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Medicaid Fraud in New York Targeted by New House Report
Date:4/4/2013

w York*, a federal qui tam case filed by Levy Phillips & Konigsberg LLP (“LPK”).

In 2009, LPK whistleblower attorneys Alan J. Konigsberg and Theresa A. Vitello filed a lawsuit under the Federal False Claims Act based on the allegations made by whistleblower client Dr. Gabriel Feldman. According to the complaint, Dr. Feldman, a local medical director employed by a private company under contract with New York City’s Human Resource Administration (“HRA”), alleged that New York City’s HRA routinely and improperly authorized and reauthorized personal care services (“PCS”)** for thousands of Medicaid beneficiaries each year who did not meet the regulatory requirements for the services. The United States Attorney for the Southern District of New York intervened in Dr. Feldman’s Medicaid fraud case, resulting in a $70 million recovery for the federal government in the end of 2011.

The House Report goes on to cite the following other lead contributors to the New York Medicaid problem:

? Overpayments to New York Developmental Centers, i.e. State-operated institutions that treat and house patients with developmental disabilities.
? Abuses of Medicaid Eligibility Rules in New York, i.e. so called “Medicaid estate planning”
? Excessive Salaries Paid to Executives of Medicaid-funded Organizations, i.e. in 2011 top executives at the Young Adult Institute, a nonprofit that runs group homes, used Medicaid money to lease luxury cars, pay tuition bills and living expenses for their children, and gave themselves generous compensation packages.

In an effort to correct New York’s Medicaid problems, the House Report recommends six specific actions that it says “should be taken immediately to reduce Medicaid fraud, waste, and abuse in New York’s program”:

? CMS or a qualified government watchdog agency should conduct a complete and indep
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