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Post date: June 16 2015

A.G. Schneiderman Announces Arrest Of Capital Region Personal Care Aides For Allegedly Defrauding Medicaid For Services Never Provided

Robert Lee Van Horne And Nicholas Gallup Submitted False Claims In Excess Of $1K Each

Schneiderman: Those Who Steal from Medicaid Will Be Prosecuted To the Fullest Extent

ALBANY- Attorney General Eric T. Schneiderman today announced the arrest of personal care aides Robert Lee Van Horne and Nicholas Gallup in Albany. Van Horne and Gallup were arraigned in Albany City Court in front of the Hon. William Carter. Van Horne, 33 and Gallup, 27, both of Schenectady, were arraigned on multiple counts of Falsifying Business Records in the First Degree, and Grand Larceny in the Fourth Degree, both Class E felonies. It is charged that both defendants caused more than 50 false entries in the business records of Capital District Physicians Health Plan (CDPHP), a Medicaid Managed Care contractor for New York State, located in the City of Albany, and stole property in excess of one thousand dollars.

“Stealing funds intended for those in need is truly reprehensible, and will not be tolerated,” Attorney General Schneiderman said. “We will seek out those who defraud the Medicaid program at the expense of hardworking taxpayers and prosecute them to the fullest extent.” 

Van Horne and Gallup were hired to provide personal care services to a Medicaid recipient who required the services due to her health issues, through the billing group, Resource Center for Independent Living, (RCIL) a Medicaid provider, from April through June 2014. Van Horne and Gallup agreed to provide care on alternate days. It is alleged that Van Horne and Gallup never provided services to the Medicaid recipient from April to June 2014, and that both Van Horne and Gallup utilized a telephone-based time tracking system by calling into the system to falsely document the time they allegedly provided care for the Medicaid recipient. As a result of the falsely documented time records, RCIL generated a claim and submitted it to CDPHP for payment. CDPHP issued payment to RCIL; then RCIL issued payment to Van Horne and Gallup. As a result of the false documentation, Van Horne and Gallup each received over one thousand dollars.  

Van Horne, 33, of Schenectady, entered a plea of not guilty today before Albany City Court Hon. William Carter, to twenty-eight counts (28) of Falsifying Business Records in the First Degree, and one count of Grand Larceny, both Class E Felonies. Gallup, 27, also of Schenectady, entered a plea of not guilty today before the Hon. William Carter, to twenty four (24) counts of Falsifying Business Records in the First Degree, and one count of Grand Larceny, both Class E Felonies.

The charges are merely accusations and the defendants are presumed innocent unless and until proven guilty in court.

The case was investigated by Investigator Danette Benson, with the assistance of Supervising Investigator Dianne Tuffey and Upstate Deputy Chief Investigator William Falk, and Senior Special Auditor-Investigator Melissa Tulip with the assistance of Assistant Chief Auditor-Investigator Charles R. Norfleet.

The case was prosecuted by the Albany Regional Office of the Medicaid Fraud Control Unit of the Office of the Attorney General. Regional Director Kathleen A. Boland represented the people. Catherine Wagner is MFCU's Upstate Chief of Criminal Investigations. Amy Held is the Acting Director of the Medicaid Fraud Control Unit and Kelly Donovan is the Executive Deputy Attorney General for Criminal Justice.