Operation 'home Alone' Nets Crooked Aides, Nurses, Patient
NEW YORK, NY (August 22, 2007) – Attorney General Andrew Cuomo today announced the convictions of ten home health aides, two registered nurses, and a Medicaid recipient, as his office continues to widen its investigation of the multibillion-dollar home health care industry.
The convictions are part of the first round of indictments resulting from the Attorney General’s ongoing probe, dubbed “Operation: Home Alone,” into the expanding home health care industry.
“The problems our investigation has uncovered suggest organized, calculated operations that have bilked the system for tens of millions of New York taxpayer dollars,” Cuomo said. “As the home health care industry continues to grow, so too must we expand our aggressive pursuit of those who would defraud New York’s Medicaid system – and taxpayers – for personal gain.
“Medicaid fraud impacts every New Yorker – driving up income and property taxes and threatening the very lives of those who count on the care Medicaid provides. I urge anyone who may have information on suspected Medicaid fraud to contact our office’s Medicaid Fraud Hotline.”
Vano Saralidze, 27; Ketevan Saralidze, 28; and Hershl Schwartz, 55, pleaded guilty to felony grand larceny and related charges.
Former home health aides George Babuadze, 28; Raisa Haypapeyan, 43; Rima Petrosyan, 50; Julieta Sephashvili, 58; Elvira Bruce, 41; and Sahakanush Yuzbashyan, 41, each pleaded guilty to petit larceny, an A Misdemeanor, and will pay restitution ranging from $3,000 to $5,000. Miriam Schwinder, 58, also pleaded guilty to the misdemeanor, received a conditional discharge, and will pay $40,000 over the next five years.
The charges against the aides were based on their possession of falsified certification documents, and with respect to many of the aides, their lies about the hours they worked. Medicaid requires home health care aides – who primarily care for elderly patients, administer medication, and provide services such as catheter care, colostomy care and wound care – to successfully complete a training program licensed by the Department of Health or the State Education Department. All such aides must receive a minimum of 75 hours of training, including sixteen hours of supervised practical training conducted by a registered nurse. None of the aides received that training, and as a result, Medicaid was billed for ineligible services and Medicaid patients were given care by untrained aides. Two of the aides – Schwartz and Schwinder – were caring for family members, which is also not Medicaid-reimbursable.
Additionally, many of the aides worked concurrently for multiple home care service agencies, often submitting time sheets that, when put together, totaled more than 24 hours worked in a single day. In at least one case, Medicaid was billed for 36 hours of care provided for patients by one aide in a single day.
Schwartz caused Medicaid to be billed for care he was supposedly providing to his father when he was in fact working in a grocery store.
Two registered nurses also pleaded guilty to related misdemeanor charges. Medina Manashirova, 36, and Anna Mills, 34, both worked for multiple certified home health agencies, and would submit bills to the agencies for multiple patients during concurrent periods of time.
In some cases, the recipients did not need care, but were complicit in the fraud. Home care recipient Raisa Tarakanova, 80, pleaded guilty to a misdemeanor and is to repay $3,000 for her role in a scam in which she split Medicaid payments with her home health aide, who provided no services. Cases against other recipients are also pending.
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.
Today’s announcement comes on the heels of a round of guilty pleas by four home health aides for the same types of offenses. Attorney General Cuomo announced Monday he had issued subpoenas and requests for self-disclosure to nearly 60 certified home health agencies in the New York Metropolitan area, and expects many more arrests, indictments and convictions to follow as the investigation continues.
The number for the Attorney General’s Medicaid Fraud Hotline is 1-866-NYS-FIGHT (1-800-697-3444).
Attorney General Cuomo’s investigation of fraud in the home health care industry is ongoing. “Operation: Home Alone” is being prosecuted by Richard Harrow, Director of the New York City Regional Office of the Medicaid Fraud Control Unit, assisted by Special Assistant Attorney General Kiran Heer, under the supervision of Special Deputy Attorney General Heidi Wendel, Director of the Medicaid Fraud Control Unit. The investigation was conducted by Senior Special Investigators Michael Casado, Frederick Rondina and Hazel Walters, and Special Investigator Natalie Sotnikova, Associate Special Auditor Investigator Cristina Truta, and Special Auditor Investigator Lisa Close under the supervision of Supervising Special Auditor Investigators Paul Erhardt and Thomasina Smith. Deputy Director of MFCU Information Technology Carolyn Pollard also contributed to the case.