The Origin Signal: How We First Unmasked the Waiver Fraud Scheme

Every federal case begins with a single discrepancy. For the Connecticut ABI Waiver, the "Unmasking" began when we noticed a statistical impossibility: active care plans were being cut by identical percentages across unrelated client cases. The Discovery: Our internal audit revealed that the Department of Social Services (DSS) had deployed a "Shadow Policy"—an unwritten rule to cap services regardless of medical necessity. The Mechanism: The Trigger: Automated flags targeted high-need survivors. The Cut: Hours were reduced without clinical justification. The Cover-Up: The state claimed these were "individual assessments," but the data proved it was a mass algorithm. This report documents the initial data set that proved the fraud was not accidental—it was systemic, intentional, and programmed. This post details the initial findings and the systemic issues discovered within Connecticut's Acquired Brain Injury (ABI) Waiver program. It outlines how vulnerable brain injury survivors were systematically denied crucial services, leading to widespread neglect and financial exploitation. The investigation began with a single tip and quickly uncovered a pattern of abuse that demanded immediate action. We present the evidence that first brought this injustice to light, setting the stage for the ongoing fight for accountability.