Over 20 New Yorkers allegedly engaging in Medicaid fraud were charged this week as part of a national effort to address health care fraud, including cases in the Lower Hudson Valley and Rochester area involving millions of dollars.
Nationwide, 455 individuals were charged for their alleged participation in health care fraud and opioid abuse schemes resulting in more than $6.5 billion in false claims and significant patient harm, according to the U.S. Department of Justice.
“We are aggressively scaling our offensive against anyone using health care as a front to steal from the American people,” says Assistant Attorney General Colin M. McDonald of the Justice Department’s national fraud enforcement division.
“As today’s cases and arrests show, there is no case too big, no scheme too complex, and no hiding place too remote for our relentless fraud-fighting team,” he added in the statement. “Our message is simple: if you put profit over patients, you should expect to be put in prison.”
Here’s what to know.
How many people were charged for health care fraud in New York?
More than 20 New Yorkers were charged by either the state or federal government for health care fraud, the DOJ says. Many of these individuals were receiving kickbacks, or compensation for using, ordering, prescribing or buying a specific drug, medical device, service or product, which is illegal.
Here’s a breakdown of cases filed in state court, including allegations linked to the Lower Hudson Valley and Finger Lakes regions.
Here’s a breakdown of several of the cases involving the largest sums of money filed in federal court.
“This is very important,” First Assistant U.S. Attorney John A. Sarcone III said during a news conference inside the Federal Bureau of Investigation’s Albany bureau on Tuesday, June 23.
“There are a lot of people out there that are in need of these scarce resources that are provided and to find out that we’re being defrauded of tens of thousands, hundreds of thousands, millions of dollars is absolutely disgusting,” he added.
Why is New York being sued by the Trump administration?
This comes on the heels of the Trump administration suing New York and a contractor that runs a large Medicaid-funded home care program for the state.
The federal case alleges Public Partnerships LLC — the company brought in to replace hundreds of agents who oversee the state’s Consumer Directed Personal Assistance Program payments, which delivers $11 billion annually to those caring for more than 200,000 people with disabilities and other home-bound New Yorkers — is improperly keeping “millions” as part of a fraud scheme.
According to the lawsuit, the company was supposed to be paid a fixed rate for its services but has instead been lining its own pockets by raising caregiver bills and keeping part of the care payments as its share. Additionally, the case alleges the Georgia-based company was chosen through a “sham bid process” and took too long to start managing the program.
New York Gov. Kathy Hochul pushed to consolidate the program’s fiscal oversight, asserting it would save the state money and help prevent wasteful or fraudulent billing. The Hochul administration has dismissed the lawsuit as a politically motivated action with no legal basis and the LLC has disputed the claims.
Contributing: New York State Team reporter Chris McKenna
Emily Barnes covers state government for the USA TODAY Network-New York with a focus on how policy and laws impact New Yorkers’ taxes, communities and jobs. Follow her on Instagram or X @byemilybarnes. Get in touch at ebarnes@usatodayco.com.
This article originally appeared on Rockland/Westchester Journal News: New York cases tied to $6.5B Medicaid fraud revealed. See the charges
Reporting by Emily Barnes, New York State Team / Rockland/Westchester Journal News
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By Emily Barnes, New York State Team | USA TODAY Network
