ole11An investigation, which included several undercover visits by a healthy and vibrant senior working on behalf of the New York Attorney General’s Office, revealed that an adult day health care facility was not providing services as represented in claims for payments to the federal government. The covert portion of the investigation captured on video two medical employees falsifying the health senior citizen’s medical admissions forms to ensure the resident qualified for services that, in actuality, he was too healthy and not qualified to receive. The investigation also uncovered that the facility hired unqualified individuals to provide social work services and perform initial psycho-social assessments. In the civil settlement with the government, the company agreed to close its subject facility and also agreed to pay back $6,500,000 to resolve the Attorney General’s civil claims. Medicare and Medicaid fraud is a real problem in the long-term care industry. The nursing home industry in 2012 alone was paid $32.2 Billion by Medicare for just skilled nursing services, not including other therapy and rehabilitation services. With such a large amount of money going to the long-term care industry, it is ripe for fraud. If you believe that a nursing home or adult daycare facility is submitting fraudulent claims to Medicare or Medical on behalf of yourself or a loved one and would like your complaint to be investigated, please contact Wendy York at York Law Firm at 916-643-2200. To read more about the New York Attorney General’s $6.5 million settlement for Medicaid fraud, please visit: http://www.ag.ny.gov/press-release/ag-schneiderman-announces-arrest-home-health-care-worker-facing-felony-charges.

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