Tonawanda News

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January 24, 2013

AG boasts 'banner year' in health fraud recovery

Tonawanda News — About $330 million was recovered in Medicaid fraud and other health-related cases by the state’s top legal arm in 2012 — including in Western New York — state Attorney General Eric Schneiderman said.

Calling it a “banner year” for Medicaid fraud recoveries, Schneiderman issued a statement Wednesday highlighting $1.6 million in excess Medicaid payments recovered on dental claims for services provided through Kaleida Health at Women’s & Children’s Hospital and a $180,000 civil settlement secured after Buffalo Transportation Inc. improperly billed the program, among the many cases statewide last year.

It was the second-highest annual recovery total ever by the AG’s Medicaid Fraud Control Unit, and the highest recovery in seven years, a statement from Schneiderman’s office states.

“Part of my first major initiative when I took office was to bolster the Medicaid Fraud Control Unit with additional prosecutors, investigators and auditors, in order to even more aggressively root out fraud and return money illegally stolen from taxpayers and their government,” Schneiderman said in the statement. “That initiative has paid off with record recoveries for taxpayers this year.” 

Some criminal prosecutions were also undertaken locally in the medical realm, including obtaining a jail sentence for a certified nurse aide for breaking the leg, and endangering the welfare of an 87-year-old resident with Alzheimer’s disease at Beechwood Nursing Home in Amherst, and charging an Erie County physician for sexual contact with a patient during office visits, according to Schneiderman’s office.

The state’s top prosecutor also credited the Medicaid fraud task force with various prescription drug crimes involving street-level sales of such substances, health care providers that billed for unnecessary services, providers who made referrals to unlicensed facilities in exchange for kickbacks and “unethical” practices among drug companies.

“The Medicaid Fraud Control Unit does an outstanding job, not only protecting taxpayers, but protecting patients from fraudulent practices that endangered their safety,” Schneiderman said. “I know this unit will continue to be vigilant in the coming year and send the message that fraud and abuse that endangers patients and rips off taxpayers will not be tolerated in our state.”

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