Schneiderman settles three cases

Jessica M. Karmasek Feb. 11, 2011, 10:39am


ALBANY, N.Y. (Legal Newsline) - New York Attorney General Eric Schneiderman announced on Thursday his office reached three settlement agreements in Medicaid fraud investigations, totaling more than $1.6 million in recovered funds.

The agreements come as Schneiderman's launch of a major initiative to bolster his office's Medicaid Fraud Control Unit and create a Taxpayer Protection Unit to increase fraud recoveries during a period of fiscal crisis.

"As I said when we unveiled our new Taxpayer Protection Unit, this office will leave no stone unturned in the quest to save money for taxpayers by rooting out waste, fraud, and corruption wherever we find it," Schneiderman said in a statement.

"In these cases, New York State taxpayers were being short-changed through over-billing, sloppy record-keeping, and unnecessary medical procedures. Given the budget challenges we face, this is unacceptable, and we will work every day to ensure those who cheat the taxpayers are caught and forced to pay for their crimes."

The three fraud settlements include:

- Patrick Mascarenhas, who owns Delancey Dental, P.C., and Tru-Dental, P.C., dental practices and has several offices in Dutchess County, including in Beacon, Hyde Park, Pawling and Poughkeepsie, as well as others across the state. Medicaid rules and regulations require medical records to demonstrate medical necessity for dental fillings, which the dental practices did not do for the period of January 2002 through February 2008, Schneiderman's office said. They have agreed to the pay the State $376,560;

- Queens Medical Associates, P.C., a Queens-based, hematology and oncology group practice, has repaid the State $851,927.16 for overbilling the Medicaid program. An investigation by the attorney general's Medicaid Fraud Control Unit revealed that the practice improperly overbilled Medicaid for physician-administered drugs, in violation of state law. Under New York State law, to ensure that medical judgment is not improperly influenced by financial considerations, doctors are not permitted to make a profit on the drugs they dispense. The practice also billed Medicaid as the primary insurance on claims that should have been paid 80 percent by Medicare, Schneiderman's office said; and

- Absolute Home Health Care, Inc., a licensed home care services agency located in Mount Vernon, has agreed to repay the State $397,000 as a result of an investigation that revealed sloppy record keeping. An investigation into Absolute's Medicaid billings for the period of February 2002 through September 2007 revealed that Absolute failed to maintain records, such as time sheets and nurses notes, which would have verified whether the nursing services for which it billed were in fact provided, Schneiderman's office said. Medicaid rules and regulations require health care providers to maintain records supporting their right to reimbursement.

From Legal Newsline: Reach Jessica Karmasek by e-mail at

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