Arrests Lead to $6.5 Million Settlement in Brooklyn Medicaid Fraud Case

Four employees of Brooklyn’s Northern Manor Adult Day Health Care Program (Northern Manor ADHC) were arrested after a long investigation that centered on their alleged fraudulent activities. Soon afterward, the facility reached a settlement with the Attorney General’s Medicaid Fraud Control Unit to shut down and to pay $6.5 million in penalties.

To investigate the case, an undercover senior working for the Attorney General’s office visited the facility to analyze its services. The investigation revealed that Northern Manor ADHC was misrepresenting the services it provided in Medicaid payment claims. Two of the employees charged were caught in the act of falsifying medical admissions forms on behalf of the senior, ensuring he could qualify for various types of services for which he was actually too healthy.

Additionally, Northern Manor HDC was found to have hired employees that were unqualified to provide social work services, diagnose mental and emotional needs of registrants and conduct psycho-social examinations.

The operator of that facility in Brooklyn, Northern Manor Multicare Center, Inc., also came to a separate civil settlement admitting that for a period of about a year it operated the ADHC facility without a single qualified social worker on staff, and that during that time period the facility had admitted more registrants than the New York State Department of Health had certified it to take.

This case is just another example of how attempting to defraud the Medicare or Medicaid system may affect not only the alleged fraudsters, but also their entire health care organization. Any medical care providers dealing with issues of fraud in the workplace should speak immediately with a New Jersey health care fraud lawyer at Buttaci Leardi & Werner, LLC.

Tagged with: health care fraud, Medicaid payment claims, penalties

• Posted on: Sep 29 2014