Health care aides subject of new Cuomo probe

John O'Brien Aug. 21, 2007, 3:00pm


NEW YORK - The investigation into Medicaid fraud being conducted by New York Attorney General Andrew Cuomo has shifted its focus to home health care providers.

Cuomo subpoenaed more than 60 of the agencies in the New York metropolitan area on Monday, claiming his Medicaid Fraud Control Unit has already uncovered several instances of fraud in the industry.

"The evidence we've obtained to date suggests endemic, persistent fraud and malfeasance at all levels of the home health care industry," Cuomo said. "From unqualified aides to deceptive billing practices, the operations we've uncovered threaten patient care while bilking taxpayers out of millions.

"The findings from these subpoenas will help us put together a global picture of the extent of the problem and a roadmap for repair."

Cuomo says several home health aides are operating with falsified certifications and are causing Medicaid to be billed for their work. Resulting indictments in the past few months have helped Cuomo gain a tighter grasp on the industry.

The subpoenas sent Monday request information about the aides who have been billing Medicaid.

"We're finding increasingly that home health care seems to offer crooks many opportunities to exploit loopholes and oversights in the regulations," he said.

"The early stages of our investigation showed us where to look and gave us an idea of what we'd find. We continue to press deeper into the corruption plaguing the home health care industry and will continue to prosecute wrongdoers at all levels of these criminal operations."

Two managed care organizations recently paid $7 million to Cuomo as a result of his investigation into fraud in the state's Medicaid system.

According to a story in the Rochester Democrat and Chronicle, Cuomo's office expects to recover $100 million as a result of the new investigation, while the president of the state's Home Care Association says state agencies that oversee certification programs are part of the problem.

"When home-care agencies get timely, accurate information from the state about the nature of certification programs, they put a lot of weight in that," Joanne Cunningham said. "When this investigation started, agencies asked the state for clarification to make sure these programs were getting appropriate oversight."

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