A.G. Schneiderman Announces Over $335 Million In Medicaid Fraud Recoveries For Taxpayers In 2012 - Hudson Valley

WHITE PLAINS – Attorney General Eric T. Schneiderman today announced that his office recovered over $335 million in 2012 that had been improperly claimed through fraud or abuse in the Medicaid system. This was the second highest annual recovery total ever by the Attorney General’s Medicaid Fraud Control Unit (MFCU), the highest recovery in seven years.

“Part of my first major initiativewhen 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 New York taxpayers and their government,” Attorney General Schneiderman said. “That initiative has paid off with record recoveries for taxpayers this year, including in the Hudson Valley Region. My office’s Medicaid Fraud team will keep working hard to root out fraud wherever it exists, and protect the integrity of the Medicaid program for those who truly need it.”

Attorney General Schneiderman’s Medicaid Fraud Control Unit was active in the Hudson Valley area, pursuing a variety of cases concerning matters ranging from the prescription drug abuse crisis to patient abuse:

• Recovered over $2.3 million for taxpayers through settlements with Sound Shore Medical Center of Westchester and Mount Vernon Hospital, resolving claims that the hospitals improperly overbilled Medicaid for physician-administered “J-code” drugs.

• Continued the crackdown on New York’s prescription drug crisis with the arrest of a Westchester doctor who conspired to deal prescriptions for 15,000 oxycodone pills, worth over $450,000.

• Secured the arrests of two Westchester nursing home aides, one who caused the death of an elderly resident by ignoring establishing safety precautions and, with another, then covered up the crime.

MFCU shut down schemes to illegally obtain prescription drugs through Medicaid and distribute them on the street for profit. The head of one prescription drug ring in the Bronx and another on Staten Island received prison sentences. MFCU also targeted providers that billed for unnecessary services or unnecessary visits to perform services that could have been rendered in a single visit; providers that referred patients to unlicensed facilities in exchange for kickbacks; unlicensed healthcare workers; and black market drug sellers that diverted prescription medications of unknown origin, re-packaging and re-selling them to pharmacies.

MFCU continued to vigilantly pursue major pharmaceutical manufacturers that engaged in unethical marketing practices. Abbott Laboratories, Boehringer-Ingelheim, Dava Pharmaceuticals, Inc., GlaxoSmithKline, K-V Pharmaceutical Company, McKesson Corporation, and Merck Sharp & Dohme Corp, among others, paid over $250 million to settle cases where they marketed their drugs to physicians for treating conditions that the Food and Drug Administration had not approved or for marketing and illegal pricing practices.  Some of those companies took criminal pleas in federal court for this conduct.

“The Medicaid Fraud Control Unit does an outstanding job, not only protecting taxpayers, but protecting patients from fraudulent practices that endangered their safety,” Attorney General 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.”

MFCU’s Hudson Valley office in Pearl River is headed by Special Assistant Attorney General Anne Jardine.

The Medicaid Fraud Control Unit operates under the supervision of Special Deputy Attorney General Monica Hickey-Martin, within the Criminal Justice Division led by Executive Deputy Attorney General Kelly Donovan.