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Post date: January 7 2016

A.G. Schneiderman Announces Sentencing Of Capital Region No-Show Personal Care Aide Who Bilked Medicaid

Aide Submitted False Records To CDPHP, Causing Over $1,000 In Theft To Medicaid

Schneiderman: Those Who Exploit Medicaid Flexibility Will Be Held Accountable

ALBANY- Attorney General Eric T. Schneiderman today announced the sentencing of personal care aide, Nicholas Gallup, 27 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. Gallup was sentenced in Albany County Court by the Honorable Peter Lynch to 30 days in Albany County Jail and five years’ probation. 

“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.”

Gallup entered a plea of guilty on November 4, 2015 to one count Falsification of Business Records in the First Degree, a Class E felony in front of Albany County Court Judge Peter Lynch. In addition to the sentence, Gallup has paid $1,444.00 in restitution, was ordered 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, Gallup 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.  Gallup and his co-defendant Robert Van Horne– 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. Van Horne also entered a plea of guilty in Albany County Court and is scheduled to be sentenced on February 1, 2016.

The case was investigated by Investigators Danette Benson and J. R. Benshoff with the assistance of 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.

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