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Medicaid

$4.4M Medicaid Fraud Scheme: Five In Orange, Saratoga Counties Plead Guilty, NY AG Says $4.4M Medicaid Fraud Scheme: Five In Orange, Saratoga Counties Plead Guilty, NY AG Says
$4.4M Medicaid Fraud Scheme: Five In Orange, Saratoga Counties Plead Guilty, NY AG Says Five Hudson Valley and Capital Region residents and seven transportation companies have admitted to stealing millions from Medicaid. New York Attorney General Letitia James announced Thursday, Dec. 5, that five have pleaded guilty to stealing more than $4.4 million from New York’s Medicaid program through fake billing, illegal kickbacks, and engaging in money laundering and other fraudulent schemes to conceal their crimes.  Muhammad Rizwan Khan, 38, Muhammad Usman Khan, 40, and Farhan Khan, 29, all of Orange County, and their related companies pleaded guilty on Wednesday, Dec. 4, in Or…
Westchester Pharmacies Tied To $11.5M Medicaid Fraud Scheme, Former Owner Gets Prison Time Westchester Pharmacies Tied To $11.5M Medicaid Fraud Scheme, Former Owner Gets Prison Time
Westchester Pharmacies Tied To $11.5M Medicaid Fraud Scheme, Former Owner Gets Prison Time The owner of several pharmacies in Westchester County and New York City has been sentenced to prison for running a multimillion-dollar Medicaid fraud scheme that endangered vulnerable HIV patients, officials said. Aftab Hussain was sentenced to two to six years in prison for stealing over $11.5 million through a scheme involving illegal kickbacks and black market medications, the Attorney General’s Office announced on Wednesday, Nov. 20.  According to the AG's Office, Hussain owned or controlled more than 20 pharmacies, including some in Westchester County, where he exploited low-…
White Plains Nursing Home Among 4 In NY To Pay $45M Settlement After Mistreating Residents: AG White Plains Nursing Home Among 4 In NY To Pay $45M Settlement After Mistreating Residents: AG
White Plains Nursing Home Among 4 In NY To Pay $45M Settlement After Mistreating Residents: AG A Westchester County nursing home is one of four in New York that will be required to pay tens of millions of dollars following years of mistreating and neglecting its senior residents, officials announced. In an announcement on Thursday, Nov. 14, New York Attorney General Letitia James revealed that four New York nursing homes, including the Martine Center for Rehabilitation and Nursing at 12 Tibbets Ave. in White Plains, would pay a $45 million settlement to address years of alleged insufficient staffing and resident neglect. The other nursing homes, all managed by Centers for Care, …
Monroe Business Admits To $2.1 Million Medicaid Fraud, AG Says Monroe Business Admits To $2.1 Million Medicaid Fraud, AG Says
Monroe Business Admits To $2.1 Million Medicaid Fraud, AG Says A Hudson Valley business and three employees admitted stealing more than $2.1 million from Medicaid by submitting fake claims for service. New York Attorney General Letitia James announced Tuesday, Oct. 22, that the Orange County owners of DYD Universe, a New York Medicaid-enrolled transportation company, have pleaded guilty for their roles in a scheme that stole more than $2.1 million from Medicaid and paid illegal kickbacks to Medicaid recipients.  According to James, Damir Yuldashev, age 64, his son Daler Yuldashev, age 38, and Daler’s mother, Nigina Iskandarova, age 60, all of Monr…
Stamford Woman Swindled $300K From State Medicaid Over 2 Years: Police Stamford Woman Swindled $300K From State Medicaid Over 2 Years: Police
Stamford Woman Swindled $300K From State Medicaid Over 2 Years: Police A 59-year-old Connecticut woman faces decades in prison after state investigators claim she stole more than $300,000 from Medicaid by submitting false claims and changing patient's medical records.  Iselande Desyr, of Stamford in Fairfield County, is charged with one count each of health insurance fraud and larceny in the first degree by defrauding the public community, the state's Division of Criminal Justice said.  Desyr was the owner of Holistic Psychiatric Services, LLC, which claims to treat a variety of disorders in children and adults with holistic means on its website…
Girl Scout Dues Hit Historic High: PA Council Says Girl Scout Dues Hit Historic High: PA Council Says
Girl Scout Dues Hit Historic High: PA Council Says Membership fees or dues to join Girl Scouts have risen to a historic high, Girl Scouts in the Heart of Pennsylvania announced on Tuesday, Oct. 22.  The decision to raise the dues is not just local, but came as a result of "12 hours of thoughtful deliberation, the national delegates of Girl Scouts, representing councils across the country, including representatives from Girl Scouts in the Heart of Pennsylvania," GSHPA wrote.  The increase will go into effect in the next membership year.  The membership dues for girls will increase from $25.00 to $45.00 for the membership year 2026 and to $6…
Bensalem Lab Must Pay $7.3M To NJ After Charging $1,000 For $3 For Drug Tests: Comptroller Bensalem Lab Must Pay $7.3M To NJ After Charging $1,000 For $3 For Drug Tests: Comptroller
Bensalem Lab Must Pay $7.3M To NJ After Charging $1,000 For $3 For Drug Tests: Comptroller A Pennsylvania-based lab has been ordered to pay $7.3 to the state of New Jersey after overcharging New Jersey’s Medicaid program for urine drug testing services, officials said. Atlantic Diagnostic Laboratories (ADL) in Bensalem violated Medicaid regulations when it charged Medicaid as much as $1,035 per drug test while charging other payers as little as $2.38 for the same test, New Jersey's State Comptroller's office (OSC) said citing an audit report. Medicaid paid ADL between $63.40 and $180.40 for these same services. ADL also improperly billed for tests that the physician or …
Fake Urine Tests By Married PA Doctors Lead To Millions In Restitution: USDOJ Fake Urine Tests By Married PA Doctors Lead To Millions In Restitution: USDOJ
Fake Urine Tests By Married PA Doctors Lead To Millions In Restitution: Usdoj A husband and wife team of Pennsylvania doctors have been sentenced for a urine drug test fraud, the US Department of Justice and Federal Bureau of Investigation announced on Tuesday, Sept. 24. Physician with specialized training in anesthesiology, John H. Johnson and his physician wife, Paula Z. Johnson, both age 62, of Hollidaysburg, were sentenced for committing fraud by U.S. District Court Judge Christopher C. Conner on Tuesday, Sept. 17, as detailed in the USDOJ release.  Dr. John Johnson received a sentence of 97 months in prison, followed by three years of supervised release. D…
New Canaan Counselor Ripped Off Medicaid For $80K, Officials Say New Canaan Counselor Ripped Off Medicaid For $80K, Officials Say
New Canaan Counselor Ripped Off Medicaid For $80K, Officials Say A Fairfield County counselor with a business in Stamford defrauded Medicaid by billing thousands in fraudulent claims for services he did not provide. According to state judicial officials, Andrew R. Golden, age 56, of New Canaan, was sentenced to three years in prison, which was suspended, and five years of conditional discharge.  The judge ordered Golden to pay $80,328.19 in restitution and to not act as a Medicaid provider or provide services to any Medicaid recipient. Golden has paid the restitution, said officials with the state Division of Criminal Justice,  The division sa…
Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes
Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes A pair of South Jersey nursing homes, riddled with poor conditions and alleged Medicaid fraud, have been turned over to the control of an independent receiver, authorities said. The state Comptroller previously suspended the owners of Deptford Center for Rehabilitation and Healthcare and Hammonton Center for Rehabilitation and Healthcare from New Jersey Medicaid. A Superior Court judge ordered the appointment of Allen Wilen of the Eisner Advisory Group, LLC to run the nursing homes effective June 17, according to the New Jersey Comptroller's Office. The judge's appointment means that the r…
Multi-Million Dollar Scheme: 8 NYers Accused Of Scamming Government For Services Never Provided Multi-Million Dollar Scheme: 8 NYers Accused Of Scamming Government For Services Never Provided
Multi-Million Dollar Scheme: 8 NYers Accused Of Scamming Government For Services Never Provided Eight New Yorkers who owned, operated, or were employees of several transportation companies have been accused of scamming the government out of millions of dollars for services never provided. The indictments were unsealed on Long Island at federal court in Central Islip on Tuesday, June 11. Seven of the eight are from Long Island and the other from New York City: Noman Ahmed, age 37, Port Jefferson Station; Adnan Arshad, also known as “Eddie,” age 45, Mount Sinai; Rehman Diwan, age 24, Hicksville; Jessica Hendrickson, age 36, Patchogue; Jose Marte, age 33, …
Longtime CT Eye Doctor Sentenced For Bogus Brain Scan Scheme Longtime CT Eye Doctor Sentenced For Bogus Brain Scan Scheme
Longtime CT Eye Doctor Sentenced For Bogus Brain Scan Scheme A longtime ophthalmologist in Connecticut will have to pay back over $1 million and spend time in federal lockup after confessing that he ordered unnecessary brain scans to line his pockets. Hartford County resident Donald Salzberg, age 69, of Avon, was sentenced to one year in prison in Boston federal court on Thursday, May 9. It came nearly two years after Salzberg, who operated Salzberg, M.D. on Farmington Avenue in West Hartford for nearly 40 years, pleaded guilty to conspiracy to commit health care fraud and receive kickbacks. Earlier Report: Popular CT Eye Doctor Admits To Tak…
NJ Hospital In Financial Duress Given 24 Hours To Draw Up Disaster Plan NJ Hospital In Financial Duress Given 24 Hours To Draw Up Disaster Plan
NJ Hospital In Financial Duress Given 24 Hours To Draw Up Disaster Plan A beleaguered hospital in Essex County has just 24 hours to draw up a financial disaster plan, the state Department of Health ordered. In a letter sent to Carewell Health Medical Center in East Orange, Gene Rosenblum, the director of the Office of Program Compliance paints a dire financial picture for the hospital. CareWell Health Medical Center has low cash on hand, maintains negative operating margins and has cited other issues with emergency cash flow, he said. The hospital has not made any payments for the entire fiscal year for the assessments it owes the Department of Health, accordin…
Welfare Fraud Task Force Makes 2 Arrests In Region Welfare Fraud Task Force Makes 2 Arrests In Region
Welfare Fraud Task Force Makes 2 Arrests In Region Two women from the region have been nabbed for alleged welfare fraud. The arrests occurred in Sullivan County in Monticello on Friday, April 12, and Thursday, April 25. According to the Sullivan County Welfare Fraud Task Force, the following arrests were made:  Drewcilla R. Noel, age 31, of Monticello, was arrested on Friday, April 12, and charged with grand larceny and theft of services. It is alleged that Noel utilized Medicaid Medical Transportation services on various dates beginning June 2023 and continuing through December 2023 with multiple transportation compan…
Medicaid Fraud Scheme: CT Man Sentenced For Stealing $900K Medicaid Fraud Scheme: CT Man Sentenced For Stealing $900K
Medicaid Fraud Scheme: CT Man Sentenced For Stealing $900K A Connecticut man who posed as a counselor was sentenced to prison and ordered to pay back more than $900,000 after pleading no contest to a large Medicaid fraud scheme.  Hartford County resident Ramon Apellaniz, 39, of East Hartford, will serve 15 months in prison for submitting thousands of fraudulent claims to Medicaid for services provided by unlicensed personnel and services not provided, as well as for stealing the identity of a licensed professional to submit the fraudulent claims.  Apellaniz, who has paid $156,000 in restitution, was also ordered to repay with the remainin…
Mount Kisco-Based Ambulette Company To Shut Down Due To Financial Hardship Mount Kisco-Based Ambulette Company To Shut Down Due To Financial Hardship
Mount Kisco-Based Ambulette Company To Shut Down Due To Financial Hardship As a result of financial hardship, a Northern Westchester-based ambulette service will soon shut down, affecting hundreds of daily medical trips.  Mount Kisco-based United Transportation Providers of Westchester County, Inc. will be shutting down its ambulette services for Westchester residents with serious medical conditions and mobility difficulties at the end of the day on Friday, March 8, the company announced.  The decision to end services came as a result of financial hardship. According to the company, the service cannot continue to operate while being reimbursed at 30 perc…
Bergen Doc Who Said He Treated Medicaid Patients When He Was Not Even In The U.S. Pays Up Bergen Doc Who Said He Treated Medicaid Patients When He Was Not Even In The U.S. Pays Up
Bergen Doc Who Said He Treated Medicaid Patients When He Was Not Even In The U.S. Pays Up A Bergen County doctor and former medical director of the New Jersey Veterans Memorial Home in Paramus busted for "up-coding" and lying about care provided has agreed to pay $700,000, federal authorities said. Arun Sehgal and his Ramsey practice, Preventive & Diagnostic Medical Center P.A., violated the "False Claims Act" by billing patients for more service than they could possibly provide in a single day, or for services that they never provided, U.S. Attorney Philip R. Sellinger said Thursday, Feb. 22. Sehgal and his practice agreed to pay $693,490 plus interest to resolve the three …
Brockton Care-Taker Took $150K From 95-Year-Old Boston Woman, Let Home Go Into Foreclosure: DA Brockton Care-Taker Took $150K From 95-Year-Old Boston Woman, Let Home Go Into Foreclosure: DA
Brockton Care-Taker Took $150K From 95-Year-Old Boston Woman, Let Home Go Into Foreclosure: DA A 41-year-old Brockton care-taker left the 95-year-old woman she was caring for in financial ruin by stealing more than $100,000, allowing her home to fall into foreclosure, and swindling rent money meant for her, authorities said.  Dominique Emmanuel is facing one count of medical assistance fraud by provider and theft of over $1,200 by a single scheme, the Suffolk County District Attorney.  Emmanuel was a Tempus Unlimited personal care attendant for the Mattapan woman. In February 2023, the woman's daughter noticed that Emmanuel was named an alternate executor of her mother's wi…
$1.6M Scheme: CT Psychologist Admits Submitting Fraudulent Medicaid Claims $1.6M Scheme: CT Psychologist Admits Submitting Fraudulent Medicaid Claims
$1.6M Scheme: CT Psychologist Admits Submitting Fraudulent Medicaid Claims A 75-year-old psychologist from Connecticut has admitted to submitting false Medicaid claims as part of a more than $1.6 million scheme, federal officials announced.  Hartford County resident Michael Pines of Avon, a Glastonbury-based psychologist, pleaded guilty to healthcare fraud charges on Wednesday, Jan. 31, the US Attorney's Office for the District of Connecticut announced.  According to federal officials, Pines, who owned and operated Michael B. Pines, Ph.D., P.C., provided psychotherapy to young children, adolescents, and adults and had been individually enrolled…
Disgraced Owner Of Failed NJ Nursing Home Chain From NY Admits Stiffing IRS Out Of $39M: Feds Disgraced Owner Of Failed NJ Nursing Home Chain From NY Admits Stiffing IRS Out Of $39M: Feds
Disgraced Owner Of Failed NJ Nursing Home Chain From NY Admits Stiffing IRS Out Of $39M: Feds 𝗨𝗣𝗗𝗔𝗧𝗘: A onetime insurance broker from Rockland County who ran a nationwide network of nearly 100 nursing homes into the ground from an office over a Bergen County pizzeria admitted that he purposely shorted the IRS nearly $39M, federal authorities said. Joseph Schwartz, 64, of Suffern, owned Skyline Management Group, which was based in the Wood-Ridge and amassed 95 nursing homes across 11 states. These once included Hudson View Care & Rehab Center in North Bergen, Brookhaven Health Care Center in East Orange and the Voorhees Care & Rehabilitation Center. Over a period of only sev…
Shelton Man Who Ripped Off Medicaid While Employed With Greenwich Police Avoids Jail Shelton Man Who Ripped Off Medicaid While Employed With Greenwich Police Avoids Jail
Shelton Man Who Ripped Off Medicaid While Employed With Greenwich Police Avoids Jail A Fairfield County man who was working as a police officer has avoided jail for Medicaid fraud but must repay monies stolen. Chief State’s Attorney Patrick J. Griffin Friday, said on Friday, Jan. 5 that  Michael Mastronardi, age 49, of Shelton, was sentenced to a three-year suspended sentence after pleading guilty to one count of cruelty to persons. In addition, he was ordered to pay $57,278.24 in restitution to the Department of Social Services to reimburse the Medicaid program. An investigation by the Medicaid Fraud Control Unit determined that between August 2014 and April 2019, Ma…
New Canaan Man Accused Of Ripping Off Medicaid For $80K New Canaan Man Accused Of Ripping Off Medicaid For $80K
New Canaan Man Accused Of Ripping Off Medicaid For $80K A Fairfield County man was charged with allegedly submitting fraudulent claims to the government for services that were not rendered. Andrew R. Golden, age 55, of New Canaan, was arrested Monday, Dec. 18, by inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney. He was charged with larceny by defrauding a public community and health insurance fraud. According to the arrest warrant affidavit, Golden is a licensed professional counselor, listed as an individual practitioner and owner of a Stamford practice.  Between January 2020 and July 2022, Gold…
Stamford Woman Accused Of Ripping Off Medicaid For Thousands Stamford Woman Accused Of Ripping Off Medicaid For Thousands
Stamford Woman Accused Of Ripping Off Medicaid For Thousands A Fairfield County woman who worked as a personal care service staff was charged with billing Medicaid for personal care services while the client was incarcerated or inpatient. Latasia Robertson, age 30, of Stamford, was arrested Wednesday, Dec. 6, by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney.  She was charged with larceny by defrauding a public community and health insurance fraud, said the Chief State's Attorney Office. According to the arrest warrant affidavit, between August 2021 and March 2022, Robertson billed for support servic…
NY Doctor Forced Invasive, Unnecessary Tests On Patients, Attorney General Claims NY Doctor Forced Invasive, Unnecessary Tests On Patients, Attorney General Claims
NY Doctor Forced Invasive, Unnecessary Tests On Patients, Attorney General Claims A New York doctor has been indicted for his alleged involvement in a kickback scheme that involved him defrauding Medicaid and giving patients unnecessary tests, officials announced. New York Attorney General Letitia James announced on Wednesday, Nov. 22 the indictment of Long Island resident Payam Toobian, M.D., alongside his company, America’s Imaging Center, Inc., for over 10 years of alleged Medicaid fraud. Through his corporation, Toobian, age 51, of King's Point, ran Empire’s Imaging, a diagnostic radiology center based in Queens. From January 2006 to August 2017, the AG’s Office …
Phone Scammer From Atlantic City Who Preyed On Recently Widowed Seniors Pleads Out: US Attorney Phone Scammer From Atlantic City Who Preyed On Recently Widowed Seniors Pleads Out: US Attorney
Phone Scammer From Atlantic City Who Preyed On Recently Widowed Seniors Pleads Out: US Attorney A heartless public housing tenant from Atlantic City admitted that she scammed elderly victims out of more than $100,000 by claiming that they owed money on life insurance policies bought by a spouse who’d just recently died. Victoria Crosby, 46, was receiving Social Security and Medicaid benefits when she targeted the victims, all of whom were over 70 years old, U.S. Attorney Philip R. Sellinger said. Crosby called the seniors on a burner phone and, using phony names, claimed to be an employee of a retirement benefit office in some instances and a life insurance company in others, the U.S.…
Weeks-Long Cyberattack Brings 3 CT Hospitals To Their Knees Weeks-Long Cyberattack Brings 3 CT Hospitals To Their Knees
Weeks-Long Cyberattack Brings 3 CT Hospitals To Their Knees A cyberattack on three Connecticut hospitals affected patient care so severely that many were sitting on the floors of emergency rooms bringing the operation of the group to its knees financially. The attack took place in August and affected Waterbury Hospital in New Haven County; Manchester Hospital in Hartford County, and Rockville General in Tolland County. All three are part of Prospect Medical Holdings, based in Connecticut, according to reporting from the CT Mirror. The cyberattack also affected medical offices affiliated with the hospitals. Thinking the attack would last for a …
CT Hearing Aid Dealer Gets Years In Prison For Submitting False Medicaid Claims CT Hearing Aid Dealer Gets Years In Prison For Submitting False Medicaid Claims
CT Hearing Aid Dealer Gets Years In Prison For Submitting False Medicaid Claims The 54-year-old owner of a Connecticut hearing aid dealer will spend several years in prison for submitting false claims to the state's Medicaid program for services and equipment that were not provided or were medically unnecessary.  New Haven County resident Dennis Dellaghelfa, age 54, of Waterbury, was sentenced on Wednesday, Sept. 6 to four years in prison for health care fraud, the US Attorney's Office for the District of Connecticut announced.  According to federal officials, Dellaghelfa, a licensed hearing instrument specialist, is the owner of Waterbury-based hea…
$695K Scheme: Former CT Counselor Convicted Of Submitting False Medicaid Claims $695K Scheme: Former CT Counselor Convicted Of Submitting False Medicaid Claims
$695K Scheme: Former CT Counselor Convicted Of Submitting False Medicaid Claims A former New London County counselor has admitted to submitting thousands of dollars of fraudulent claims to Medicaid for therapy services he never provided, officials said.  Former East Lyme resident Jeffrey Slocum, age 55, pleaded guilty to healthcare fraud and kickback charges on Wednesday, Aug. 16, the US Attorney's Office for the District of Connecticut announced.  According to federal officials, between 2017 and 2022, Slocum, who now lives in Johnstown, Pennsylvania, was a licensed professional counselor with a New London office located at 300 State St.  …
$70K Fraud Scheme Racks Up Charges For Hudson County Woman: Prosecutor $70K Fraud Scheme Racks Up Charges For Hudson County Woman: Prosecutor
$70K Fraud Scheme Racks Up Charges For Hudson County Woman: Prosecutor A 47-year-old Hudson County woman was arrested in a $70,000 healthcare fraud scheme, authorities said. Nicole Saunders, of Union City, failed to report income from a business she owns, resulting in an unlawful payment of more than $70,000 in medical benefits from NJ FamilyCare between 2017 and 2021, Hudson County Prosecutor Esther Suarez said. Saunders was arrested Tuesday, July 25, by members of the Hudson County Prosecutor’s Office Insurance Fraud Unit. She was charged with theft by deception and false reporting to Medicaid. Saunders was released on a summons pending her&n…
Naked, Bed-Sore Covered Victim's Daughter, Husband Charged With Neglect In Chester County Naked, Bed-Sore Covered Victim's Daughter, Husband Charged With Neglect In Chester County
Naked, Bed-Sore Covered Victim's Daughter, Husband Charged With Neglect In Chester County The daughter and husband of a woman found dead in a home in July 2021 have been charged with neglect, state authorities said. The 71-year-old woman's body was emaciated and covered in untreated bedsores when it was found in a Chester county home, Attorney General Michelle Henry said. Kaci Nightingale, the victim's daughter, and Richard Nightingale, the victim's husband, have been charged with felony neglect of a care-dependent person, Henry said. The victim, who died of a stroke, was found dead in her home on West Lincoln Highway in Parkesburg, on July 20, 2021, Henry said. She was nu…
Pharmacy Owner From Long Island Engaged In $26M Health Care Fraud Scheme, Feds Say Pharmacy Owner From Long Island Engaged In $26M Health Care Fraud Scheme, Feds Say
Pharmacy Owner From Long Island Engaged In $26M Health Care Fraud Scheme, Feds Say Two pharmacy owners, including one from Long Island, are facing federal charges for their alleged roles in a massive health care fraud scheme, authorities said. Taesung Kim, age 58, of Great Neck and Dacheng Lu, age 44, of Flushing, Queens are each accused of submitting false and fraudulent claims to Medicare and Medicaid, according to an indictment unsealed Tuesday, May 2, in federal court in Brooklyn. The pair owned and operated four pharmacies located in Brooklyn and Queens. According to federal prosecutors, between January 2015 and December 2022 Kim and Lu conspired with others to subm…