A.G. Schneiderman Announces Jail Time For Capital Region No-Show Personal Care Aide Who Bilked Medicaid

A.G. Schneiderman Announces Jail Time For Capital Region No-Show Personal Care Aide Who Bilked Medicaid

ALBANY – Attorney General Eric T. Schneiderman today announced the sentencing of personal care aide, Robert Van Horne, 29, of Schenectady, for submitting false time sheets to Capital District Physicians Health Plan (CDPHP), causing over $1,000 in losses to Medicaid. The defendant submitted false claims for providing care to a Medicaid recipient that never occurred. Van Horne was sentenced yesterday in Albany County Court by the Honorable Peter Lynch to 2 years in the Albany County Jail. 

“When individuals exploit the Medicaid program’s flexibility and a patient’s vulnerability, it takes away from those who are in need of basic health care services,” said Attorney General Schneiderman. “The Medicaid program’s Consumer Directed Personal Assistance Program was intended to provide essential health care services by trusted persons in the patient’s own home, and those who abuse that trust and steal from Medicaid will be held accountable.”

Van Horne entered a plea of guilty on December 7, 2015 to one count each of Falsification of Business Records in the First Degree, and Petit Larceny, both Class A misdemeanors, in front of Albany County Court Judge Peter Lynch. Van Horne was sentenced to 1 year in the Albany County Jail, for each misdemeanor, to be served concurrently.  In addition to the sentence, Van Horne was ordered to pay $1,552.00 in restitution, to stay away from the Medicaid recipient, and to not participate in the Consumer Directed Personal Assistance Program.

According to the original complaint and his admissions at plea, Van Horne was hired to provide in-home personal care services to a Medicaid recipient who required the services due to her health issues, through the billing group Resource for Independent Living, (RCIL) a Medicaid provider, from April through June 2014.  Van Horne and his co-defendant Nicholas Gallup– who were selected by the recipient to provide the care – agreed to provide care on alternate days.  Van Horne and Gallup never provided services to the Medicaid recipient from April to June 2014, and called into a telephone time-keeping system to falsely document that they had provided care for the Medicaid recipient.  As a result of the false 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 in Medicaid funds.   Gallup also entered a plea of guilty in Albany County Court and was sentenced on January 7, 2016.

The case was investigated by Investigators Danette Benson and J. R. Benshoff with the assistance of Supervising Investigator Dianne Hart and Upstate Deputy Chief Investigator William Falk 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 of the State of New York.  Catherine Wagner is MFCU’s Upstate Chief of Criminal Investigations.  MFCU is led by Acting Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney.  The Criminal Justice Division is led by Executive Deputy Attorney General Kelly Donovan.