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NY. NY Guilty Again of Medicaid Fraud

January 15, 2011

 Dr. Gabriel Feldman blew the whistle on what federal prosecutors are calling the city’s attempt to bilk taxpayers out of “tens of millions” by overbilling Medicaid.

Now the feds are fighting to recover more than $60 million – and Feldman stands to get a 15%-25% cut of the cash under the whistleblower law.

The feds charge the city improperly approved 24-hour home care for thousands of poor, elderly patients, often despite the recommendations of doctors paid to review the cases.

A doctor, for instance, suggested a 75-year-old with dementia should be moved to a psychiatric facility because she routinely tried to jump out the window. Yet, the city approved 24-hour home care for her.

Feldman, a 49-year-old upper West Sider, is one of the doctors the city contracted to make recommendations.

After the Human Resources Administration ignored his gripes, he filed a complaint with the court in fall 2009.

As a result, the feds investigated the 17,500 people who received 24-hour personal care services and allege misbilling was widespread over a 10-year period.

The feds suggested the city was apt to favor home care because the state and federal governments split the cost; institutionalizing a patient requires the city to help share the cost.

Read more: http://www.nydailynews.com/ny_local/2011/01/13/2011-01-13_manhattan_doctor_could_get_millions_in_reward_money_after_blowing_whistle_on_med.html#ixzz1B4CWRh3Y

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