Tag:

Medicaid

Hanover Daughter, Son-In-Law Trap Mom Behind Dog Gate During Vacation: PA AG Hanover Daughter, Son-In-Law Trap Mom Behind Dog Gate During Vacation: PA AG
Hanover Daughter, Son-In-Law Trap Mom Behind Dog Gate During Vacation: PA AG An elderly York County woman was discovered soiled and confined behind a dog gate in her basement, abandoned with only hot dogs and two cups of water while her daughter and son-in-law vacationed, Attorney General Dave Sunday announced Friday, Feb. 14, 2025. Ashley Brady and Brian Brady, both 32, of Hanover, now face disturbing charges of financial exploitation, neglect of a care-dependent person, theft by deception, and conspiracy, Sunday said. Emergency Medical Services rescued the woman in February 2024, after a relative called for help. Investigators say the Bradys locked her in the base…
Philly Psychiatrist Billed Medicaid For Phantom Visits—Now Owes $900K: Feds Philly Psychiatrist Billed Medicaid For Phantom Visits—Now Owes $900K: Feds
Philly Psychiatrist Billed Medicaid For Phantom Visits—Now Owes $900K: Feds A Philadelphia psychiatrist and his mental health clinic must cough up $900,000 after allegedly billing Medicaid for thousands of bogus patient visits, federal authorities announced Monday, Jan. 27. Dr. Ghodrat Pirooz Sholevar and Nueva Vida Multicultural/Multilingual Behavioral Health, Inc. allegedly orchestrated a years-long scheme, charging Medicaid for full 15-minute medication management appointments that often lasted mere minutes—or never happened at all—according to the U.S. Attorney’s Office for the Eastern District of Pennsylvania. Sholevar and Nueva Vida ran three mental health cl…
NJ's Largest Hospital System Ends In-Network Partnership With Horizon Over Price Disputes NJ's Largest Hospital System Ends In-Network Partnership With Horizon Over Price Disputes
NJ's Largest Hospital System Ends In-Network Partnership With Horizon Over Price Disputes Hackensack Meridian Health announced it is ending its in-network partnership with Horizon Blue Cross Blue Shield, effective June 1. A spokeswoman for Hackensack Meridian Health, New Jersey's largest not for profit healthcare organization, said they were unable to reach an agreement despite "lengthy negotiations."  "We have been and remain committed to reaching an agreement but must receive fair care reimbursements from Horizon to continue to invest in the care, medical technology, and locations that the local communities we serve rely on and expect," Jessica Cohen Nussman, public …
Branford Woman Stole $61K From Disabled Medicaid Recipient: Prosecutor Branford Woman Stole $61K From Disabled Medicaid Recipient: Prosecutor
Branford Woman Stole $61K From Disabled Medicaid Recipient: Prosecutor A Connecticut woman has been charged with stealing over $61,000 from a trust account meant to support a disabled Medicaid recipient, authorities said. Jennifer Rose, 47, of Branford, was arrested by state Inspectors from the Medicaid Fraud Control Unit after an investigation revealed she allegedly drained the trust account during her time as trustee from Jan. 2020 to Jan. 2021, state prosecutors said.   According to court documents, Rose used the funds, intended to cover the care and well-being of the disabled beneficiary, for personal expenses, including trips and other purchases…
$1 Million In Medicaid Fraud, Neglect Hidden By Wernersville Woman's Falsified Docs: PA AG $1 Million In Medicaid Fraud, Neglect Hidden By Wernersville Woman's Falsified Docs: PA AG
$1 Million In Medicaid Fraud, Neglect Hidden By Wernersville Woman's Falsified Docs: PA AG A Berks County woman who owns shared-care homes is accused of defrauding Medicaid of over $1 million and neglecting vulnerable residents under her care, Attorney General Michelle Henry announced on Wednesday, Jan. 16. Tina Bell, 56, Wernesville, the owner and manager of Superior Health, Inc., an Erie County-based home care agency, has been charged with theft by deception, receiving stolen property, Medicaid fraud, tampering with public records, and neglect of a care-dependent person, according to Henry. Bell allegedly misrepresented the qualifications of caregivers and billed Medicaid for s…
Wethersfield Man Charged in $1.8M Medicaid Fraud Scheme With 1 Other: Feds Wethersfield Man Charged in $1.8M Medicaid Fraud Scheme With 1 Other: Feds
Wethersfield Man Charged in $1.8M Medicaid Fraud Scheme With 1 Other: Feds Two Connecticut men, already under state scrutiny, are facing federal charges for allegedly orchestrating a $1.8 million Medicaid fraud scheme that spanned years and exploited critical health services, authorities said.  Ramon Apellaniz, 39, of Middletown, and Suhail Aponte, 38, of Wethersfield, allegedly defrauded the Connecticut Medicaid program through Minds Cornerstone, a company claiming to provide therapy for children with autism, the US Attorney’s Office for Connecticut said. Authorities allege Apellaniz, using aliases such as “Kristopher Rockefeller,” managed the scheme even wh…
USPS Employee Accused Of $130K Welfare Fraud Scheme: Nassau County DA USPS Employee Accused Of $130K Welfare Fraud Scheme: Nassau County DA
USPS Employee Accused Of $130K Welfare Fraud Scheme: Nassau County DA A Freeport woman and U.S. Postal Service employee is accused of defrauding public assistance programs of more than $130,000 by failing to report her income from two jobs and rental properties, Nassau County District Attorney Anne Donnelly announced Friday, Jan. 10. Angelique White, 32, allegedly received childcare and Medicaid benefits between 2017 and 2021 while omitting her income from the U.S. Postal Service, Northwell Health, and two rental properties she co-owned in Elmont and Freeport, according to Donnelly. White was arraigned Thursday before Judge Robert Pipia on charges of Grand La…
New Haven Psychiatrist to Pay $455K For Over-Prescribing 'Holy Trinity' Of Dangerous Drugs: DA New Haven Psychiatrist to Pay $455K For Over-Prescribing 'Holy Trinity' Of Dangerous Drugs: DA
New Haven Psychiatrist to Pay $455K For Over-Prescribing 'Holy Trinity' Of Dangerous Drugs: DA A Connecticut psychiatrist has agreed to pay $455,439 to resolve allegations that he issued large amounts of medically unnecessary prescriptions and submitted false claims to Medicare and Medicaid, federal and state officials announced. Dr. Naimetulla Ahmed Syed, formerly practicing in Danbury and New Haven, was accused of prescribing dangerously high amounts of controlled substances without a legitimate medical purpose between 2016 and 2021, the US Attorney for Connecticut said. Investigators alleged that Syed’s prescriptions often included benzodiazepines and other high-risk drug combinat…
PA Mom, Sister Jailed For Neglecting Quadriplegic Relative Defrauding Medicaid Of $140K: AG PA Mom, Sister Jailed For Neglecting Quadriplegic Relative Defrauding Medicaid Of $140K: AG
PA Mom, Sister Jailed For Neglecting Quadriplegic Relative Defrauding Medicaid Of $140K: AG A Philadelphia mother and sister who served as caregivers to a quadriplegic man have been sentenced to prison for neglect that left him hospitalized in critical condition, Pennsylvania Attorney General Michelle Henry announced on Thursday, Dec. 19. Rashina Long, 48, and Jasmine Long, 33, pleaded guilty in September to neglect of a care-dependent person and Medicaid fraud, according to Henry. Both women were sentenced to two to four years in prison, followed by seven years of probation. They are also banned from working as caregivers during their sentences. The Longs were employed as direct …
Husband, Wife Led $20M Medicaid Fraud Ring At Pharmacy: PA AG Husband, Wife Led $20M Medicaid Fraud Ring At Pharmacy: PA AG
Husband, Wife Led $20M Medicaid Fraud Ring At Pharmacy: PA AG A husband and wife are accused of masterminding a $20 million Medicaid and Medicare fraud scheme from their South Philadelphia pharmacy, Pennsylvania Attorney General Michelle Henry announced on Thursday, Dec. 19. Elizabeth Thompson, 70, the registered owner of Broad Street Family Pharmacy, and her husband, Peter Dello Buono, 70, allegedly ran the scheme alongside pharmacist Frank Bengermino, 70, defrauding federal healthcare programs by faking prescriptions and pocketing the cash, investigators said. From 2016 to 2021, the couple and their co-conspirators allegedly billed Medicaid and Medi…
$12M Medicaid Fraud Scheme By PA Home Health Care Agency Lands 20 People Charges: AG $12M Medicaid Fraud Scheme By PA Home Health Care Agency Lands 20 People Charges: AG
$12M Medicaid Fraud Scheme By PA Home Health Care Agency Lands 20 People Charges: AG The owner of a Bala Cynwyd-based home care agency, her daughter, and 18 others have been charged in a multi-million dollar Medicaid fraud scheme, Pennsylvania Attorney General Michelle Henry announced on Friday, Dec. 13. Stephanie Mobley, 52, owned ComfortZone Home Health Care, LLC, a Medicaid-approved provider based in Bala Cynwyd. She, her second-in-command daughter, Naya Campbell, 29, of Audubon, and 18 others allegedly defrauded the Medicaid program by filing false reimbursement claims for services never provided, according to court documents. All 20 defendants face charges including …
$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…