Attorney General Recovers $275,000 In Settlement With Rochester Health Care Provider

Attorney General Spitzer today announced that People Rebuilding and Living in Dignity (PRALID), Inc., a not-for-profit agency providing rehabilitation services to individuals who have mental disabilities as result of having suffered traumatic brain injuries, has agreed to repay taxpayers $275,083 for Medicaid billing irregularities.

"The taxpayer-funded Medicaid program was designed to assist citizens in need," said Spitzer. "The recovery of this money by my Medicaid Fraud Control Unit (MFCU) will go a long way in ensuring that those needs are properly met."

PRALID, located at 624 Westfall Road in Rochester, operates several group homes under the auspices of the State Office of Mental Retardation and Developmental Disabilities' Home and Community Based Services waiver program. PRALID also services several clients living in apartments under the Department of Health's Traumatic Brain Injury waiver program.

The settlement announced today is based on an audit conducted by the MFCU. In reviewing the billing records of PRALID for September 1995 through April 2000, the audit revealed that PRALID received Medicaid reimbursement in excess of the amounts actually due the organization.

Specifically, the audit found that PRALID inadvertently billed Medicaid for services that either were never provided or were reimbursed by another state program, and for more hours than were included in residents' service plans or actually provided. The audit also found that certain PRALID employees failed to meet the minimum education and/or experience standards established by the Health Department.

Spitzer added, "Once the problem was brought to the attention of PRALID's Board of Directors, they readily agreed to reimburse the state, and took immediate steps to ensure that the problem would never occur again."

Spitzer thanked the Monroe County Department of Social Services for referring the matter to his office.

Special Assistant Attorney General Jerry M. Solomon, Director of the Rochester Regional Office of the Attorney General's MFCU, conducted the investigation resulting in this repayment of Medicaid funds. All cases are handled under the direct supervision of Deputy Attorney General Jos?? Maldonado.