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Post date: October 1 2007

Attorney General Cuomo, District Attorney Rice Charge Li Home Care Agency Operators With Medicaid Fraud, Wide Range Of Financial Crimes

MINEOLA, NY (October 1, 2007) - Attorney General Andrew M. Cuomo and Nassau County District Attorney Kathleen M. Rice today announced the arrest of a home care agency operator and an associate for a litany of Medicaid-related crimes that were committed to bankroll extravagant lifestyles. The arrests were the result of an investigation by the Medicaid fraud task force Attorney General Cuomo and the District Attorney Rice launched in January.

Charles Zizi, 46, of South End Ave, New York City, was charged with stealing more than $300,000 from Medicaid by submitting claims for services that were not provided, inflating hours of service of the nurses he employed and billing for maximum authorized services rather than actual services rendered. He forged documents, laundered proceeds and falsified tax filings for personal gain, according to the charges.

Ricardo Francois, 37, of Corporate Drive, Westbury, NY was charged with participating in the crimes as the billing agent in Zizi’s agency. He allegedly submitted falsified claims to Medicaid, and used forged documents to obtain personal loans.

Both were arraigned before Justice David Sullivan in Nassau County Supreme Court. Zizi is being held on $150,000 bond or $75,000 cash bail; Francois is being held on $100,000 bond or $50,000 cash bail.

“These defendants used a home care agency under their control as a personal criminal enterprise to rip off taxpayers and cover their own extravagant expenses,” said Attorney General Cuomo. “Their arrests and the unraveling of their schemes were the direct result of a coordinated effort between my office and that of District Attorney Rice, and shows how cooperation between state and local agencies can effectively root out the fraud plaguing the Medicaid system.”

“I created a Medicaid fraud unit in this office because we knew Medicaid fraud was here in our county and that it was on the rise across the state,” District Attorney Rice said. “We joined forces with the Attorney General because we knew this problem extended beyond our borders and we knew their resources and information would be vital when it came to helping my administration protect Nassau County tax dollars. I’m proud of our unprecedented partnership and I look forward to prosecuting this case, and turning up the heat on those stealing from our taxpayers.”

Zizi faces charges under a 40-count indictment with crimes including Grand Larceny in the Second Degree, Forgery in the Second Degree, Criminal Possession of a Forged Instrument in the Second Degree, First Degree Identity Theft, Money Laundering in the Fourth Degree, Offering a False Instrument for Filing in the First Degree and First Degree Scheme to Defraud.

Francois faces charges under a 9-count indictment with crimes including Grand Larceny in the Second Degree, Criminal Possession of a Forged Instrument in the Second Degree, and Offering a False Instrument for Filing in the First Degree.

In 2002, Zizi assumed managerial control of then-dormant Always There Homecare, which had locations on Old Country Road in Carle Place and Fulton Street in New York City. He was in the process of purchasing the company at the time.

Zizi was charged with Identity Theft for obtaining a corporate credit card in the names of Always There and the company’s original owner, without the owner’s knowledge or permission. The card was used by Zizi and Francois for nearly $100,000 in lavish purchases such as jewelry and intercontinental trips. Zizi was also accused of using company funds for other personal uses, forging signatures to gain authorization to manage another home care agency and laundering money through another company he controlled. Zizi is also charged with keeping payroll funds meant to be withheld for state and federal taxes.

Francois was charged with forging signatures and falsifying tax filings to gain personal loans, and submitting false claims to Medicaid for services never rendered. He was also in possession of one of the credit cards falsely obtained by Zizi.

Attorney General Cuomo also filed a civil lawsuit to recover the proceeds of these crimes as well as to recoup penalties under the new False Claims Act and the Social Services law. The lawsuit also seeks to recover for other violations by Always There, which provided home care services to children and adults with ailments including cerebral palsy, muscular dystrophy, mental retardation, seizure disorders, quadriplegia, spasms and pulmonary diseases.

This is the first case to be brought by the New York State-Nassau County joint Medicaid fraud task force, which operates pursuant to an agreement between the Office of the Attorney General and the Nassau County District Attorney’s Office. The agreement calls for the cooperative investigation and prosecution of Medicaid provider fraud. It makes provisions for the shared administration and supervision of such joint endeavors.

In a continuing fight against Medicaid fraud statewide, Attorney General Cuomo is seeking to partner with local officials in counties across New York.

The Attorney General’s Medicaid Fraud Control Unit has highly specialized attorneys, auditors and investigators statewide dedicated to investigating and prosecuting Medicaid fraud. Its criminal jurisdiction covers fraud and abuse by care providers, hospitals, nursing homes, clinics and adult care facilities as well as the abuse of patients and the theft of their funds. The Attorney General’s office can also bring civil actions under New York Social Service Law and a newly-enacted False Claims Act.

For their part, counties have additional criminal jurisdiction in cases of recipient fraud. Cuomo said this, coupled with county officials’ intimate knowledge of the providers and recipients in their communities, makes for a natural partnership in “finding, fighting and fixing” Medicaid fraud.

A total of $1.4 billion was spent on Medicaid services for Nassau residents in 2006. Of that, over $123 million went to home health care, a fast-growing and lightly regulated industry. Statewide, home health care cost Medicaid $1.3 billion in 2006.

Attorney General Cuomo has made cleaning up the home health industry a priority of this administration, and recently launched an investigation, dubbed “Operation Home Alone,” into abuses in that sector of New York’s health care system. The ongoing investigation has uncovered a wide range of abuses of home health care, and has thus far resulted in charges against nearly 50 defendants.

Attorney General Cuomo urged New Yorkers who suspect cases of Medicaid fraud to call the Attorney General’s Medicaid fraud hotline at 1-866-NYS-FIGHT (697-3444).

Contributing to the case from the Attorney General’s Office are Special Assistant Attorney General Alan Buonpastore, who has also been made a Special Assistant District Attorney for the investigation; Senior Special Investigator Stephen Nicastro; Principal Special Auditor Investigator Chris Simeti; and Associate Special Auditor Investigator Gretchen Hugh. Contributing from the District Attorney’s Office are Michael C. Clarke, Chief of the DA’s Medicaid Fraud Unit; Special investigator Stanley Wojis; and Special investigator Robert Sanicola.