7 hospitals in NY accused of $50M Medicaid fraud

January 5, 2009 by  
Filed under Corruption, Featured, Latest Top Stories, National News

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ALBANY, N.Y. – Four hospitals in New York state paid kickbacks to get more patients into their drug treatment programs, which billed Medicaid for services that weren’t standard or necessary and lacked state certification, lawsuits allege.

Another hospital paid people to search homeless shelters and other places for patients to enter a three-day stay in detox in exchange for cigarettes, beer, food, and other items, according to the lawsuit brought by state Attorney General Andrew Cuomo and U.S. Attorney Benton Campbell.

The lawsuits allege those five hospitals and two others fraudulently billed Medicaid for more than $50 million in more than 14,000 different claims.

Both attorneys’ offices declined to say why they didn’t pursue criminal charges. In both investigations, former hospital employees notified authorities of the issues, dating to 2002.

Five of the hospitals denied wrongdoing Monday, while the others couldn’t be reached.

Cuomo said all seven hospitals claimed their detox services were part of a government treatment program but didn’t have the required state license.

The lawsuits allege four of the hospitals engaged in a kickback scheme with Missouri-based SpecialCare Hospital Management Corp. to refer patients to the hospitals’ detox units.

SpecialCare had an agreement to provide management and administrative services for the detox programs, but the lawsuit alleges it also illegally referred patients to the hospitals for a fee. Cuomo asserts that violates New York‘s anti-kickback laws.

“SpecialCare at times literally picked up strangers on the street, shuttled them to hospitals where they received treatment that was either inadequate or unnecessary, and then billed the state,” Cuomo said in a statement.

The hospitals accused in the kickback scheme are Columbia Memorial Physicians Hospital Organization Inc., in Hudson; Long Beach Medical Center; New York Downtown Hospital; and St. Joseph’s Medical Center in Yonkers.

The hospital accused of rounding up the homeless for detox is Queens’ Parkway Hospital, which closed in November. The other defendants are the former Our Lady of Mercy in the Bronx and Benedictine Hospital in Kingston.

Spokesmen for St. Joseph’s, Benedictine, Downtown Hospital, Columbia Memorial and Long Beach denied the allegations. Parkway officials couldn’t be reached. SpecialCare didn’t return a call for comment.

“Despite years of investigation, neither the office of the attorney general of the state of New York, nor the United States attorney’s office, has articulated any viable claims,” said Gary Schulz, an attorney for St. Joseph’s.

The state settled for $4.5 million with Our Lady of Mercy, which denied all wrongdoing. Our Lady of Mercy is now run by Montefiore Medical Center and didn’t return calls Monday.

West Palm employee probe finds e-mails, porn and trysts

December 30, 2008 by  
Filed under Corruption, Local News

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WEST PALM BEACH — Some city employees spent hours on porn sites, while others e-mailed ethnic jokes or racist photos. For others, the offense was forwarding religious inspirational e-mails to colleagues.

For the city, it added up to one thing: misusing government equipment on idle or offensive pursuits.

Employment records provided by the city Tuesday show that its ongoing inquiry into computer misuse, which began six months ago, has led to four firings, nine resignations, one suspension and three reprimands. All the employees recently received training in respecting co-workers and most also attended sessions in e-mail liability and workplace harassment, city spokesman Peter Robbins said.

Two of those reprimanded work in human resources, the department conducting the investigation.

Two of those fired, Larry Brown, a public utilities operations coordinator, and Kendrick Crawford, a public works code enforcement officer, were investigated for misuse of city vehicles and that led to discovery of offensive e-mails, according to investigators.

Brown used a city car for a romantic interlude with another employee, Patrice Robinson, investigators alleged. Brown was fired; Robinson quit.

Crawford used his city car for a lunch break outside the city limits, “for sexual interaction,” according to investigators. Further investigation showed improper Internet use, his personnel file stated.

Steven Strong, a wastewater plant operator, was fired Dec. 17 after the city cited him with “gross misconduct” and “excessive loss of normal working hours.” His termination letter said that from June through early November, he spent more than 20 hours on the Internet, including 64,853 hits on Web sites. Printouts in his personnel file show that much of it was porn.

Patricia Daniels, a secretary, was fired Nov. 6 for sending office e-mails that included racial and ethnic jokes.

The punishments were determined by the nature of the offense and were not related to city budget restraints, officials said.

Darlene Snowball, a purchasing agent, for example, allegedly had used her city computer to send religious materials; she was reprimanded. Melva Brewster, a parks and recreation secretary, spent an “enormous” number of hours on the Internet, an investigator alleged; she got a three-day suspension in November.

Some of the employees who were fired or resigned are taking legal action, through union representation or lawyers. Diane Phillips, who resigned rather than be fired, said she has requested powerhouse Stuart lawyer Willie Gary to represent her; she hasn’t heard back. Another lawyer said he didn’t think he could help, she said.

Phillips conceded that she’d sent a couple of e-mails with religious jokes “to the same two people I’ve always sent e-mails to, but nothing anyone got insulted over.” The city overreacted and treated employees unevenly, she said.

“I have received nothing but excellent reviews in the 19 years I was employed with the city and I made a stupid mistake, but it appears they chose who they wanted to keep on and who they didn’t,” she said.

Palm Beach Post