS and CSC, ¶ 36 (emphasis added).
Well, first of all, when I moved to Gordon & Rees, I left this case in the capable hands of my former partners, so I have no special intelligence, but I wager that this is not the end.
There are choices. They could:
(1) Appeal the decision to the Court of Appeals;
(2) File an insurmountable number of petition's at OAH; or
(3) Do nothing.
For some reason, I have my doubts that #3 will occur.
What do you think??? What should the Plaintiffs do now in the wake of this dismissal?
Posted in "Single State Agency", 1915 b/c Waiver, Access to Care, Administrative Costs, Administrative Law Judge, Administrative Remedies, Agency, Appeal Rights, CMS, Computer Sciences Corporation, Denials of Medicaid Services, Doctors, Health Care Providers and Services, Judicial Review, Jurisdiction, Lawsuit, Legal Analysis, Legal Remedies for Medicaid Providers, Legislation, Managed Care, MCO, Medicaid, Medicaid Appeals, Medicaid Attorney, Medicaid Billing, Medicaid Providers, Medicaid Reimbursements, Medicaid Services, Monetary Damages, NC, NC DHHS, NCTrack Glitches, NCTracks, NCTracks Billing Issues, North Carolina, OAH, Office of Administrative Hearings, Physicians, Provider Medicaid Contracts, Reconsideration Reviews, Timely Payments
Tags: Abrons vs. N.C. Department of Health and Human Services, Administrative Burden, Administrative Law Judge, Administrative Remedies, Class Action Lawsuit, Class Action NCTracks, Division of Medical Assistance, DMA, Doctrine of Exhaustion of Administrative Remedies, Exceptions to exhaustion of administrative remedies, Gordon & Rees, GORDON & REES LLP, Health care, Health care provider, Judge McGuire, Judicial Review, jusidiction, Managed Care Organizations, MCO, Medicaid, Medicaid Attorney; Medicaid Lawyer; Medicare Attorney Medicare Lawyer, NC Business Court, NC DHHS, NCTracks, NCTracks Billing Issues, NCTracks Problems, North Carolina, Office of Administrative Hearings, Petition for contested case, State agency, Subject matter jurisdiction, Superior Court, Timely Medicaid Payments
NC Medicaid Audits: Is There a Silver Lining? (Maybe Even Two!)
Normally I am "silver lining" type of person. You know…the whole, "The sun will come out tomorrow, bet your bottom dollar that tomorrow, there'll be sun," mentality…
But when it comes to North Carolina Medicaid audits conducted by Public Consulting Group (PCG) or HMS, I have failed to find the silver linings. You, as a health care provider, receive a Tentative Notice of Overpayment (TNO) for $1 million and go through various stages of acceptance: surprise, horror, anger, befuddlement, and fear. In order to defend yourself, you have to shell out tens of thousands of dollars for an attorney (hopefully one that understands Medicaid audits). Then spend countless hours compiling all the documents for the attorney to review and use at the reconsideration review. Then take off a day to attend the reconsideration review, losing even more clinical hours, only to disagree with the Department of Health and Human Services (DHHS) Hearing Officer's decision. Spend more money in legal fees to appeal the DHHS decision to the Office of Administrative Hearings (OAH). Possibly hire an extrapolation expert at even more expense. Only to prove, finally, that the PCG and/or HMS audit was erroneous and you owe nothing. Or $100. Or $1000.
Where is the silver lining in that process?
That you owe nothing in the end? But you paid exhorbent amounts to the attorney.
Well, there could be a silver lining… (maybe even two)…
Recently, the IRS released a couple private letter rulings as to whether paid overpayments could be tax-deductible.
OK, what the heck is a private letter ruling?
According to Wikipedia, private letter rulings "(PLRs), in the United States, are written decisions by the Internal Revenue Service (IRS) in response to taxpayer requests for guidance. A private letter ruling binds only the IRS and the requesting taxpayer. Thus, a private ruling may not be cited or relied upon as precedent."
The most important part of the above-referenced definition of a PLR is that the PLR is binding only on the IRS and the requesting taxpayer. Obviously, this means that if the IRS wrote 2500 PLRs saying that paid overpayments in Medicaid audits are tax-deductible, those 2500 PLRs are not binding as to you (unless you were one of the 2500 taxpayers asking for a PLR).
Regardless, PLRs are demonstrative as to how the IRS determines [whatever is determines in the PLR]. Because, despite the fact that PLRs are not binding on all taxpayers, I would find it odd if the IRS issued 2500 PLRs stating that the paid overpayments are tax-deductible, then the IRS turn around and refuse to allow you to treat the overpayment as a tax deduction. Although, I am sure stranger things have happened.
In the first PLR, which, BTW, is not fun to read. Who uses all this legalese??? Taxpayer B asks whether (1) the money he paid to the insurance company could be deducted as a loss incurred in a trade or business; and (2) the money paid to a Government Entity E and Government Entity F in the tax years in which the installment payments are made under the settlement agreement can be deducted. (I made Taxpayer B a male because the PLR makes him a male. I have no idea as to the gender of Taxpayer B).
In Year 1, the Insurance Company sued … Taxpayer B for insurance fraud, demanding both compensatory and punitive damages. In the second year, the state of New Jersey indicted Taxpayer B… for insurance fraud. Taxpayer B agreed to pay $X in restitution to Government Entity E and Government Entity F.
Taxpayer B has represented (a) that he previously included in his gross income in prior tax years the amounts he now seeks to deduct and (b) that he and all other defendants in [both] lawsuits are jointly and severally liable for the amounts due under the settlement agreement because the language of the settlement agreement imposes joint liability upon the defendants and New Jersey law imposes joint and several liability upon members of a limited liability company.
So…can Taxpayer B deduct the money paid to the insurance company and the government as a business loss????
Or, in other words, could you (a health care provider who accepts Medicaid) deduct any money paid to PCG or HMS arising our of a regulatory audit as a business loss?
According to the PLR:
We conclude that Taxpayer B may deduct the payments he made to the Insurance Company and to Government Entity E and Government Entity F in the years the payments were made or will be made, provided that he received or will receive no contribution from any other party and included the amounts he paid or will pay in his gross income in prior tax years.
The second PLR is basically identical to the first, except that Taxpayer A is at issue. For the PLR, click here.
So what does this mean? Why should North Carolina Medicaid providers care that 2 taxpayers were able to deduct the monies paid to the government/insurance companies as a business loss?
Because, these PLRs are demonstrative that, perhaps, the IRS would view regulatory audit paybacks to PCG or HMS as an allowable tax deduction as a business loss.
So, you receive a TNO in the amount of $1 million. You spend $20,000 litigating the $1 million to $1000. I know, it sucks, right?? (Not that the amount was decreased by $999,000, but that it cost $20,000 to reduce the amount $999,000).
The silver lining? Maybe you can deduct the $1000 paid as a business loss.
But what about the $20,000 attorneys' fees???
Let me preface this with:
I am no tax expert. I know Medicaid, not tax. If you want real tax advice, go to a real tax attorney. But, I did find…Publication 529, which states the following:
You can usually deduct legal expenses that you incur in attempting to produce or collect taxable income or that you pay in connection with the determination, collection, or refund of any tax.
You can also deduct legal expenses that are:
Related to either doing or keeping your job, such as those you paid to defend yourself against criminal charges arising out of your trade or business,
For tax advice related to a divorce if the bill specifies how much is for tax advice and it is determined in a reasonable way, or
To collect taxable alimony.
A definitive answer?
But…a possible two silver linings! The sun will come out tomorrow, bet your bottom dollar that tomorrow, there'll be sun!!!!
Posted in Division of Medical Assistance, Extrapolations, Health Care Providers and Services, HMS, IRS, Lawsuit, Legal Analysis, Legal Remedies for Medicaid Providers, Medicaid, Medicaid Audits, Medicaid Recoupment, Monetary Damages, NC DHHS, North Carolina, Office of Administrative Hearings, Post-Payment Reviews, Public Consulting Group, RAC, RAC Audits, Reconsideration Reviews, Regulatory Audits, Tax Dollars, Taxpayers, Tentative Notices of Overpayment
Tags: Attorneys' Fees, Audit, Division of Medical Assistance, Health care provider, HMS, Medicaid, Medicaid Audits, Medicaid Extrapolation, Monetary Damages, NC DHHS, NC Medicaid, North Carolina, North Carolina Department of Health and Human Services, PCG, Private Letter Ruling, Public Consulting Group, Recovery Audit Contractor, Regulatory Audits, Tax Deductions, Tentative Notice of Overpayment
Lawsuit Against PCG: Allegations That PCG is Inept and Malicious!
It seems that Public Consulting Group's (PCG) unscrupulous behavior has no bounds.
On June 6, 2013, LDP, Inc. d/b/a Leader Services sued PCG in the Eastern District of Pennsylvania. (Case No.: 2:13-cv-03128-AB).
According to the Complaint, Leader and PCG are direct competitors. Leader was the Pennsylvania's Department of Education (DOE) contractor responsible for executing Medicaid claims for the school-based ACCESS program. In 2011, the Pennsylvania DOE requested bids from companies. PCG won the bid by submitting a bid at less than half the amount paid under previous years. (Already fishy).
Many school agencies were concerned about the switch from Leader's computer program to PCG's program. Leader offered to serve as an intermediary during the switch.
Leader alleges that PCG took active steps to thwart Leader's intermediary role, such as changing its data formatting and not paying claims submitted by Leader. The biggest allegations is that PCG failed to process hundreds of thousands of claims for Medicaid payments submitted by Leader, which resulted in tens of millions of dollars of health-related services provided by school agencies to go unpaid.
The press got wind and some stories were written about PCG doing a "poor job."
PCG turned around and began disparaging Leader. PCG held conference calls and meetings asserting that the schools were not paid because of Leader, not PCG. Leader confronted PCG and PCG provided (for the first time) error logs (basically a log of why the claims were unpaid and as a basis for the disparaging remarks that the claims were not paid because of Leader).
Leader reviewed the error logs, only to discover that the majority of "errors" were errors because of PCG!!! (Hmmmm..sound familiar?).
What???? PCG erroneously auditing something? Say it is not so!! (This is sarcasm, people).
After seeing how PCG conducted itself in New Mexico (auditing 15 behavioral health care providers at the request of HSD, but after flying to Arizona to determine which companies should take over the 15 providers, and never showing the providers the claim audit findings) and how PCG is conducting itself in North Carolina (sending providers Tentative Notices of Overpayment saying the provider owes hundreds of thousands, if not millions of dollars, only to discover that the PCG auditors were wrong and the provider really owes a $100), I cannot say I am surprised that PCG would fail to process claims, blame Leader, and produce a report supposedly showing Leader's errors, but, in reality, the errors being on PCG shoulders.
No. Not surprising.
Although, remember, this is a Complaint. The courts have not rendered a decision. There is a chance that Leader made all this up….there is also a chance that PCG is inept and malicious.
Leader sued PCG for
1. Tortious interference with contract;
2. Unfair competition;
3. Commercial disparagement; and
4. Defamation.
Coincidentally, some of the cause of action would be the very same causes of action I would advise the NM behavioral health care providers to assert.
Posted in Behavioral health, Division of Medical Assistance, Extrapolations, Health Care Providers and Services, Injunctions, Lawsuit, Legal Analysis, Legal Remedies for Medicaid Providers, Medicaid, Medicaid Funds, Medicaid Services, Mental Health, Mental Health Problems, Mental Illness, Monetary Damages, NC DHHS, New Mexico, North Carolina, Public Consulting Group
Tags: Audit, Behavioral health, Division of Medical Assistance, DMA, Health care, Health care provider, Leader Services, Medicaid, Medicaid Audits, NC DHHS, NC Medicaid, North Carolina, PCG, Pennsylvania, Public Consulting Group, Tentative Notice of Overpayment
Watch WRAL 6pm News Tonight! NCTracks: Potential Lawsuit…
I was interviewed by WRAL's Bruce Mildwurf today. Be sure to watch WRAL at 6pm for the NCTracks story to air.
Meanwhile, also see the Channel 9 Charlotte story that was aired a couple of days ago.
Posted in Computer Sciences Corporation, Division of Medical Assistance, Health Care Providers and Services, Lawsuit, Legal Analysis, Legal Remedies for Medicaid Providers, Media, Medicaid, Medicaid Billing, Medicaid Reimbursement, Medicaid Reimbursements, Monetary Damages, NC DHHS, NCTrack Glitches, NCTracks, NCTracks Billing Issues, North Carolina, Timely Payments
Tags: Channel 9, Division of Medical Assistance, Health care provider, Lawsuit against State, Medicaid, Medicaid Lawsuits, Medicaid Provider Lawsuit, Monetary Damages, NC DHHS, NCTracks, NCTracks Billing Issues, NCTracks Problems, WRAl
Medical providers considering lawsuits over issues with NCTracks
Medical providers considering lawsuits over issues with NCTracks.
Posted in Dental Medicaid Providers, Dentistry Services, Division of Medical Assistance, Health Care Providers and Services, Lawsuit, Legal Analysis, Legal Remedies for Medicaid Providers, Media, Medicaid, Medicaid Reimbursement, Medicaid Reimbursements, Monetary Damages, NC DHHS, NCTrack Glitches, NCTracks, NCTracks Billing Issues, North Carolina, Timely Payments
Tags: Dental Medicaid Providers, Division of Medical Assistance, DMA, Health care provider, Lawsuit against State, Media, Medicaid, Medicaid lawsuit, Medicaid Provider Lawsuit, NC DHHS, NCTracks, NCTracks Billing Issues, NCTracks Problems, North Carolina, North Carolina Department of Health and Human Services
NCTracks, Monetary Damages, and Kudzu
So many providers in North Carolina who accept Medicaid have contacted me asking whether they have a legal case to bring a lawsuit against Computer Sciences Corporation (CSC), the company who created and is running NCTracks, for monetary damages.
In order to determine whether grounds for a lawsuit exist, you need to determine, generally: (a) Did CSC have a duty to timely pay Medicaid reimbursements to you; (b) Did CSC breach that duty; (c) Did you suffer monetary damages?
42 C.F.R. 447.45 states, in pertinent part, (a) Basis and purpose. This section implements section 1902(a)(37) of the Act by specifying—(1) State plan requirements for—(i) Timely processing of claims for payment…"
What does "timely" mean?
The agency must pay 90 percent of all clean claims from practitioners, who are in individual or group practice or who practice in shared health facilities, within 30 days of the date of receipt.
90%….within 30 days. Let's see…last payments were June 20, 2013. It is July 26, 2013. No payments have been rendered to many providers in 36 days, and, according to one provider, he was told that he will receive reimbursement for at least another 2 weeks.
Hmmmmm….I do not think NCTracks is adhering to the 30 day rule. That said, if I were the attorney for NCTracks, I would argue that the providers not receiving payments within 30 days were not submitting "clean claims," to which I, as myself, would say, "Prove it."
I don't think the Department of Health and Human Services (DHHS) is intentionally not paying providers Medicaid reimbursements for services rendered. I don't think that DHHS meant for NCTracks to not pay some providers.
Regardless of intent, it is correct to say that DHHS went "live" with NCTracks without a "live" trial run and without conducting proper tests necessary prior to going "live."
According to the May 2013 State Auditors' Performance Audit of NC DHHS' Implementation of NCTracks:
The Department has failed to fully test the system, and the production testing process has flaws.
• Key decisions about the addition of 1,500 user accounts and privacy and security procedures have yet to be made, increasing uncertainty about project readiness.
• A vendor hired to oversee the project did not conduct independent verifications as expected by the federal agency that administers Medicaid, and another vendor was permitted to set its own guidelines for whether its work was acceptable.
• No formal criteria exists to determine whether the new system is ready to go-live.
Why DHHS pushed NCTracks to go "live" on July 1, 2013, despite obvious concerns cited by the State Auditor, we may never know. It reminds me, somewhat, of kudzu and the fact that humans like to think that everything is controllable.
Kudzu is not native to America. Kudzu was originally introduced to America from Japan at the Japanese pavilion in the 1876 Centennial Exposition in Philadelphia. Kudzu was touted as a high-protein content cattle fodder and as a cover plant to prevent soil erosion. So people planted kudzu, thinking that kudzu would be an asset to our environment. Instead, kudzu had drastic negative effects on our environment. Kudzu is often dubbed "The Vine That Ate the South." It has spreads at the rate of 150,000 acres (61,000 ha) annually.
The problem with kudzu is that kudzu kills or damages other plants by smothering them under a blanket of leaves, encompassing tree trunks, breaking branches, or even uprooting entire trees. Kudzu's ability to grow quickly, survive, and acquire resources quickly allows it to out-compete native species.
So, think about it, we wanted kudzu because we thought kudzu would be a good thing. We did not research kudzu's growth rate or kudzu's interactions with American foliage. We did not perform test sites of kudzu to analyze the effects of kudzu on our environment. We didn't even grow kudzu in a controlled environment to determine whether kudzu's rate of growth would negatively impact our plants. Oh no, we saw kudzu, and, like a kid in a candy store, we said, "Oooohhhh….we want kudzu!" So we planted kudzu. We thought we could control kudzu.
I don't think the Japanese, who introduced kudzu, nor the Americans, who accepted the kudzu, intentionally planted kudzu in order to kill plants and trees. I don't think that the people who planted the kudzu meant for kudzu to have drastic negative consequences to our environment.
Regardless of intent, people who planted kudzu did so without fully testing kudzu's impact on our environment.
In reality, kudzu is estimated to have lost us approximately $100–500 million per year in forest productivity…as in what we could have made by trees actually growing. In addition, it takes about $5,000 per hectare (2.5 acres) per year to control kudzu. For power companies, it costs about $1.5 million per year to repair damage to power lines. See Forseth. Jr., I.N. and Innis, Anne F."Kudzu (''Pueraria montana''): History, Physiology, and Ecology Combine to Make a Major Ecosystem Threat" Critical Reviews in Plant Sciences, Vol. 23, 401-413, 2004.
Similarly, DHHS (regardless which administration) saw a new computer system, NCTracks, and like the kid in the candy store, said, "Ooooohhhh…we want NCTracks!" So we purchased NCTracks. We thought we could control NCTracks.
We certainly did not perform all necessary tests on NCTracks before going "live."
Now, due to the failure to fully test NCTracks and the "glitches" surrounding NCTracks, NCTracks, like kudzu, is producing drastic negative effects on our health care providers. Some providers are losing hundreds of thousands of dollars per week due to NCTracks. One provider told me that he already closed one location and terminated 6 staff due to NCTracks.
NCTracks is not, at least for many, many health care providers, timely paying Medicaid reimbursements.
But what are the monetary damages? What if you file a lawsuit against CSC and the day after you file a lawsuit you are paid in full? Do you still have any damages?
I got an email from a pediatric physician; we will call her Amy. For the past few weeks, Amy has been unable to sleep. She has not been paid since June 20, 2013. Unlike most providers, she does not limit the number of Medicaid recipients at her practice, and Medicaid is 85% of her income.
Amy spent her one-week-long vacation on-hold with NCTracks 70% of the time. She is behind on work. She has decreased her clinical hours. Amy was forced to ask her parents for a loan to make payroll, and still has not paid all her staff completely.
Last week, Amy and her husband did not have enough money for groceries until her husband was paid on Friday.
Yesterday, when Amy contacted NCTracks, she was told that, according to NCTracks' records, Amy was paid. But no money is in Amy's bank account.
Even if Amy were paid tomorrow by NCTracks, don't you think that Amy suffered additional damages?
Maybe we should just plant a bunch of kudzu around NCTracks and CSC.
Posted in Beth Wood, Computer Sciences Corporation, Division of Medical Assistance, Health Care Providers and Services, Lawsuit, Legal Analysis, Legal Remedies for Medicaid Providers, Medicaid, Medicaid Billing, Medicaid Reimbursement, Medicaid Reimbursements, Monetary Damages, NC DHHS, NCTrack Glitches, NCTracks, NCTracks Billing Issues, North Carolina, Office of State Auditor, Timely Payments
Tags: Computer Sciences Corporation, CSC, Delay in Medicaid Payments, Division of Medical Assistance, DMA, Health care provider, Medicaid, Medicaid Reimbursements, Medicaid Services, Monetary Damages, NC DHHS, NCTracks, NCTracks Billing Issues, NCTracks Problems, North Carolina, North Carolina Department of Health and Human Services, Timely Medicaid Payments
REGISTER TODAY: NC Medicaid Lawsuit: Telephone Conference Friday
Join the June 14 Teleconference on NC Medicaid Audit Multi-Party Lawsuit to Recoup Monetary Damages
VERY IMPORTANT: YOU MUST REGISTER FOR FRIDAY'S PHONE CALL IF YOU ARE INTERESTED IN THIS LAWSUIT.
Thank you so much for coming to the presentations on May 11 in Durham and June 1 in Charlotte. We had a great turnout at both and most attendees have confirmed they plan to join in the multi-party lawsuit against the state. To view a copy of the original presentation, please click here.
On Friday, June 14, 2013 from 12 noon to 1:00 p.m., we will hold a teleconference call for health care providers interested in joining the suit and learning more about the next step. To sign up for the teleconference, please click the Register Now link and enter your information. Once we receive your registration, we will email you the dial-in information directly.
To date, we have approximately 30-40 interested health care providers, so we are close to our goal of at least 40! We will continue to add interested providers to this case up to 30 days after our teleconference. Therefore, you have from June 14 to July 14 to register and join in. Registration for the multi-party lawsuit will close July 14.
We look forward to moving forward with this lawsuit to seek monetary damages for all the providers. Thank you and please contact me directly if you have any questions!
Posted in Behavioral health, Division of Medical Assistance, Health Care Providers and Services, Lawsuit, MCO, Medicaid, Monetary Damages, NC DHHS, North Carolina, RAC
Tags: Behavioral health, Division of Medical Assistance, Health care provider, Knicole Emanuel, Lawsuit against State, Managed Care Organizations, MCO, Medicaid, Mental health, Monetary Damages, Multi Party Lawsuit, NC DHHS, North Carolina, North Carolina Department of Health and Human Services, Recovery Audit Contractor
June 1st: Medicaid Behavioral Health Provider Meeting!! Recovering Monetary Damages!!!
This is a solicitation. (This is an effort to thwart any possible assertions that my disclaimer is not enough. I have put my warning. See also my disclaimer).
In fact, this is a group of providers meeting together who have been wronged monetarily by the Medicaid system, whether by DMA, the MCOs, and/or the RACs, to discuss future options. We had a similar group session May 11, 2012, in Raleigh and it was met with great success! Many providers attended. We were able to share stories. At the end of the meeting, everyone was excited for the future. So we wanted to host one more meeting in the western portion of the state to invite additional providers. June 15th will be our cut-off. If you are interested in this cause, please come to our June 1st meeting!!!
WHEN: 06.01.2013
WHERE: The Cornwell Center at Myers Park Baptist Church, 2001 Selwyn Avenue, Charlotte, NC
WHO: (Any provider that answers "Yes" to the following questions)
Have you been placed on Pre-Payment Status and been unable to meet the standards to get off of Pre-payment Status?
Have you been told that you are not in good standing with DMA and have been unable to receive assistance restoring your standing?
Have you been wrongly denied access to one of the new MCO provider networks?
Have you been told that your Medicaid number is being terminated or has been terminated?
Have your Medicaid payments been wrongly suspended?
Have these actions resulted in loss of income, your business closing, emotional stress, or other negative consequences?
Have you received a Tentative Notice of Overpayment stating that you must pay back money to the State?
If so, please join us!
Lunch will be provided so please RSVP to by clicking the REGISTER NOW link.
Questions? Please contact Caitlin Williamson at cwilliamson@williamsmullen.com or 804.420.6267.
Knicole C. Emanuel – 919.981.4031 – kemanuel@williamsmullen.com
Posted in Division of Medical Assistance, Harassment, Health Care Providers and Services, Legal Analysis, MCO, Medicaid, Medicaid Appeals, Medicaid Audits, Medicaid Contracts, Mental Health, Mental Illness, Monetary Damages, NC DHHS, North Carolina, Post-Payment Reviews, Prepayment Review, Provider Medicaid Contracts, RAC, RAC Audits, Tentative Notices of Overpayment, Termination of Medicaid Contract
Tags: Audit, Division of Medical Assistance, Health care provider, Managed Care Organizations, MCO, Medicaid, Medicaid lawsuit, Monetary Damages, Prepayment, Providers Pooling Funds, Public Consulting Group, Recovery Audit Contractor, Tentative Notice of Overpayment
NC Medicaid Audits: Are There Legal Grounds to Recoup Monetary Damages?
Speaking Engagement! 05.11.2013 12:00pm — 2:00pm (Lunch will be provided) To register, please contact referral@ahbpsych.com.
3326 Chapel Hill Blvd, Suite D, Durham, NC
Presented by: Williams Mullen and AHB Psychological Services
Providers of Medicaid Behavioral Health Services:
Guest Speaker will be Attorney Knicole C. Emanuel of Williams Mullen Law Firm. Ms. Emanuel focuses her practice on Medicaid Law and has assisted providers in navigating Medicaid investigations and audits.
Lunch will be provided so please RSVP by Thursday, May 9th at 5pm to referral@ahbpsych.com.
Posted in Federal Law, Harassment, Health Care Providers and Services, Legal Analysis, Legislation, MCO, Medicaid, Medicaid Audits, Mental Health, Monetary Damages, North Carolina, Prepayment Review, Provider Medicaid Contracts, RAC Audits, Reconsideration Reviews, Termination of Medicaid Contract
Tags: Audit, Division of Medical Assistance, Health care provider, Legal Action, Managed Care Organizations, Mental health, Monetary Damages, North Carolina, Recovery Audit Contractor


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FPI reveals which Pac-12 teams have the easiest schedules in 2022
In 2019, UCLA faced Cincinnati and Oklahoma in the nonconference portion of the season. In 2021, the Bruins played LSU and Fresno State. In their respective seasons, three of those four would go on to win double-digit games. The only team that didn't—LSU—still played in a bowl game. In recent years, the Bruins have gone the opposite direction of some of their peers with regard to the nonconference. That'll change this upcoming year.
The Bruins' out-of-league opponents for the 2022 season include Bowling Green, FCS Alabama State, and South Alabama. Add in home games against division foes Utah and USC and UCLA will be looking at the easiest schedule in the Pac-12. That's according to ESPN's Football Power Index (FPI), which released updated 2022 projections this week.
In fact, FPI says UCLA has the lowest-ranked strength of schedule (read: easiest) of any Power Five team.
Here's how everyone else in the league ranks, from toughest to easiest (national SOS rank in parenthesis):
Stanford (39th)
Oregon (41st)
California (55th)
Colorado (56th)
Arizona (60th)
Utah (61st)
Washington State (65th)
USC (66th)
Oregon State (68th)
Arizona State (69th)
Washington (70th)
UCLA (75th)
FPI gives the Bruins only a 1.3% chance of posting fewer than six wins during the upcoming season, based on 20,000 simulations of the year using the predictive index. It gives Utah only a 0.7% chance of posting fewer than six wins. In total, six Pac-12 schools (Washington, ASU, USC, Oregon, UCLA, and Utah) have a percentage chance greater than 85% of reaching six wins.
It's worth pointing out that FPI seems to be relatively down on the Pac-12 as a whole, and that likely influences strength of schedule rankings across the board. SEC teams have eight of the 10 toughest schedules, according to the index. Among P5 teams, it gives Pac-12 teams eight of the 10 easiest schedules. (Virginia and Purdue are the other two.)

redpajama_set_name: RedPajamaCommonCrawl


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109147, Moscow, Taganskaya St. 3, Taganskiy Passage Business Centre, office 514
Reproductive Law
Legal Regulation of Surrogacy in Russia
Surrogacy and Inheritance Law
How to Find the Right Surrogate
How We Choose Surrogates
Adoption vs Surrogacy
Child Custody Agreement
Dividing Marital Property
Parental Rights Termination
Prenup Agreements
News29 October 20200 комментариев
Konstantin Svitnev to the Ombudsmen, Prosecutor General and Chairman of the Investigative Committee of Russia: The first year of life cannot be returned. But at least NOW – help RETURN the children to their parents!
Today, October 29th, 2020 is the first birthday of two Filipino babies, Arturo and Anika C. The third Filipino child Czandro P. also illegally detained in Russia, will be celebrating his first birthday in two days, on November 1st, 2020. All these children were born in Russia through surrogacy programs.
The children will be celebrating their first birthday in a state-owned orphanage for mentally ill children, away from their families, parents, brothers and sisters. This celebration will be without other kids and the love of their families, something natural and familiar for billions of people. No bunnies, teddy bears and balloons. This day will be spent on grey bureaucratic linen marked with blurred blue stamps. This day will be spent in a cold foreign country, in which they were born by the will of fate and which, like a steel roller of arbitrariness, lawlessness and indifference, rode through their lives, through the lives and destinies of their parents.
The children were supposed to go home in mid-January this year. Still, these plans were ruined by the "investigation" intervened in the "reproductive specialists' case." On January 09th, 2020, despite the presence of documents and powers of attorney, these babies were illegally seized and placed in a shelter from an apartment where they were taken care of by their parents' proxies.
Since then, the parents have not received from the Russian Federation's officials any information about their children, their state of health, and what is happening to them. Are they alive at all?
Since January 9, 2020 parents have been fighting to get their children back. They have been appealing to all Russian Federation's child and human rights organizations, going to the courts, but to no avail. And nowhere do they find sympathy and help in the Russian Federation. Tired of hopelessness, the parents addressed the Constitution's guarantor, President of the Russian Federation Vladimir V. Putin.
To no avail again. "Investigation is in progress," they answer. "Your complaint has been submitted to the Russian Federation's Investigative Committee for consideration," they answer. In the meantime, neither parents nor their proxies have access to the children. There is no way to see them, even in photographs. "Secrecy of the investigation," they answer.
The parents had a DNA test at the place of residence to prepare their genetic passport. This is a kind of a very complex master key, which, nevertheless, AUTOMATICALLY fits each native genetic "door," the unique genetic code of each child related by blood with his or her parent. This key will not open any other door since the grooves will not match. Such a test takes from two to three days. No sharp needles needed to take blood. It is enough to take a buccal smear by swiping a cotton swab along the inside of the parent and child's cheek.
Personal presence is not required either. The tests can be done even if they are performed tens of thousands of miles apart by comparing their results. And these results will either match or not.
It is impossible to pick the genetic code artificially.
The grooves have already matched in both families in relation to all their children who managed to leave Russia for their home country. Paternity has already been confirmed for all children who are already in the Philippines.
But the Russian "investigation" officers refuse to file the test results as the materials of their fabricated "case." They refuse to run a test on their own to compare two papers with the DNA test results (one sent from the Philippines and the domestic one). Based on the comparison results, a Russian laboratory must issue a third document. This conclusion will either confirm paternity or not.
This is the kind of paper that is missing to release unfortunate Arturo and Anika and their peer Czandro from the Russian state captivity, a hospital for children with organic mental disorders. This is the kind of paper I have been seeking from the "investigation" officers for the past ten months.
The "investigation" officers are not willing to run such a test. If they do run it, the children, whom the "law enforcement officers" consider "victims," will have to be released from prison. If they do run it, their whole fabricated "case" will burst like a soap bubble.
Actions committed by the Russian Federation's Investigative Committee in relation to these and many other children who have become victims of the "investigation" officers are indeed a crime.
The children are indeed the victims. However, the Investigative Committee's officers are committing this crime. Instead of protecting young children's interests, they are ruining the children's and their parents' lives. They are crippling their lives, injuring their psyche, and destroying their future. This is a crime against the family, parenthood and childhood. This is a crime against the Russian Constitution, international treaties signed by the Russian Federation, a crime against humanity.
Indeed, the first year, the most crucial year in a child and parents' life, has been irretrievably lost. One can neither return it nor live it again. There are no and will never be touching photos and videos with the first smiles and first words addressed to mom and dad, the dearest people in the world. And there will be no first steps. The Russian Federation's Investigative Committee deprived the children and their parents of all this. The babies' life, health, and mental development have been severely damaged. But there is still a chance to return them to everyday life by immediately freeing them from Russian captivity and returning them to their parents.
The performance of any system is not determined by whether it makes mistakes or not. Everyone makes mistakes. Errare humanum est, as the ancients said. A response to a human error determines the system's performance. Finally, admit that you are wrong. Just acknowledge and return the children to their parents. How long can you victimize people who have believed in our country and entrusted it with the most precious thing in a person's life, their children?
I DEMAND from the Russian Federation's Investigative Committee to show the children to their parents, to prove that they are alive and report on their state of health!
I DEMAND to carry out a genetic examination for paternity by comparing the DNA test results already at the "investigation" officers' disposal in order to establish paternity between the parents and children living in their families in the Philippines, as well as little Arturo, Anika and Czandro, who are still in the clutches of the "investigation" officers.
I DEMAND from the Russian Federation's General Prosecutor's Office to fulfill its SUPERVISION functions and put an end to the lawlessness perpetrated in the Russian Federation's Investigative Committee!
Konstantin N. Svitnev,
Director of Rosjurconsulting Law Firm,
Parents' Representative in the Russian Federation
Генеральный директор компании Константин Николаевич Свитнев является членом Российской Ассоциации Репродукции Человека (РАРЧ), Американского общества репродуктивной медицины (ASRM), юридическим экспертом Европейского общества человеческой репродукции и эмбриологии (ESHRE).Профессионально занимается изучением данной проблематики на протяжении более чем 25 лет, и является признанным авторитетом в сфере репродуктивного права и биоэтики.
Rosjurconsulting C.E.O. Konstantin N. Svitnev was interviewed by DW regarding a crackdown on surrogacy in Russia targeting single intended parents and specifically gay fathersПред
Statement by CEO of Rosjurconsulting Law FirmСлед
Today we publish some abstracts from an extensive interview of RJC C.E.O. Konstantin N. Svitnev to Surrogacy.ru
On the first day of the New Year 2021, Konstantin N. Svitnev, CEO of Rosjurconsulting law firm, called the first reprodissident in Russia, gave an extensive...
News1 January 2021
Merry Christmas and a Happy New Year 2021!
Dear Friends,We wish you a Merry Christmas and a Happy New Year 2021! Thank you for all your trust and confidence in our team!Best regards,...
News24 December 2020
Four questions from Konstantin Svitnev to Vladimir Putin went unanswered
At the President of the Russian Federation's press conference, the most acute and topical issues for the country were raised, such as how Dzyuba...
Rosjurconsulting (est. 2003) is the first law firm in Russia and Europe specialized exclusively in reproductive and family law, a leader in the area of starting a family through medically assisted reproduction (specifically – third party reproduction) incl. gestational surrogacy, sperm, egg and embryo donation.
109147, Moscow,
3 Taganskaya St.,
Taganskiy Passazh Business Center,
191025, St. Petersburg,
3 Б Mayakovskogo St.,
«Alia Tempora» Business Center,
offices 404, 405
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You've just slaved over an amazing dinner. The kitchen is filled with the smells of delicious food. Everyone sits at the table together and then it starts. The "EWWWW, I don't like this", "do I have to eat this?", "I'm not hungry". Then we get discouraged and feel like we shouldn't even bother. But like you, I got TIRED of this exhausting cycle and decided it was time to make some changes!
My husband and I created a "Family Food Pact" and this applies to everyone eating with us, including the ADULTS!
No one is FORCED to eat anything, we just don't allowed or tolerate negative food talk. See, the entire point of food is for nourishment, not comfort, entertainment or just because you're bored. When we complain about the food, it is disrespectful to the cook and says that we don't appreciate the work it took to prepare the meal. If one of the kids complains, it is an immediate pick from the consequences can! Negativity spreads like wildfire! It must be nipped ASAP!
I have to work with many of my health coaching clients on this same concept. We treat ourselves to ice cream or cookies. If we try one bite we get dessert. Or even worse, if you don't eat your veggies, there are negative consequences (early bedtime, a spanking, no TV). As parents, we want our children to develop memories of people and events — NOT food. By making the focus on food, we will constantly struggle with this.
As parents, we want our children to develop memories of people and events- NOT food.
I'll be totally honest and say that my husband and I both go crazy about this pact! VERY, VERY rarely are outside activities allowed to interfere with dinner. Yes, this is tough, but necessary. I'm also often asked if we all eat the same thing. The answer is YES and we eat it with a positive attitude.
Look, I get it! I"m a very picky eater myself. But I eat waaaaaay more food these days than I ever did before. Even as an adult. SO our pact is that we each are willing to try at least one small bite of the food served. This can be as simple as one green bean, one bite of chicken or one bite of sweet potatoes! If you like it, GREAT! You can always ask for more. Don't like it? NO PROBLEM! We praise their willingness to try foods.
Our pact is that we each are willing to try at least one small bite of the food served.
5) A Hungry Tummy is OK!
I know children who are given a snack as soon as their tummy growls or they are just a little hungry. Or they feel like enjoying a bowl of cheesy crackers. Or we are trying to entertain them in public or on a longer car ride. Look, I get it! Sometimes we just need to do what to do to save our sanity, right!? But it is when we make daily, or sometimes multiple times a day, that it becomes a problem. We we have normal hunger at meal times, we are all more likely to eat whatever is served and eat enough of it to avoid hunger pangs 30 minutes after clean up. We should all want our children to learn how to identify what it feels likes to be full and hungry. The constant indulging in snacks and eating does not give our tummies a chance to inform us that we are hungry. Then we are less likely to try foods.
When we are eating whole foods our bodies know exactly how to process and use the fuel we nourish ourselves with. This is easier when we actually cook from scratch. YES, this involves a little planning and preparation, but when we focus on real ingredients and real food, it can be done with less stress. One of the things I teach in The Stress-Free Jumpstart to Meal Planing Success is getting the kids involved! When everyone is involved and invested, they start to encourage OTHERS to eat the quality food that has been prepared.
Does your family have any rules around meals, food or nutrition? What works for you?
NEXT POST Next post: 10 Ways to Enjoy Healthier Holidays Without Giving Up Your Favorite Foods!
Great tips!! It's amazing what habits we carry from our childhoods. As adults and parents it's our responsibility to stop the cycle of those bad habits.
Love the idea of a food pact. We don't have children, but I think it's a great idea even for just the two of us. My favorite list item is the "Meal time is family time" because it seems that so few people use meal time to gather together and bond. I need a 'no cell phones' rule! Terrific tips.
Great tips! I love that meal time is family time.
Fantastic information. It is not just the information you shared that is so great, but the whole concept of looking at food differently. This is true for everyone, not just children. Love it!
I must confess that the try it again is key! My oldest hated eggs as a kid, but around age 8 or so she started to really like them.
I mean, look at me. I hated zuchinni and it wasn't until I was 40 years old that I started to love it!
I am very much the same way!!! Try – Try – Try – Try! 🙂 I am still willing to try eggplant even though I never seem to like it!
A big amen to this. I do several of these things with the teens and preteens I mentor on the farm when they come out to work with our llamas for their 4-H projects. My parents were both depression era kids and lived through rationing during WW2. They were/are grateful for each meal and the hands that prepared it. They instilled that in me.
Maybe that is where learned some of this! Growing up, I spent a lot of time with my grandparents — depression era families! I'm so glad you're mentoring young adults to learn this!
I think I must have done something right! My kids rarely complained about eating! They ate what was in front of them – if even a little bit. That was ok with me. Today, in their 30s, they all are closer to eating healthier than I am! My daughters were this way in their 20s – so now I learn healthy recipes FROM THEM! Yes, we believed in family time at meals. Sadly, not so much between my husband and I – so I still have work to do to be the example to our kids STILL and the beginnings of grandkids!Picky eaters don't live here!
We stick to having dinner together as a family almost every night as well. My husband often grumbles about it, but I remind him that this time is extremely important. I grew up with dinner time and he did not! All the books point to dinner time together as the most important. Thanks for the tips on trying new foods. My kids will not eat ANYTHING!!
These are great agreements. My family never had these kind of agreements when I was young. However, I am just grateful that I grew up eating vegetables and fruits. I know that for some, eating those was a problem. I pretty much would eat anything.


In addition to the most popular attraction, the volcano treks, and enjoying the weather, the village of Port Vatu offers many other activites.
Watch and help village people make local food, including nalot, laplap, and bunia. Participate in traditional roasts with local meat, vegetables, and roots.


After a few months of emailing friends and family large photos of scrapbook pages, I've decided to start a blog. This blog will be largely dedicated to sharing my scrapbooking pages, projects, and photography, which are intrinsically connected to my personal life.
That said, how about a page?
patterned paper: The Girls' Paperie, Paper Girl line, Cabbage Rose and Newsprint Scallop. letters: American Crafts Thickers, Lullaby (pink), Delight (green). journal block: Making Memories, Noteworthy Delaney. flower: Prima. punches: Martha Stewart monarch butterfly, classic butterfly, and 3 in 1 classic butterfly. resin embellishments: Anna Griffin, Carolina Collection. rhinestones: Kaiser. brads.
This page reflects how I'm feeling about my life right now. We're in a bit of a restful "season" for the foreseeable future. We're settled into a good groove, so we're taking advantage of it by visiting lots of family in the next few months. I'm getting in touch with friends who were on the back burner as I finished the CPA exam. And Dave and I are making each other laugh...a lot. And lots of movies, books, and hiking at Cameron Park. I wanted a page that reflected those moments when you can tell you're in a different phase of your life and when you're deciding what you're going to do with it. Of course, the butterflies represent change and being free, unentangled, and moving forward.


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Darrell Parrish retires after 27 years of service
Fareen Dhuka and Ella Chen|May 21, 2020
Courtesy of Darrell Parrish
Darrell Parrish plays a guitar accompaniment for choir at Candlelight in December 2018.
Harboring a love for music since he was six years old, Darrell Parrish performed in the wind ensemble and jazz band at John Jay High School in San Antonio, often playing music at the expense of doing his schoolwork. After 27 years teaching at St. John's, he is retiring.
"He just loves to perform and he loves music, and that's how he got into teaching," his wife Audra said. "And, of course, he's always smiling because he's enjoying it so much."
Parrish plays with the Jazz Band during a concert 20 years ago. (Courtesy of Darrell Parrish)
Following the encouragement of his high school band director, Dan Schreiber, Parrish decided to pursue a career in teaching music.
"He was almost like a second father to me," Parrish said. "When I got to be a sophomore, I said, 'I want to do what he does.'"
Parrish was working at the High School for the Performing and Visual Arts teaching music theory when he married Audra in June of 1992. The next year, Janet Scarcella, SJS Director of Fine Arts at the time, approached Parrish and asked him to become director of the Wind Ensemble and Jazz Band.
As soon as he arrived at SJS in 1993, Parrish had one goal: "Try to make music fun."
Sophomore Lily Pesikoff, who has known Parrish him since second grade, said that Parrish has done just that and so much more. Not only did their Middle School advisory spend an entire period making band jokes, but Parrish walked his advisory to Whataburger during a Community Service Assembly after their advisory lunch was cancelled for the third time.
"Mr. Parrish made band easy and fun, not something stressful," Pesikoff said. "He made students want to come to band."
Senior Marina Ring has been part of the band program since middle school. She said that Parrish's devotion to his job instilled a love for music in everyone he taught.
Parrish conducts the Jazz Band at the Wassail Party after Candlelight. (Courtesy of Darrell Parrish)
"Everybody loved having him as a teacher," Ring said. "He was a face of St. John's because everyone associated him with the band program. He was very charismatic and really brought life to band."
Parrish is known to accompany almost every instrumental performance at St. John's.
"When you're a band director, you can play every instrument because you have to know how to play the instrument to teach someone how to play it," Audra said. "You can basically hand him any instrument, and he knows how to play it."
Ring recalled one occasion when Parrish played a trumpet solo with one hand while strumming his bass with the other.
"It was the craziest thing I have ever seen," Ring said. "Just incredible."
Parrish dons a Santa hat and beard in the Great Hall during the Wassail Party. (Jonah Pesikoff)
To commemorate Parrish's 27 years, Band Parent Liaison Tracy Pesikoff initially planned a surprise cake party following the spring concert. After the School's closure and social distancing guidelines were implemented, Pesikoff organized a car parade in front of the Parrish household during which students brought their instruments and played some of Parrish's favorite songs, including "Feliz Navidad."
"It's bittersweet that I don't have to experience band without him, but I'm sad for the people who won't get to experience Mr. Parrish," Ring said. "You can't miss him in a room, and you'll definitely notice when his presence is gone."
Parrish retains high hopes for the future of the SJS band program and is confident that his students will remain successful under any director.
"It's tough having gone through this career my whole life and it ending in this difficult way without a final concert and seeing the seniors off, but I have absolutely enjoyed my time at St. John's," Parrish said. "It never felt like a job because it was what I loved to do."
Fareen Dhuka, Online Editor-in-Chief
Fareen Dhuka is a senior in her fourth year on Review. Her dream vacation is going to Disney World with Laney and she can't stop making overnight oats.
Ella Chen, Copy Editor
Ella is a junior in her third year on Review. Her dream is to go skydiving and she's addicted to Honey Nut Cheerios.
One Response to "Darrell Parrish retires after 27 years of service"
Paul Beebe on May 23rd, 2020 11:59 PM
Mr. Parrish was very cool, though I didn't have him as a jazz band instructor. Warren Sneed was the jazz band instructor until he left in 1996, at which point Mr. Parrish took over the position in addition to wind ensemble, which he was already directing. I did have the pleasure of working with him on a couple of occasions as an alumnus returning to give music presentations. He definitely inspired students and leaves a lasting legacy.
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Why is everyone covering up their laptop cameras?
June J. ClarkSeptember 19, 2022Comments Off on Why is everyone covering up their laptop cameras?0360
For the past half-decade, the technology industry has been racing to build better cameras into the hardware we use every day. Yet the surveillance age has inspired an odd cottage industry battling against this trend: a glut of cheap stickers and branded plastic slides designed to cover up the front-facing cameras on phones, laptops, and even televisions. For years, security researchers have shown that hackers can hijack the cameras to spy on whoever is on the other end. To put that in perspective, think of all the things your devices have seen you do.
Such warnings have finally caught on. Last month, the FBI director, James Comey, told an audience: "I put a piece of tape over the camera because I saw somebody smarter than I am had a piece of tape over their camera." The corporate swag company Idea Stage Promotions describes its Webcam Cover 1.0 as "the HOTTEST PROMOTIONAL ITEM on the market today." USA Networks sent journalists a "Mr. Robot" webcam cover for the popular hacker thriller's upcoming season.
Covering cameras isn't new for those who know that the internet is always watching. Eva Galperin, a policy analyst for the Electronic Frontier Foundation, says that since she bought her first laptop with a built-in camera on the screen, a MacBook Pro, in 2007, she's been covering them up. EFF started printing its own webcam stickers in 2013, as well as selling and handing out camera stickers that read: "These removable stickers are an unhackable anti-surveillance technology."
Specially crafted for Windows 10, this app gives you full access to the Guardian's award-winning content. With automatic caching, you can keep reading even when you're offline. "People purchase these regularly," a spokesman said Net Maddy. The fear of web cameras has penetrated deep into popular culture. The trailer for Oliver Stone's forthcoming biopic Snowden, on the US spy contractor, features a clip of actor Joseph Gordon-Levitt, who plays the title character, looking nervously at his laptop camera during an intimate moment with his girlfriend.
So are we all being paranoid? One couple claimed a hacker posted a video of them having sex after hacking their smart TV. Well, it's not science fiction. In 2013 showed how they could activate a Macbook's camera without triggering the green "this-thing-is-on" light. And federal court records show that the FBI knows how to use laptop cameras to spy on users.
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So, naturally, where there's fear, there is money to be made. The DC-based CamPatch describes itself as "the Mercedes Bens [sic] of putting tape over your webcam." Its founders started the company in 2013 after hearing a briefing from Pentagon cybersecurity experts on how webcams were a new "attack vector," said Krystie Caraballo, CamPatch's general manager. Caraballo wouldn't disclose financials other than to say the company has had "six-figure revenues for the last several years" and that it has distributed more than 250,000 patches. The company advertises bulk pricing "as low as $2.79".
Yet, not everyone is on the camera-covering bandwagon. Brian Pascal, a privacy expert who has worked for Stanford and Palantir Technologies, says a cost-benefit analysis led him to conclude he'd rather have a usable camera, which he can use to record his son. But he acknowledged such stickers are a way for people to signal that they too worry about Big Brother. "Security actions without threat modeling are just performative," said Pascal.
Others just haven't gotten around to it yet. "Because I'm an idiot," replied Matthew Green, an encryption expert at Johns Hopkins University, when asked why he doesn't cover his cameras. "I have no excuse for not taking this seriously … but at the end of the day, I figure that seeing me naked would be punishment enough." Of course, webcam paranoia is likely to be only the first of many awakenings as consumers bring more devices into their lives that can be turned into unwitting spies. Amazon.com has had enormous success with its Echo smart speaker that, by default, is always listening to its owners' commands. Google plans to release a similar product this year called Google Home.
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Trump presents 'fake news' awards for 10 stories — some of which really were false
The flawed rollout of the "fake news" awards capped a much-hyped social media spectacle from the media critic-in-chief.
Trump presents 'fake news' awards for 10 stories — some of which really were false The flawed rollout of the "fake news" awards capped a much-hyped social media spectacle from the media critic-in-chief. Check out this story on USATODAY.com: https://usat.ly/2mKIh0K
Gregory Korte, USA TODAY Published 9:15 p.m. ET Jan. 17, 2018 | Updated 11:33 a.m. ET Jan. 18, 2018
President Trump bestowed "fake news awards" to six highly respected media organizations. USA TODAY
President Trump speaks to reporters in the Oval Office after signing the tax bill and continuing resolution to fund the government Dec. 22, 2017.(Photo: Evan Vucci, AP)
WASHINGTON — President Trump gave out fake news "awards" to six news organizations Wednesday night, capping a much-hyped social media spectacle that matched Trump's penchant for showmanship with his disdain for the news media covering it.
None of the recipients of Trump's backhanded laurels were surprising: They've been frequent targets of the president's scorn for much of his first year in office. Among the news organizations cited: CNN, The New York Times, The Washington Post, ABC News, Newsweek and Time Magazine.
Most of the stories cited were verifiably false: ABC News retracted its report about former National Security Adviser Michael Flynn's testimony in the Russian collusion probe, and suspended correspondent Brian Ross. A report from a Time reporter about a missing Martin Luther King Jr. bust in the Oval Office on inauguration day was quickly corrected. And CNN admitted an error in dates that caused it to report that Donald Trump Jr. had access to leaked Democratic emails before they were posted on the website Wikileaks.
More: Trump takes top 'honors' in Press Oppressors awards
Previously: Trump to announce 'most dishonest' and 'corrupt media awards' next week
But the top example of "fake news" was actually an opinion piece from New York Times columnist Paul Krugman predicting stock market losses after Trump's election victory. Instead, the markets have boomed.
The media critic-in-chief also cited coverage of the investigation into Russian interference in the 2016 presidential campaign, which has focused on whether the Trump campaign colluded with agents of the Russian government.
"Russian collusion is perhaps the greatest hoax perpetrated on the American people," Trump said.
But a special counsel investigation led by former FBI Director Robert Mueller has already led to indictments or convictions of at least four people, including Flynn. There's been no publicly released evidence that Trump knew about his campaign's contacts with the Russians.
The very term "fake news" came out of Russian attempts to interfere with the election by — among other tactics — planting false stories on social media. But Trump quickly co-opted the term "fake news" to refer to stories that portrayed him in a negative light. But unlike the original meaning of fake news, the stories cited by Trump Wednesday weren't deliberately falsified — even if the reporting relied on false information.
The rollout of the awards didn't go smoothly. The awards were delayed nine days because, Trump said, "the interest in, and importance of, these awards is far greater than anyone could have anticipated!"
They were expected to come at 5 p.m. ET Wednesday, but Trump posted a link to the awards on Twitter three hours later.
A screen capture of the error message for President Trump's fake news awards on the GOP website. (Photo: USA TODAY)
Then a series of website errors, presumably from high traffic volume, prevented most people from seeing the post until nearly half an hour later.
They were hosted not on the White House website but the Republican National Committee's. Ethics experts had expressed doubts about whether it was appropriate to use taxpayer resources to promote the awards.
"Despite some very corrupt and dishonest media coverage, there are many great reporters I respect and lots of GOOD NEWS for the American people to be proud of!" Trump said. "ISIS is in retreat, our economy is booming, investments and jobs are pouring back into the country, and so much more! Together there is nothing we can't overcome — even a very biased media. We ARE Making America Great Again!"
Despite some very corrupt and dishonest media coverage, there are many great reporters I respect and lots of GOOD NEWS for the American people to be proud of!
As Trump hyped the event, a growing number of bipartisan lawmakers, First Amendment groups and others rebuked the president.
"When a figure in power reflexively calls any press that doesn't suit him 'fake news,' it is that person who should be the figure of suspicion, not the press," Sen. Jeff Flake, R-Ariz., said in a speech on the Senate floor Wednesday.
More: Sen. Jeff Flake: Trump 'charting a very dangerous path' with media attacks
Sen. John McCain, R-Ariz., wrote in an op-ed for The Washington Post that Trump's anti-press rhetoric was giving cover to repressive regimes around the world.
"The phrase 'fake news' — granted legitimacy by an American president — is being used by autocrats to silence reporters, undermine political opponents, stave off media scrutiny and mislead citizens," McCain said.
Follow Gregory Korte on Twitter: @gregorykorte
Read or Share this story: https://usat.ly/2mKIh0K


Has original thought gone out of style?
My favorite professor in college was a former Washington Post journalist who was "old school" in every sense of the phrase but most notably in his strict adherence to the fundamentals of the science of reporting. His class was twice a week at 9 o'clock in the morning, the crack of dawn for a 20-year-old who lived on the opposite side of campus.
He required each of us to come to every class with a compilation of five grammatical, spelling, reporting or AP Style mistakes from national publications with the current date. This meant that I spent every Tuesday and Thursday morning at 6:30 a.m. poring through the New York Times, The Chicago Tribune, and The Wall Street Journal with a fine toothed comb. All 15 students came to class each morning with a neat package of that day's failings of the journalism industry and left that semester with a habitual, spasmodic ability to spot errors (to the detriment of our future spouses and direct reports... see meme below).
We also came to abhor and judge reporters who broke the fundamental public trust of the trade by editorializing, inserting their own opinions, using unnamed sources, or failing to investigate alternate viewpoints to offer a balanced and fact-based story. Our professor taught us that words matter, because they incite thoughts, beliefs and actions - and a reporter's job was to present the facts in a way that enabled the reader to think critically about the story and come to his or her own opinion.
Fairness and accuracy are the foundations of ethical journalism, meaning that stories must be written with facts and balanced perspectives. Journalists are ethically bound to honor their duty to the public by reporting the truth, acting independently, providing transparency, and omitting their own biases to put the principles that guide their work first.
As my wise professor predicted, journalism has been transformed by social media to a point where it's almost unrecognizable. Real-time updates are shared online before there could possibly be time to check the facts. Anonymous phone calls and Facebook posts have become cited sources. Dubious and shabbily reported stories go viral on Twitter and YouTube. And the American public eats it all up without stopping to think about what it is they're hearing and subsequently believing. The majority of our news industry has transformed from one that used to encourage opinions and healthy debate, into one that discourages any perspective that represents a diversion from the court of public opinion.
I think the shift in how money is made when it comes to sharing information has got to be one of the primary drivers of the decline in trustworthy reporting: newspapers used to sell information to audiences, and today media outlets sell audiences to companies. The problem with this shift is that facts and balanced perspectives don't win likes, shares, comments and follows on social media. Organizations that develop and distribute "news" are incentivized to do things that grow their audience, meaning that driving user engagement takes the place of adhering to the fundamental ethics of journalism. It no longer matters if the information is true, but if it is popular.
We all know what catching our attention looks like. Our feeble human brains are wired for survival, meaning that we enthusiastically tune in to shocking information that either a. threatens our lives (e.g., natural disasters, terrorism, the great debate on eggs and heart attacks, etc.); b. threatens our identities (e.g., opinions on education, family and relationship norms, politics, whether or not there is life on Mars, etc.); c. feeds our voyeuristic urge to watch disasters happen to others (e.g., the Bachelorette, 15-car-pileups on the highway, coverage of Kim Kardashian's attack in Paris, etc.); or d. is purely entertaining.
Amidst all this chaos and distraction, there is still a government collecting our taxes and waging wars and making decisions on our behalf that affect our country, our lives, our children's lives and we don't have any reliable insight into what is actually happening nor do we really seem all that interested anyway.
So what to do about this in the event you've made it this far in the post and haven't been distracted by a gif of a cat hanging from a ceiling fan? I suggest you shrug your shoulders, sigh, and turn on House of Cards to temporarily placate your utter despair at your powerlessness. Just kidding, of course. I've been trying to answer this question myself for a while, and decided to do a few things to better educate myself and take a more proactive approach to staying informed. The most important of which has been cutting out any publication that violates the fundamental principles and ethics I learned in my college journalism classes (looking at you and your "anonymous sources," CNN) and reading all information with a critical lens.
Can I tell what the reporter personally thinks about this story or situation?
Can I understand at least one other point of view in this story?
If I can't answer "no" to the first bullet, and "yes" to the second, I tend to disregard as unbalanced and poorly reported.
This is the good old "prove it" tactic that you already use on a daily basis when people are trying to sell you on something. A healthy dose of doubt never hurt anyone and in fact probably helped you to invest in better anti-aging creams and index funds. Might as well apply the same principles to what you allow to take hold in your mind, right?
A time tested tactic that should never have gone out of style. Trustworthy sources of information are independent, meaning that there is nothing influencing the information other than the desire to present the facts in a balanced way. When newspapers first came online, they offered subscriptions to access content in order to enable them to remain independent. This tactic was criticized, but it's allowed the ones that stuck to their guns to continue to hold themselves to the highest standards. This model relies on viewers to value independence, and be willing to pay for it to be better educated. Which is something I'm realizing is well worth the cost.
Ok, that's the end of my rant. I'm a believer that if you complain about something, you take on responsibility for helping to fix it, so I hope that this tirade did something for you. If you took something away from this, or have thoughts on the topic, please leave me a comment, shoot me an email, or share this post.