Attorney General James Sues CVS for Harming New York Safety Net Hospitals and Clinics by Diverting Millions from Underserved Communities

 

Lawsuit Alleges CVS Violated Antitrust Laws by Requiring Safety Net Hospitals to Exclusively Use a CVS-Owned Company to Process Federal Subsidy Claims

CVS Forced Health Care Providers to Incur Millions, Diverted Funds from Patient Care for Underserved Communities

 New York Attorney General Letitia James today sued CVS Health Corporation (CVS) for violating antitrust laws and hurting New York safety net hospitals and clinics that provide care for underserved communities across the state. CVS required New York safety net hospitals and clinics to exclusively use a CVS-owned company, Wellpartner, to process and obtain federal subsidies on prescriptions filled at CVS pharmacies. CVS’s scheme forced safety net health care providers to incur millions in additional costs, while CVS continued to benefit through its subsidiary. The lawsuit alleges that CVS’s unfair business practice deprived safety net hospitals and clinics of critical federal funding that could have been used to improve and expand patient care. Through her lawsuit, Attorney General James is seeking to end CVS’s unfair and illegal practices and to recoup lost revenue for impacted safety net hospitals and clinics that would improve health care services.

“While safety net health care providers are tackling public health crises and helping underserved communities, CVS is robbing them out of millions of desperately needed funds that could improve patient care,” said Attorney General James. “CVS’s actions are a clear example of a large corporation using its clout and power to take advantage of institutions and vulnerable New Yorkers, but my office will not allow it. We are taking action to stop CVS’s harmful practices and recoup critical funds to improve health care for our communities. When powerful corporations undermine the health and wellbeing of vulnerable communities in New York, they can expect to hear from my office.”

For years, CVS did not allow New York safety net hospitals and clinics to use the company of their choice to obtain subsidies on prescriptions filled at CVS pharmacies through the 340B federal program. This program allows safety net hospitals and clinics to purchase certain drugs at a discount from pharmaceutical companies and use the savings for patient care. Safety net health care providers in New York obtain substantial savings from the 340B program, which are critical to their viability and to the health of the surrounding community. To realize the benefits of the 340B program, safety net hospitals and clinics must contract with the pharmacies that are used by their patients. Under the CVS scheme, thousands of safety net health care providers across the state were only allowed to use Wellpartner to process claims filled at CVS retail and specialty pharmacies, forcing them to incur millions of dollars in additional costs to hire and train staff and change their data systems to align with Wellpartner’s system.

The lawsuit alleges that New York patients were the ultimate victims of CVS’s unfair practice, which siphoned off critical federal funding from safety net health care providers that could have used the funds to improve access to health care for the neediest New Yorkers — including New Yorkers without health insurance or an ability to pay for health care.

As of 2021, there were more than 4,440 safety net health care providers enrolled in the 340B program across New York, which include Federally Qualified Health Centers (FQHCs), critical access hospitals, Ryan White HIV/AIDS Program grantees, rural referral centers, sole community hospitals, black lung clinics, community health centers, family planning clinics, and tuberculosis clinics. These facilities primarily treat low-income patients and rely on 340B savings to fund patient care services to underserved and vulnerable populations.

Safety net health care providers bear full legal responsibility for keeping records and may only collect 340B revenues on certain prescriptions, including patient prescriptions for medications used to treat HIV/AIDS and hepatitis C. Most safety net providers contract with a third-party administrator, or TPA, to administer their 340B programs. The TPAs confirm eligibility for each transaction and keep detailed records, as required by the federal 340B program rules.

In 2017, CVS acquired a TPA, Wellpartner, and began requiring New York hospitals to use Wellpartner rather than another TPA. The Office of the Attorney General’s (OAG) investigation found CVS pharmacies did not contract with hospitals that do not use Wellpartner as their TPA, a violation of New York’s antitrust laws. Since there was no contract, the hospitals and clinics were unable to collect 340B funds that were rightfully theirs. Hospitals and clinics had little choice — they either had to go along with CVS’s self-serving scheme, or simply forgo the benefits to which they were otherwise entitled under the 340B program.

The OAG found that CVS’s plan was to leverage the strength of its retail pharmacy network in New York to force hospitals to use Wellpartner, rather than any other TPA. Many hospitals objected because they were already using other TPAs.

The lawsuit alleges that CVS’s actions undermined the goal of the 340B program and hurt the financial condition of safety net health care providers. CVS required health care providers to transition at a significant cost to Wellpartner if the hospitals wanted to obtain 340B revenues from prescriptions filled at CVS pharmacies. Many hospitals switched to Wellpartner for all their 340B needs because it was not practical or economical to pay for two TPAs. In addition, CVS knew that the 340B program rules do not allow hospitals to steer patients away from certain pharmacies, so health care providers had no choice in practice — if they didn’t go along with CVS’s tying scheme, they simply couldn’t collect 340B savings for patients who choose to go to CVS pharmacies. 

Through her lawsuit, Attorney General James is seeking injunctive relief, equitable monetary relief for the lost revenue and additional costs safety net health care providers were forced to incur, and civil penalties for CVS’s unfair and illegal business practices. In addition, Attorney General James seeks to require CVS to inform all safety net health care providers that they are not required to exclusively use Wellpartner.

Governor Hochul Applauds PACB Approval of Landmark Funding Agreement to Redevelop Penn Station, Revitalize Surrounding NeighborhoodNew Penn Station

Critical Milestone Advances Governor's Proposal to Renovate and Potentially Expand Penn and Fund Public Realm and Transit Improvements Without Raising Taxes or Fares on New Yorkers

Project Components Include Station Reconstruction and Potential Expansion; Up to 708 Units of Affordable and Supportive Housing; Vibrant Open Space; and Enhancements to Streets, Sidewalks, and Transit Infrastructure

Vote Follows ESD Board Approval of Penn Station General Project Plan

Information on Project Financing, Costs, and Cost-Sharing Available Here 

 Governor Kathy Hochul today applauded the Public Authorities Control Board's vote to approve a financial framework supporting her proposal to rebuild and potentially expand Penn Station and reactivate the surrounding area. The unanimous vote marks a major step toward actualizing the Governor's plan, which includes the construction of a new, modern train station; up to 1,800 units of housing - including hundreds of affordable and supportive housing units - brand-new, state-of-the-art office space; 8 acres of open space; and enhancements to the streets, sidewalks, and local transit infrastructure. It also affirms the State's commitment to delivering the project without raising taxes on New Yorkers or fares on transit riders.

Last week, Empire State Development's Board of Directors voted to approve the Pennsylvania Station Area Civic and Land Use Improvement Project's General Project Plan, Governor Hochul's vision to reimagine Penn Station and the surrounding area.

"For far too long, Penn Station has been an overcrowded, cramped, and neglected mess. This vote is a major milestone in our plan to fix Penn Station and transform the surrounding neighborhood," Governor Hochul said. "New Yorkers deserve a station they can be proud of, quality affordable housing to call home, walkable streets and sidewalks, and easy access to transit. This plan will provide all of that and more. I thank the Public Authorities Control Board for their approval, and I look forward to continued engagement with elected partners, community leaders, and other stakeholders as we move this project forward and deliver a station worthy of New York."

"For decades there has been talk of building a new Penn Station, but now we have a once-in-a-generation opportunity to deliver a station worthy of the greatest city in the world," said New York City Eric Adams. "Future generations of New Yorkers will see the new Penn Station as proof that New York City can achieve big things, even during challenging times. I applaud the PACB for this historic vote, which will bring a world-class transit hub, quality jobs, and much-needed affordable housing to our city. I also want to thank Governor Hochul, as well as Governor Murphy and our partners at the MTA, Amtrak, and NJ Transit, for demonstrating that government can work quickly and collaboratively to 'Get Stuff Done.'"

Empire State Development President, CEO, and Commissioner Hope Knight said, "Governor Hochul's vision for a world-class Penn Station and revitalized surrounding neighborhood is the positive, long overdue transformation that New Yorkers deserve. Not only is the plan a win-win for riders, residents, and commuters, it is also a forceful catalyst for New York's long-term economic development. Transit-oriented development is a model of sustainable growth, and we are proud of the open, public process this project has gone through over the last two years, strengthened by the input of civic groups and community members who made their voices heard and helped improve the plan."

The PACB vote locks in an agreement between Governor Hochul and New York City Mayor Eric Adams on a financial framework to fund the station reconstruction and potential expansion, public realm improvements, and enhancements to transit infrastructure. The framework ensures that the City maintains a current and consistent level of property tax revenue while requiring that the project funding come in part from private development. As part of the agreement, the City and State have committed to establishing a joint city-state development corporation to oversee public realm improvements in coordination with the Penn Station Public Realm Task Force.

Last November, Governor Hochul announced a comprehensive vision for a new commuter-first, world-class Penn Station and revitalized surrounding neighborhood that reflects the community's needs and focuses on public transit and public realm improvements. The Governor's plan prioritizes the reconstruction of the existing station while the station expansion and the Gateway Hudson Tunnel Project - both of which the Governor supports - continue to advance. Under the plan, New Yorkers can expect:

• A modern, single-level, double-height train station that doubles passenger circulation space on the new public level from approximately 123,000 square feet to approximately 250,000 square feet.
• Up to 1800 residential units, (of which up to 708, or nearly 40 percent of units, would be affordable or supportive housing);
• 8 acres of vibrant open space.
• Wider sidewalks, pedestrian-friendly shared streets, brand-new pedestrian plazas, and protected bike lanes.
• Nearly twice as many entrances to Penn Station with new underground corridors connecting 34th Street-Herald Square to Penn.
• A suite of social services to support people experiencing homelessness and those with substance use disorders and co-occurring disorders.

In June, Governor Hochul announced that the Penn Station Reconstruction project had entered the design phase and launched a request for proposals for the design of the new Penn Station. Awards are expected to be announced in the fall.

Governor Hochul's plan comes after more than two years of community engagement, including more than 100 public meetings held by Empire State Development (ESD) and a year of public comment to solicit neighborhood input and recommendations. The final plan is a direct response to public feedback from local officials, community members, civic organizations, and other stakeholders.

Additional information about the project, including project financing, anticipated costs, cost-sharing, and revenues from private development, is available on ESD's website.

President and Chief Executive Officer of the Regional Plan Association Tom Wright said, "For far too long, the region's commuters and New Yorkers have suffered the humiliation of Penn Station - a symbol of everything that was wrong with 20th century planning: disinvestment, apathy and poor urban design. As both Penn Access and Gateway move forward, bringing more passengers, energy and connectivity to the district, we are pleased to see the renovation and expansion of Penn Station take a major step forward thanks to Governor Hochul's strong leadership and partnership with Mayor Adams. With input from elected officials, community members and stakeholders, the public won significant improvements to the plan including over 700 new units of affordable housing, commitments to improve the public realm, and reduced commercial density. We still have a long way to go, but this plan sets in motion significant improvements to Penn Station and the surrounding district which will benefit commuters, businesses and residents for decades to come."

Permits Filed For 1472 Shakespeare Avenue In Highbridge, The Bronx

 

Permits have been filed for a six-story residential building at 1472 Shakespeare Avenue in Highbridge, The Bronx. Located at the intersection of West 172nd Street and Shakespeare Avenue, the corner lot is near the Mount Eden Avenue subway station, serviced by the 4 train. Egris Haxhari under the H20 LLC is listed as the owner behind the applications.

The proposed 61-foot-tall development will yield 22,852 square feet designated for residential space. The building will have 34 residences, most likely rentals based on the average unit scope of 672 square feet. The steel-based structure will also have a cellar, a 38-foot-long rear yard, and 10 open parking spaces.

Node Architecture Engineering Consulting PC is listed as the architect of record.

Demolition permits will likely not be needed as the lot is vacant. An estimated completion date has not been announced.

Escooter Company Expanding in Community Board 11 Outside of the Regulated Areas

Byrd Escooter dropped off six Escooters in front of the Liberty Diner Tuesday night at the corner of Williamsbridge Road and Lydig Avenue. The problem is that there is, and never was an Escooter coral there, so why would Byrd Escooter drop the six Escooters in front of the Liberty Diner? Has Byrd Escooter decided that they are going to drop off their Ecooters anywhere in Community Board 11? 

As if it wasn't bad enough that Byrd Escooter has their trucks dropping off their Escooters anywhere, but the rented trucks have out of state Oklahoma license plates which is depriving New York State of monies from the registrations of their trucks and do they have the proper New York State insurance? 

Byrd Escooters are being unloaded from this van to be placed in front of the Liberty Diner for the first time.

The Byrd Escooter van can hold up to 40 Byrd Escooters.

You can see six Byrd Escooters are lined up in front of the Liberty Diner at the corner of Williamsbridge Road and Lydig Avenue, where there are no coral markings and never were any Escooters placed here before.

When we look at the front of the Byrd Escooter van we see the number ten on the hood, but see no New York State License plate, registration, or inspection stickers. 

A close up of the rear license plate of the Byrd van shows a license plate from Oklahoma, so the Byrd Escooter Company has a fleet of out of state vans to pick up and put out their Escooters.

BRONX MAN SENTENCED TO 25 YEARS TO LIFE IN PRISON FOR FATALLY STRANGLING MOTHER-IN-LAW

 

Victim’s Grandchildren Witnessed Part of Killing

 Bronx District Attorney Darcel D. Clark today announced that a Bronx man has been sentenced to 25 years to life in prison for second-degree Murder in the strangling of his mother in-law in her apartment in 2019.

 District Attorney Clark said, “The defendant killed the grandmother of his children while his three children were in her home. Two of them witnessed the murder and are living with that trauma. A jury found him guilty of second-degree Murder and he will spend many years in prison for destroying so many lives in a single heinous act.”

 District Attorney Clark said the defendant, Angel Montanez, 42, last of 1269 Sheridan Avenue, was sentenced today to 25 years to life in prison by Westchester County Supreme Court Justice James McCarty, formerly of Bronx Supreme Court. The defendant was found guilty of second-degree Murder by a jury on May 25, 2022 after a trial before Justice McCarty.

 According to the investigation, at approximately 3:00 a.m. on July 3, 2019, the defendant was in the apartment of Lidia Herrera, 65, on Sheridan Avenue, where his then four-year-old daughter, six-year-old son and 10-year-old son were and began arguing with Herrera. Montanez punched her in the head, then strangled Herrera by wrapping an HDMI cord around her neck.

 The incident took place in a room near where the children slept. The argument and struggle woke two of the children. They went to check on their grandmother and witnessed the murder. Herrera was pronounced dead at the scene. The victim suffered a fractured hyoid bone and thyroid cartilage, and sustained abrasions and bruising on her face and body.

 District Attorney Clark thanked NYPD Detectives Justin Prieto and Jose Mercedes of the 44th Precinct, and NYPD Detective Sasha Brugal of Bronx Homicide for their work in the investigation.

Suburban Chicago Man Charged in Federal Court with Trafficking More than 35 Firearms

 

 A suburban Chicago man has been arrested on federal firearm charges for allegedly trafficking more than 35 guns, including “ghost guns,” machine guns, and rifles.

ARSHAD ZAYED, 38, of Orland Hills, Ill., is charged with willfully dealing firearms without a license and illegally possessing and transferring a machine gun.  Zayed was arrested this morning and made an initial appearance this afternoon in federal court in Chicago.  A detention hearing is scheduled for Friday at 2:30 p.m. before U.S. Magistrate Judge Beth W. Jantz. 

The charges and arrest were announced by John R. Lausch, Jr., United States Attorney for the Northern District of Illinois; Emmerson Buie, Jr., Special Agent-in-Charge of the Chicago Field Office of the FBI; Kristen de Tineo, Special Agent-in-Charge of the Chicago Field Division of the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives; David Brown, Superintendent of the Chicago Police Department; and Justin Campbell, Special Agent-in-Charge of the IRS Criminal Investigation Division in Chicago.  The Illinois State Police provided valuable assistance.  The government is represented by Assistant U.S. Attorneys Jimmy L. Arce, Patrick Mott, and Tiffany Ardam.

According to a criminal complaint unsealed today in U.S. District Court in Chicago, Zayed sold approximately 36 firearms on seven occasions this year and last year.  Many of the transactions occurred in a car wash that Zayed managed in Matteson, Ill., the complaint states.  Several of the firearms were considered “ghost guns” because they contained no identifiable serial number and were manufactured from parts collected from various sources.  Some of the firearms, including some of the ghost guns, were machine guns capable of automatically firing more than one shot with a single pull of the trigger, the charges allege.  Unbeknownst to Zayed, the high-ranking Chicago gang member to whom he sold the guns was cooperating with law enforcement, the complaint states.

Disrupting illegal firearms trafficking is a centerpiece of the Department of Justice’s cross-jurisdictional strike force aimed at reducing gun violence.  As part of the Chicago firearms trafficking strike force, the U.S. Attorney’s Office collaborates with the FBI, ATF, CPD, and other federal, state, and local law enforcement partners in the Northern District of Illinois and across the country to help stem the supply of illegally trafficked firearms and identify patterns, leads, and potential suspects in violent gun crimes.

Holding firearm offenders accountable through federal prosecution is also a focus of Project Safe Neighborhoods (PSN) – the Department of Justice’s violent crime reduction strategy.  In the Northern District of Illinois, U.S. Attorney Lausch and law enforcement partners have deployed the PSN program to attack a broad range of violent crime issues facing the district.

The public is reminded that a complaint contains only charges and is not evidence of guilt.  The defendant is presumed innocent and entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.  The unlawful possession and transfer charge is punishable by up to ten years in federal prison, while the unlawful dealing charge carries a maximum sentence of five years.  If convicted, the Court must impose a reasonable sentence under federal sentencing statutes and the advisory U.S. Sentencing Guidelines.

CURRENT CITY EMPLOYEE AND FORMER CITY EMPLOYEE CHARGED WITH DEFRAUDING NEW YORK STATE MEDICAID PROGRAM

 

 Jocelyn E. Strauber, Commissioner of the New York City Department of Investigation (“DOI”), announced the arrests today of Human Resources Administration (“HRA”) employee, NATALI TALOVIKOVA, 55, and former HRA employee, ROLAND TUBMAN, 47, on federal charges of agreeing to defraud, and defrauding, Medicaid by renewing benefits for ineligible individuals in exchange for payments. DOI worked on the investigation in partnership with the Federal Bureau of Investigation (“FBI”) and the United States Attorney’s Office for the Eastern District of New York.

 DOI Commissioner Jocelyn E. Strauber said, “These HRA employee defendants, as alleged, were responsible for ensuring that Medicaid benefits were issued only to those individuals who were eligible to receive them. But instead of doing their jobs, as charged, they used their positions, access and knowledge to renew benefits for ineligible individuals and to obtain kickbacks. DOI thanks the United States Attorney’s Office for the Eastern District of New York and the FBI for their collaboration on this investigation.”

 According to the Indictment and DOI’s investigation, between January 2009 and December 2017, TALOVIKOVA and TUBMAN defrauded Medicaid by conspiring to illegally renew Medicaid benefits for various ineligible individuals in exchange for payments from these individuals. Specifically, TUBMAN, who worked at HRA until March 2009, received payments from individuals in exchange for ensuring that their Medicaid benefits would be renewed. TALOVIKOVA, who was an HRA Eligibility Specialist at the time of the scheme, was responsible for reviewing Medicaid renewal forms and conducting Medicaid eligibility determinations. TALOVIKOVA renewed the individuals’ Medicaid benefits and shortly thereafter TUBMAN paid TALOVIKOVA for doing so.  TALOVIKOVA and TUBMAN, both of Brooklyn, are each charged with the federal felony offense of conspiring to use the facilities of interstate commerce in furtherance of unlawful activity and to receive bribes. Upon conviction, the offense is punishable by up to five years’ imprisonment.

 TALOVIKOVA has been an employee of HRA since October 2006, and receives an annual salary of approximately, $43,600. She was suspended upon her arrest today. TUBMAN worked for HRA as an Eligibility Specialist from September 2000 to March 2009, and at the time of his separation from HRA received an annual salary of approximately $36,745.

 Commissioner Strauber thanked U.S. Attorney for the Eastern District of New York Breon Peace and his staff for their prosecution of this matter, specifically Assistant United States Attorney Adam Toporovsky, from the General Crimes bureau. Commissioner Strauber also thanked Assistant Director in Charge of the FBI’s New York Office, Michael J. Driscoll, and his staff for their partnership on this investigation as well as City Department of Social Services (“DSS”) Commissioner Gary P. Jenkins and his staff for their cooperation in this investigation. DSS is comprised of the administrative units of HRA and the Department of Homeless Services (“DHS”).

 A criminal indictment is an accusation. Defendants are presumed innocent until proven guilty.

DiNAPOLI STATEMENT ON THE MTA's JULY FINANCIAL PLAN

 

New York State Comptroller Thomas P. DiNapoli issued the following statement regarding the Metropolitan Transportation Authority’s July Financial Plan.

“The MTA’s revised ridership projections underscore that it must somehow bridge a looming fiscal canyon of more than $2 billion annually and plan for long-term service challenges. The MTA’s July financial presentation shows operating budget gaps when excluding federal one-time relief, making clear what my office has been saying since September 2021: the MTA is facing major risks to its operating revenue streams as costs continue to rise, worsening a long-term budgetary imbalance.

“Ridership as a percentage of pre-pandemic ridership is now forecasted to be 61% this year and 79% in 2026, a far cry from the 77% and 87% that was expected in the MTA’s February Plan, leading to a sustained drop in revenues. The MTA’s current projections could become even worse as the threat of a recession looms. The growing disparity between revenues and expenditures necessitate that the MTA act quickly and creatively to provide options to boost revenue amid service demand changes and generate cost efficiencies and savings solutions to mitigate the widening gap.

“The MTA has fortunately turned aside from its ill-advised plan to plug operational gaps through borrowing, which will reduce recurring debt service costs associated with the bonds. The Authority also took a step forward on congestion pricing naming its traffic mobility review board, a critical step towards funding its capital plan.

“Reliable and safe mass transit is critical to revive New York City’s economy in an equitable manner.  Monthly customer satisfaction surveys and recent quarterly transit summit discussions with New York City on the state of service are good steps forward, but the MTA must show how it intends to use this information to keep the public informed on how it plans to provide quality service for years to come.”