Cuomo Initiates Audit Of Home Care Providers
In an effort to rein in fraud in New York's home health care industry, Attorney General Andrew M. Cuomo has subpoenaed over 50 certified home health agencies in the New York metropolitan area, and has requested self-disclosure information from 10 of the largest among them.
"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."
In recent months, the Attorney General's Medicaid Fraud Control Unit has uncovered several home health aides operating with falsified certifications - some issued by schools with no required state accreditations and causing Medicaid to be billed for their work. The resulting indictments exposed a wide range of fraudulent practices and schemes- by the aides, the facilities that train them, and the agencies that employ them. They included working without proper certifications, providing and billing ineligible services and billing for services never provided.
The final round of subpoenas went out on August 20.
They request information about the aides for whose services the agencies billed Medicaid, including personal information, verification of qualifications, schedule of hours billed, and the names of the licensed home care service agencies that furnished their services. The aim is to separate the legitimate operators from the frauds, and help determine the appropriate course of action to repair the damage.
"We're finding increasingly that home health care seems to offer crooks many opportunities to exploit loopholes and oversights in the regulations," Cuomo continued. "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."
Provisions establishing and regulating home health care in New York were set forth in Chapter 895 of the state laws of 1977. The aim was to create a "nursing home without walls," reducing the costs associated with institutionalization and providing patients a greater level of comfort. Every month, more than 80,000 New Yorkers receive some sort of Medicaid-funded home health services- just over 54,000 of them live in New York City. In 2006, Medicaid spent nearly $1.3 billion on home health care. Because there is no centralized registry for home health aides, an accurate estimate of their numbers cannot be given.