Governor Hochul Updates New Yorkers on State's Progress Combating COVID-19 - JULY 14, 2022 Borough Monday, July 11, 2022 Tuesday, July 12, 2022 Wednesday, July 13, 2022 Bronx 9.81% 9.54% 9.13% Kings 8.64% 8.63% 8.53% New York 8.82% 8.83% 8.22% Queens 11.19% 10.88% 10.77% Richmond 10.37% 10.24% 9.45%

Governor Encourages New Yorkers to Keep Using the Tools to Protect Against and Treat COVID-19: Vaccines, Boosters, Testing, and Treatment

14 Statewide Deaths Reported Yesterday 

NOTE: Beginning June 24, 2022, the Vaccine data will be updated weekly on Fridays to align with CDC's updated data refresh schedule. For additional information on COVID-19 Vaccination Data provided by CDC, see https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-total-admin-rate-total.

Governor Kathy Hochul today updated New Yorkers on the state's progress combating COVID-19. Earlier today, Governor Hochul announced the launch of a new public awareness campaign on treatment options for people who test positive for COVID-19 and have symptoms. Yesterday, Governor Hochul announced the launch of a new free Hotline for those who test positive for COVID-19, but don'thave a health care provider.

"We've made significant progress in our fight against COVID-19, but as new variants continue to spread we remain vigilant in our ongoing efforts to protect New Yorkers," Governor Hochul said. "I encourage all New Yorkers to keep using tools that we know protect against and treat COVID-19. Stay up to date on your vaccine and booster doses, and consult with your child's pediatrician about getting them vaccinated as soon as possible. Test often if you have symptoms, and if you test positive stay home and talk to you doctor about available treatment options."

Today's data is summarized briefly below:

• Cases Per 100k - 47.35
• 7-Day Average Cases Per 100k - 36.54
• Test Results Reported - 97,605
• Total Positive - 9,253
• Percent Positive - 9.08%**
• Patient Hospitalization - 2,460 (+63)
• Patients Newly Admitted - 506
• Patients in ICU - 233 (+3)
• Patients in ICU with Intubation - 70 (-1)
• Total Discharges - 320,033 (+413)
• New deaths reported by healthcare facilities through HERDS - 14
• Total deaths reported by healthcare facilities through HERDS - 56,740

** Due to the test reporting policy change by the federal Department of Health and Human Services (HHS) and several other factors, the most reliable metric to measure virus impact on a community is the case per 100,000 data -- not percent positivity.

The Health Electronic Response Data System is a NYS DOH data source that collects confirmed daily death data as reported by hospitals, nursing homes and adult care facilities only.

Important Note: Effective Monday, April 4, the federal Department of Health and Human Services (HHS) is no longer requiring testing facilities that use COVID-19 rapid antigen tests to report negative results. As a result, New York State's percent positive metric will be computed using only lab-reported PCR results. Positive antigen tests will still be reported to New York State and reporting of new daily cases and cases per 100k will continue to include both PCR and antigen tests. Due to this change and other factors, including changes in testing practices, the most reliable metric to measure virus impact on a community is the case per 100,000 data -- not percent positivity.

• Total deaths reported to and compiled by the CDC - 72,417

This daily COVID-19 provisional death certificate data reported by NYS DOH and NYC to the CDC includes those who died in any location, including hospitals, nursing homes, adult care facilities, at home, in hospice and other settings.

Each New York City borough's 7-day average percentage of positive test results reported over the last three days is as follows **:

Borough	Monday, July 11, 2022	Tuesday, July 12, 2022	Wednesday, July 13, 2022
Bronx	9.81%	9.54%	9.13%
Kings	8.64%	8.63%	8.53%
New York	8.82%	8.83%	8.22%
Queens	11.19%	10.88%	10.77%
Richmond	10.37%	10.24%	9.45%

Long Island Man Convicted of over $600 Million Health Care Fraud, Wire Fraud and Identity Theft Scheme

 

Defendant Impersonated Patients on Calls to Insurance Companies and Staged Fake Emergency Room Visits to Fraudulently Inflate Claims

 A federal jury in Central Islip returned a guilty verdict on eight counts of a superseding indictment charging Mathew James with perpetrating an over $600 million health care fraud scheme, which also included wire fraud and aggravated identity theft charges.  The verdict followed a six-week trial before United States District Judge Joanna Seybert.  

Breon Peace, United States Attorney for the Eastern District of New York, Kenneth A. Polite Jr., Assistant Attorney General of the Justice Department’s Criminal Division, and Michael J. Driscoll, Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI), announced the verdict.

“The defendant stands convicted of carrying out an audacious scheme in which he used insurance companies like ATM machines.  He stole hundreds of millions of dollars until he was finally exposed by a paper trail a mile-long, phone recordings on which he impersonated patients, and text messages and emails with his co-conspirator doctor clients demonstrating his nefarious billing practices. For this massive fraud, a federal jury convicted him today,” stated United States Attorney Peace.  “Health care fraud is not a victimless crime, because fraudulent billing ultimately affects consumers who must pay the cost of higher insurance premiums.”

“James orchestrated a fraudulent medical billing scheme to steal from insurance companies and businesses, in order to line his own pockets,” said Assistant Attorney General Polite of the Justice Department’s Criminal Division. “This conviction shows that medical billers who fuel health care fraud will be brought to justice.”

As proven at trial, James operated medical billing companies to provide billing services for physicians, primarily plastic surgeons throughout the United States, and used his companies to carry out a massive scheme to defraud insurance companies.  As a third-party medical biller, James submitted claims to insurance companies and when necessary, requested reconsideration or appeals of denied claims.  The evidence showed that James billed for procedures that were either more serious or entirely different than those his doctor-clients performed.  For example, the government presented evidence that James impersonated Jeff Pash, the National Football League’s general counsel, and Marcus Smart, a professional basketball player for the Boston Celtics of the National Basketball Association, in calls the defendant made to insurance companies in which he exaggerated medical procedures.  James made thousands of impersonation calls resulting in over tens of millions of dollars in additional reimbursement to his doctor-clients and from which he received a percentage of the fraudulent proceeds.

James also directed his doctor-clients to schedule elective surgeries through the emergency room so that insurance companies would reimburse at substantially higher rates. When insurance companies denied the inflated claims, James impersonated patients to demand that the insurance companies pay the outstanding balances of tens or hundreds of thousands of dollars.

Attorney General James Demands National Gun Distributors Immediately Stop Selling and Bringing Illegal Ghost Gun Parts Into New York

 

Following Lawsuit Against Gun Distributors, AG James Files Motion for Preliminary Injunction Against Companies That Sold and Delivered Illegal Ghost Gun Parts to Undercover Investigators in New York

 New York Attorney General Letitia James took action to stop national gun distributors from selling and bringing illegal ghost gun parts into New York. Following her landmark lawsuit against these distributors, Attorney General James filed a motion for a preliminary injunction against six of those gun distributors that sold and shipped unfinished frames and receivers to undercover investigators in New York. An investigation by the Office of the Attorney General (OAG) found that these businesses sent thousands of similar unfinished frames and receivers to individuals in New York who later committed violent crimes.

“Every single day people across the country are losing their lives to gun violence,” said Attorney General James. “We cannot and will not allow our children and our communities to continue to live in fear that their school, parade, or grocery store will be next. Today, we are taking serious action to immediately stop these companies from illegally selling and bringing these dangerous ghost gun parts into New York. We will continue to fight to protect New Yorkers and bring justice to communities devastated by gun violence.”

Attorney General James is seeking a preliminary injunction against six of the gun distributors that her office sued. These six gun distributors were caught red-handed when they sold and shipped nine unfinished frames to undercover investigators in New York. They include Brownells, Inc. (Brownells), Rock Slide USA, LLC (Rock Slide), Arm or Ally, LLC (Arm or Ally), Rainier Arms, LLC (Rainier Arms), Salvo Technologies, Inc. (80 P Builder or 80P Freedom Co), and Indie Guns, LLC (Indie Guns).

In the filing for a preliminary injunction, Attorney General James asserts that these businesses sell these dangerous products with the intention that their customers will convert them into working firearms, and even take steps to assist them in doing so. Rainier Arms’ web page marketing an AR-15-compatible receiver links to a PDF of milling instructions, while Brownells offers step-by-step video instructions on finishing a Glock-compatible pistol frame, and a telephone support line where customers can ask for assistance. They also sell their products inside a “jig,” a plastic structure for the product that guides the user’s tools through the simple steps required to finish the frame. In the words of 80 Percent Arms, the jigs “make it ridiculously easy for a non-machinist to finish their [handgun frame] in under 1 hour with no drill press required.” This process is designed to be a workaround to avoid federal gun serialization, recordkeeping, and background check requirements. Once turned into a working firearm, these illegal weapons have been used to commit crimes and harm New Yorkers.

Attorney General James is asking the court to order these businesses to immediately stop selling, shipping, distributing, or otherwise supplying unfinished frames or receivers to any person or entity with a New York address.

Last month, Attorney General James filed a landmark lawsuit against multiple gun distributors for fueling the gun violence crisis and endangering New Yorkers. The nation-leading lawsuit alleges that these businesses violated several laws, including New York’s licensing laws, by selling weapons to felons and others without a background check. Attorney General James’ lawsuit stands out by detailing how these businesses repeatedly undermined the law and flooded New York’s streets with illegal ghost guns that harmed New Yorkers.

NYSOFA Annual Report Details Services to 1.3 Million Older New Yorkers

 

Over 1.3 million New Yorkers received services through NYSOFA and aging network programs in 2021

 The New York State Office for the Aging (NYSOFA) has published a comprehensive 2021 Annual Report detailing the work of aging service providers who delivered vital services to over 1.3 million older adults and their families in 2021. The report offers a definitive analysis on the landscape of aging in New York State, including data on economic and demographic trends, the prevalence of chronic conditions, growth in long term care needs, and more.

“This comprehensive report provides a blueprint for what we do and why we do it,” said NYSOFA Director Greg Olsen. “Older adults with the most serious chronic conditions or functional limitations have needs that are all fundamentally served by core Office for Aging and network programs, including nutrition, personal care, transportation, and chronic disease self-management. But this network also serves a much wider population and purpose, providing supports that help older New Yorkers to thrive, manage their independence, and avoid situations that could put them at risk of worsening chronic care needs, as outlined in the report."

NYSOFA partners with 59 Area Agencies on Aging (AAAs) and almost 1,200 community-based partners. Collectively, these organizations provide a wide array of programs and supports that help older New Yorkers stay healthy, access services, prevent and mitigate elder abuse, stay engaged in their communities, understand and apply for benefits, and maintain their autonomy as they age.

According to NYSOFA’s Annual Report, older adults and their families received the following network services through AAAs and community partners in 2021:

• 63,825 older New Yorkers received registered dietician (RD)-certified home-delivered meals.

• 196,547 older New Yorkers received RD-certified meals in a congregate setting.

• 69,561 older New Yorkers had case managers help them maintain their independence and navigate various health and social service systems.

• 13,087 older New Yorkers received personal care services in their homes.

• 108,044 older adults received transportation services to medical appointments, pharmacies, and other community outlets.

• 10,823 received legal assistance.

• 88,921 received nutrition counseling and education.

• 293,633 received information and assistance.

• 109,144 received health promotion/prevention.

• 248,000 received Medicare plan and prescription counseling and assistance.

• 13,109 received support services and respite that make it possible for caregivers to continue caring for a frail loved one.

• 600 received services through the Social Adult Day Services (SADS) programs directly funded by NYSOFA.

• Approximately 2,600 victims of elder abuse had their cases referred to an Enhanced Multidisciplinary Team (E-MDT) coordinator. E-MDTs bring together professionals from various disciplines within each county whose primary focus is to intervene and prevent abuse of older adults, with a focus on complex cases. 

• More than 250,000 contacts were made to NY Connects, a trusted resource for free, objective information about long term services and supports in New York State for people of all ages or with any type of disability. Also, the NY Connects Resource Directory received 1.5 million page hits.

For more information about NY Connects, or to access other local supports, visit https://www.nyconnects.ny.gov/ or call 1-800-342-9871.

NYSOFA’s Annual Report also contains additional information about New York's aging services system – its roles, responsibilities, and structure under the Older Americans Act and New York State Elder Law as well as case studies and program accomplishments in 2021. 

Below is a snapshot of other data included in the report.

General Data

• New York has the fourth largest population of older adults in the nation: 4.6 million New Yorkers are 60 years of age or older, and 4.2 million are between the ages of 45 and 59.

• By 2025, the population of individuals age 60 and over is projected to account for 25% of all people in 33 counties and 30% of all people in 18 counties.

Economics and Community Involvement Data

• Older New Yorkers and baby boomers make up 65% — $481 billion — of all the household income generated in New York State. They support local businesses, Medicaid and schools through home ownership, contributing significantly to the local and state economy and care economy.

• 80% of the state retirement system payouts stay in New York State at a value of $10.6 billion annually.

• 64% of New Yorkers age 60 and over own their own homes and have no mortgage.

• Approximately 935,000 New Yorkers over the age of 55 contribute more than 495 million hours of community service at an economic value of more than $13.9 billion annually.

Chronic Conditions and Long Term Care Needs

• Approximately 6.2 million adult New Yorkers (41.1%) suffer from a chronic disease such as arthritis, asthma, stroke, heart disease, diabetes, or cancer, and New Yorkers with chronic diseases are more likely to report poor health status and activity limitations than those without a chronic disease.

• NYSOFA projects that the number of people age 60 and over with functional impairments will grow over 20% by 2025. Eighty-one percent will live in the community and 19% will live in nursing homes or other group care facilities.

• 10% of the population has self-care limitations – that is, difficulty taking care of their own personal needs, such as bathing, dressing, or getting around inside the house due to a health condition that lasts for six or more months. This number rises to 15% for people who are 75 and over; and 25% for those who are 85 and over.

• 20% of the population has mobility limitations – that is, difficulty going outside the house alone (for example, to shop or visit a doctor’s office) due to a health condition that lasts for six or more months. This number rises to one-third for individuals age 75 and over, and 50% for ages 85 and over.

Read the complete report here.

About the New York State Office for the Aging

NYSOFA continuously works to help the state’s 4.6 million older adults be as independent as possible for as long as possible through advocacy, development and delivery of person-centered, consumer-oriented, and cost-effective policies, programs, and services that support and empower older adults and their families, in partnership with the network of public and private organizations that serve them. Stay connected—visit the NYSOFA Facebook page; follow @NYSAGING on Twitter and NYSAging on Instagram; or visit aging.ny.gov.

United States Files Claims Alleging Fresenius Vascular Care, Inc. Defrauded Medicare and Other Healthcare Programs by Billing for Unnecessary Procedures Performed on Dialysis Patients

 

Civil Fraud Complaint Alleges Unnecessary Procedures Performed on Patients with End Stage Renal Disease Were Potentially Harmful

 The United States filed a civil complaint yesterday in federal court in Brooklyn against Fresenius Vascular Care, Inc. (“Fresenius”) alleging that the company performed unnecessary procedures on dialysis patients at nine centers across New York City and Long Island, and billed the procedures to Medicare, Medicaid, the Federal Health Benefits Program and TRICARE.  The complaint seeks damages and penalties under the False Claims Act.  

The filing was announced by Breon Peace, United States Attorney for the Eastern District of New York, and Scott J. Lampert, Special Agent-in-Charge, U.S. Department of Health and Human Services, Office of Inspector General’s Office of Investigations (HHS-OIG).

“The conduct alleged in this case is egregious, as Fresenius not only defrauded federal healthcare programs but also subjected particularly vulnerable people to medically unnecessary procedures,” stated United States Attorney Peace.  “This Office will hold medical providers accountable for practices that needlessly expose patients to harm for financial gain at taxpayer expense.”

Mr. Peace also expressed his thanks to the Federal Bureau of Investigation, New York Field Office, the United States Office of Personnel Management, and the United States Department of Defense for their assistance with the investigation.

“The alleged conduct by Fresenius unnecessarily compromised patient care and undermined the financial integrity of federal health care programs,” stated HHS-OIG Special Agent-in-Charge Lampert.  “Along with our law enforcement partners, HHS-OIG is committed to protecting beneficiaries and taxpayers from such abusive practices.”

As alleged in the complaint, from about January 1, 2012 through June 30, 2018, Fresenius routinely performed certain procedures on patients with End Stage Renal Disease (ESRD) who were receiving dialysis, without sufficient clinical indication that the patients needed the procedures.  These interventions included fistulagrams, which are radiological procedures in which dye is injected into the patient’s vein or artery to visualize the port and surrounding blood vessels, and angioplasties, in which wires and balloons are inserted into veins or arteries that have narrowed to restore the patient’s blood flow.  Fresenius knowingly subjected ESRD patients—who included elderly, disadvantaged minority, and low-income individuals—to these procedures to increase its revenues.  

The government filed its complaint in an ongoing action commenced pursuant to the qui tam provisions of the False Claims Act, United States ex rel. Pepe and Sherman v. Fresenius Medical Holdings, Inc., et al., No. 14-CV-3505 (ERK).  The case is being handled by Assistant U.S. Attorneys Jolie Apicella and Anjna Kapoor, and Special Assistant U.S. Attorney Mary Ellen Buntin of the Office’s Civil Division.

Defendants operated vascular access centers at the following locations during the relevant period:

• American Access Care of Bellmore (now “American Access Care Nassau County”), 250 Pettit Avenue, Suite 2, Bellmore, NY 11710
• American Access Care Brooklyn, 577 Prospect Avenue Lower Level, Brooklyn, NY 11215
• American Access Care of New York (now “American Access Care Manhattan”), 403 E. 91st Street, Floor 2, New York, NY 10128
• American Access Care Queens, 176-60 Union Turnpike #130, Suite 130, Flushing, NY 11366
• American Access Care Suffolk County, 32 Central Avenue, Hauppauge, NY 11788
• American Access Care Bronx, 1200 Waters Place N. Lobby, Suite M 115, Bronx, NY 10461
• Saqib Chaudhry, MD – Flushing, 176-60 Union Turnpike Utopia Center, Suite 145, Flushing, NY 11366
• Saqib Chaudhry, MD – Roslyn, 1044 Northern Boulevard, Suite 302, Roslyn, NY 11676 (no longer operating)
• Verrazano Vascular Associates at Access Care Physicians, 2025 Richmond Avenue, Suite 1LL, Staten Island, NY 10314

BioReference Laboratories and Parent Company Agree to Pay $9.85 Million to Resolve False Claims Act Allegations of Illegal Remuneration to Referring Physicians

 

BOSTON – BioReference Health, LLC, formerly known as BioReference Laboratories, Inc., (BioReference) and OPKO Health, Inc. (OPKO) have agreed to pay $9.85 million to resolve alleged violations of the False Claims Act. The government alleges that BioReference rented office space from physicians and then paid those physician-landlords above-market rent so that the physicians would send their laboratory business to BioReference. BioReference, a subsidiary of OPKO, is headquartered in New Jersey and is one of the largest clinical laboratories in the United States.

Between January 2013 and March 2021, BioReference made lease payments to physicians and physician groups for the rental of office space for amounts that exceeded fair market value, in violation of the Physician Self‑Referral Law and the Anti-Kickback Statute.  The Physician Self‑Referral Law, commonly known as the Stark Law, prohibits a health care provider from billing for certain services referred by physicians with whom the provider has a financial relationship, unless that relationship satisfies one of the law’s statutory or regulatory exceptions. The Anti‑Kickback Statute prohibits offering or paying remuneration with the intent to induce the referral of items or services covered by Medicare, Medicaid, and other federally funded programs. Both the Stark Law and the Anti-Kickback Statute are intended to ensure that physicians’ medical judgments are not compromised by improper financial inducements.

As part of today’s settlement, BioReference admitted that it rented the office space from the specified physician practices for Patient Service Centers (PSCs) where patients could have their blood samples taken. In calculating payments under certain PSC lease arrangements, BioReference inaccurately measured the amount of space it would use exclusively and included a disproportionate share of common spaces. BioReference analyzed referrals from nearby health care providers—including physician-landlords—when deciding whether to open, maintain, or close PSCs. Following OPKO’s acquisition of BioReference, the companies conducted multiple internal audits that showed that the payments to the specified physician-lessors exceeded fair market value. BioReference did not report or return any overpayments to federal health care programs.

“Medical decisions by doctors should be based on what is best for each patient, not a doctor’s personal financial interest,” said United States Attorney Rachael S. Rollins. “When companies violate the federal health care laws that are meant to protect patients, health care costs for hard working people increase. We will continue to find fraud and use the False Claims Act to make companies that break the law pay back the taxpayers they defrauded as well as pay a financial price for their misconduct.”

“The integrity of federal health care programs depends on providers making decisions based on the interests of their patients,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The Department of Justice and its agency partners are committed to enforcing laws prohibiting illegal financial arrangements that may distort health care decision-making and drive up costs to federal health care programs and patients.”

In connection with the False Claims Act settlement, BioReference and OPKO have also entered into a five-year Corporate Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General, which provides for periodic reviews of BioReference’s processes, policies, and transactions for compliance with the Anti-Kickback Statute and the Stark Law by an Independent Review Organization. 

“This settlement is a warning to laboratories that think they can boost their profits by entering into improper financial arrangements with referring physicians,” said Special Agent in Charge Phillip M. Coyne of the U.S. Department of Health and Human Services, Office of Inspector General. “Working with our law enforcement partners, we will continue to crack down on such deals, which work to undermine impartial medical judgement, drive up health care costs, and corrode the public’s trust in the health care system.”

“Laboratories that scheme to enrich their businesses through health care fraud—such as by paying kickbacks—drive up health care costs for everyone,” said Joseph R. Bonavolonta, Special Agent in Charge of the FBI Boston Division. “This settlement shows how seriously the FBI takes its responsibility to weed them out, and we’d also like to thank the whistleblower in this case for helping us ensure these entities are held accountable.”

“When health care companies pay unlawful remuneration to physicians and submit false claims for improper referrals, they undermine the integrity of TRICARE and place an unnecessary financial burden on the program,” stated Special Agent in Charge Patrick J. Hegarty of the Defense Criminal Investigative Service, the law enforcement arm of the Department of Defense Office of Inspector General.  “The settlement agreement announced today demonstrates our ongoing commitment to work with our law enforcement partners to investigate healthcare fraud and protect TRICARE, the healthcare system for military members and their dependents.”

The False Claims Act allegations being resolved were originally brought in a lawsuit filed by a whistleblower under the qui tam provisions of the False Claims Act. Under those provisions, a private party can file an action on behalf of the government and share in any recovery.  In connection with today’s settlement, the whistleblower will receive 17 percent of the recovery. 

Under the settlement, the defendants will also pay approximately $145,000 to the Commonwealth of Massachusetts and the State of Connecticut to resolve alleged violations of their respective state False Claims Acts. 

U.S. Attorney Rollins, HHS-OIG SAC Coyne, FBI SAC Bonavolonta and DCIS SAC Hegarty made the announcement today. Assistant U.S. Attorneys Alexandra Brazier and Charles B. Weinograd of Rollins’s Affirmative Civil Enforcement Unit, and Trial Attorney Douglas Rosenthal of the Justice Department’s Civil Division, Commercial Litigation Branch, handled the matter.