Saturday, May 13, 2017

A.G. Schneiderman Announces Joint $54 Million Settlement With Carecore Resolving Allegations Company Submitted Millions In False Claims To Medicaid


NYs Medicaid Program To Receive Over $7.6 Million In Restitution As Part Of Joint State-Federal Settlement

  Attorney General Eric T. Schneiderman announced today that New York, along with 20 other states, has reached an agreement in principle to join the federal government in a settlement with CareCore National LLC (CareCore), now part of eviCore healthcare that was unsealed today. CareCore provides utilization management services including determinations of medical necessity to New York Medicaid Managed Care Organizations (MCOs).  The agreement settles allegations that CareCore instituted a scheme to auto-approve or Process As Directed (PAD) hundreds of radiology service requests on a daily basis, deeming those diagnostic services as reasonable and medically necessary, even though there had been no evaluation of those cases by the appropriate medical personnel. CareCore will pay the federal government $54 million, of which $18 million will go to the state Medicaid programs, to resolve allegations that CareCores fraudulent PAD program caused false claims to be submitted to government health care programs. Of the $18 million, New Yorks Medicaid Program will recover over $7.6 million.    
 “Companies that overbill Medicaid are undermining efforts to help some of our neediest citizens. Since 2011, my office has secured over $1 billion in restitution for Medicaid, and we will continue to vigorously safeguard the integrity of this incredibly vital program,” said Attorney General Schneiderman. 
Specifically, the agreement in principle resolves allegations that from January 1, 2005 through June 13, 2013, CareCore developed and implemented the “PAD” program through which CareCore improperly approved over 200,000 prior authorization requests which CareCore initially determined could not be approved based on the information provided.  The states’ settlement in principle mirrors the federal settlement agreement regarding CareCore’s conduct that is the subject of the settlement. The federal settlement agreement was filed in federal court and contained CareCore’s admissions and acceptance of responsibility for conduct including: 
  • Starting in at least 2007 through June 13, 2013, CareCore developed the “PAD” program, and thereafter the “PAD” Program consisted of its Clinical Reviewers improperly approving certain prior authorization requests awaiting physician review on the Medical Queue without having obtained any new objective medical information about the requests, and without a Medical Director having independently reviewed the prior authorization requests. 
  • From 2007 through June 13, 2013, these “padded”requests were then transmitted to CareCore’s client insurers, including MCOs, as preauthorized requests.  
  • From 2007 through June 13, 2013, when CareCore approved these padded requests, CareCore made a representation that it had appropriately reviewed the requests when it knew it had not. Thus, those padded requests incorporated CareCore’s false representation that it had approved a case after completing the required review process.
The settlement in principle resolves claims that CareCore auto-approved the requests in an effort to keep up with the volume of preauthorization requests for diagnostic radiology services and to avoid a contractual monetary penalty per case for untimely reviews.  The settlement in principle also resolves claims that this practice caused false or fraudulent claims to be submitted to and reimbursed by the State’s Medicaid program, including through its contracted MCOs, for diagnostic procedures that were not properly authorized as medically reasonable or necessary in a manner consistent with the policies and procedures set forth by New York’s Medicaid program and its contracted MCOs, using federal and state funds provided through Medicaid Managed Care.  
The settlement in principle resolves allegations asserted in a qui tam action brought by a whistleblower in the United States District Court for the Southern District of New York. A multi-state team, which included New York’s Medicaid Fraud Control Unit, participated in the investigation and conducted the settlement negotiations with CareCore on behalf of the states. The team also included representatives of the Florida, Georgia and Ohio Medicaid Fraud Control Units. The states coordinated their investigation in conjunction with the U.S. Attorney’s Office for the Southern District of New York. 

A.G. Schneiderman Announces $4.19 Million In Settlements With Six Companies That Illegally Purchased And Resold Hundreds Of Thousands Of Tickets To Concerts And Other NY Events


Five of the Companies Regularly Used Illegal Bots To Procure Tickets For Sale On The Secondary Market
One Broker Purchased 1,012 Tickets To A U2 Concert At Madison Square Garden In 1 Minute
  Attorney General Eric T. Schneiderman today announced settlements with six ticket brokers that illegally purchased and resold hundreds of thousands of tickets in New York State since 2011, including on popular ticket resale platforms like StubHub and Vivid Seats. 
Five of the companies – Renaissance Ventures, LLC (d/b/a Prestige Entertainment) of Connecticut, Ebrani Corp (d/b/a Presidential Tickets) of New York, Concert Specials, Inc. of New York, Fanfetch Inc. of New York and BMC Capital Partners, Inc. of New York – violated New York’s ticket laws by using illegal software (known as ticket “bots”) to purchase large numbers of tickets on websites such as Ticketmaster.com before the tickets could be obtained by consumers.  After obtaining the tickets illegally, resellers then resold them at a large profit to New York consumers, among others. Five of the companies – Prestige Entertainment, Presidential Tickets, Concert Specials, Fanfetch and JAL Enterprises, LLC (d/b/a Top Star Tickets) of Massachusetts – each illegally sold tickets to events in New York over the last several years without first obtaining the required license. 
The settlements require that the companies and their principals maintain proper ticket reseller licenses if they wish to resell tickets to New York events, abstain from using bots, and pay penalties for having operated illegally. The settlements require the six companies to pay a combined total of $4.19 million in disgorged profits and penalties to the State. 
The Attorney General also announced a settlement with a seventh company, Componica, LLC of Iowa, that developed software libraries used by ticket bots to try to get around tests that websites use to determine if a user is a human or a bot (often referred to as “CAPTCHA” tests).  Componica has agreed to not develop or use software to bypass security measures on ticketing websites.
“Unscrupulous ticket resellers who break the rules and take advantage of ordinary consumers are one of the major reasons why ticketing remains a rigged system,” said Attorney General Schneiderman. “We will continue to fight to make ticketing a more fair and transparent marketplace, so fans have the opportunity to enjoy their favorite shows and events. Anybody who breaks the law will pay a steep price.” 
Attorney General Schneiderman’s investigation found that Prestige Entertainment ran one of the largest ticket purchasing and reselling operations in the United States. Prestige Entertainment used at least two different bots and thousands of credit cards and Ticketmaster accounts to purchase tickets to New York shows. Prestige Entertainment also bought IP addresses from online IP proxy services to evade detection of its bots by retail ticket marketplaces such as Ticketmaster.com.  Prestige Entertainment used all of its illegal advantages to great effect, purchasing huge quantities of tickets to popular shows. For example, Prestige Entertainment purchased 1,012 tickets to a 2014 U2 Concert at Madison Square Garden in 1 minute.    
Prestige Entertainment paid $3,350,000, Concert Specials paid $480,000, Presidential Tickets paid $125,000, BMC Capital paid $95,000, Top Star Tickets paid $85,000, and Fanfetch paid $55,000.
Since releasing its report on the concert and sports ticket industry titled Obstructed View: What’s Blocking New Yorkers From Getting Tickets in January 2016, the Attorney General’s office has now announced settlements with 15 businesses involved in the illegal ticket trade, including resellers, facilitators, and software developers, for a total of $7.1 million. The office’s broader investigation into the secondary ticketing industry remains ongoing.
In 2016, New York enacted legislation called for by Attorney General Schneiderman that added criminal penalties for bot use to the existing civil penalties.  That law took effect in February 2017.  The settlements announced to date involved misconduct committed before the new law took effect.

BRONX DISTRICT ATTORNEY DARCEL D. CLARK ANNOUNCES TWO KEY APPOINTMENTS TO HER STAFF


Deputy Chief of Strategic Enforcement/Intergovernmental Relations Division and Chief of Child Abuse/Sex Crimes Bureau 

  Bronx District Attorney Darcel D. Clark today announced that Carmen J. Facciolo has joined the Office as Deputy Chief of Strategic Enforcement/Intergovernmental Relations Division, and Rachel Ferrari will be Chief of the Child Abuse/Sex Crimes Bureau. 

  District Attorney Clark said, “These new additions to our Office bring a scope of experience that will enhance our excellent staff and help us to give the people of the Bronx the criminal justice system they deserve, with intelligence-driven prosecutions, collaboration with our law enforcement partners and criminal justice stakeholders; and pursuing justice for the most vulnerable and traumatized victims.” 

  In his new position, Mr. Facciolo will collaborate with federal, state and local agencies on crime strategies and will develop partnerships with criminal justice advocates. 

  His most recent position was as a senior policy advisor with the U.S. Department of Justice, where he helped manage the DOJ’s efforts to support prosecutors, law enforcement and other criminal justice agencies. He directed DOJ’s Violence Reduction Network efforts in Compton, CA.

  Ms. Ferrari will head the Child Abuse/Sex Crimes Bureau, in the Special Victims Division, when she joins the Office later this month. 

  Her most recent position was Deputy Chief of the Manhattan District Attorney’s Child Abuse Unit, where she supervised and trained attorneys on child abuse cases, oversaw caseloads and investigations and advised on legal and ethical issues, among other duties.

  Ms. Ferrari served for 15 years in the Manhattan District Attorney’s Office, prosecuting approximately 30 trials, including murder, rape and long term sexual abuse of children. In her 10 years in the Child Abuse Unit, she prosecuted felony cases of sexual and physical abuse of children and conducted long-term investigations of abuse at schools, institutional caretakers and religious organizations.

BAHSID MCLEAN INDICTED FOR ASSAULTING CORRECTION OFFICER AFTER HIS CONVICTION FOR MURDERING, DISMEMBERING MOTHER


 Defendant Slashed CO at Rikers While Waiting to Be Sent to Prison for Over 25 Years

  Bronx District Attorney Darcel D. Clark today announced that Bahsid McLean has been indicted on Attempted Assault for stabbing a NYC Department of Correction officer at Rikers Island, where McLean was waiting to be sent to state prison for killing his mother and severing her head. 

  District Attorney Clark said, “This defendant continued his vicious ways behind bars, assaulting a Correction Officer. If he is convicted of this brutal crime, we will ask that he serve the maximum 15 years, to run consecutively to his 25 years-to-life sentence for murdering his mother.” 

   District Attorney Clark said McLean, 26, was arraigned yesterday before Bronx Supreme Court Justice William Mogulescu and is due back in court on July 10, 2017. McLean was indicted on Attempted Assault in the first degree and related charges. If convicted on the top charge, McLean could face up to 15 years in prison. He also has a pending assault case involving the slashing of an inmate at Rikers.

  According to the investigation, the incident occurred in the West Facility of Rikers Island on December 14, 2016, when McLean used a small weapon to stab Correction Officer Matthew Hines near the eye. Hines sustained a laceration near the eye, briefly lost consciousness and sustained other injuries in the ensuing assault, including a fractured nose. 

   At the time, McLean was being held at Rikers after being convicted on November 4, 2016, of fatally stabbing his mother, Tanya Bird, on February 25, 2013 and dissecting her body. McLean took “selfie” photos with the victim’s severed head. He was sentenced on that case on December 5, 2016, to 25 years to life in prison for the murder and one and one-third years for the dissection to run consecutively. 

An indictment is an accusatory instrument and not proof of a defendant’s guilt.

New Analysis Shows New York City’s Economy Continues to Produce


NYC’s economy grew at 2.3% in the first quarter of 2017, outpacing the national economy
Unemployment reached a record low, but nearly half of job growth came from low-wage industries
Comptroller’s Office Includes New Set of Leading Economic Indicators which indicate if the economy will grow over the next 6 to 12 months
  New York City’s economy continued to grow in the first three months of 2017 while unemployment reached a record low, according to a new Quarterly Economic Update released today by New York City Comptroller Scott M. Stringer. The new economic analysis showed the City’s economy expanded 2.3 percent in the first quarter of 2017 and highlighted strong job creation, which brought the City’s unemployment rate to 4.3 percent – a record low, and below the national rate of 4.7%.
While New York’s economy is robust, the report highlighted data that could indicate long-term challenges. Although unemployment fell to the lowest rate on record, concerns remain about the type of jobs created. Continuing a years-long trend, roughly 48 percent of the jobs added in the first quarter of 2017 were in low-wage industries, which pay an average of just $42,000 per year. In addition, venture capital investment in New York City fell almost 45 percent year-over-year, reaching just $1.5 billion – the fourth consecutive quarterly decline.
“After a few quarters of bumpy growth, our economy has gotten onto more solid footing. We’re growing jobs, but too many are in low-wage areas. The real estate market is heating up, but unevenly. And we’re seeing national trends pull venture capital investment in the City down.” New York City Comptroller Scott M. Stringer said. “With more and more uncertainty coming out of Washington every day, we need to prepare now, while our economy is strong, for whatever comes next.”
For the first time, the Comptroller’s report includes a new set of leading economic indicators for New York City, which tend to indicate where the economy will be in the next six months to a year. The indicators point to continued growth this year. Released every three months, the Comptroller’s Quarterly Economic Update tracks economic indicators for our City and reports on the health of New York City’s economy in the national context. The report includes data on economic growth, unemployment, average wages, business activity, and real estate indicators.
Findings include:
New York City’s economy grew at the beginning of 2017
  • The City’s economy grew 2.3 percent in the first quarter of 2017, up from 1.8 percent at the end of 2016.
  • The City’s economy outpaced the nation, clocking in expansion 1.5 percentage points higher than the national economy.
Unemployment drops, but low-wage jobs are on the rise 
  • In the first quarter, the City added 32,300 private sector jobs — the largest increase since the third quarter of 2014. 
  • This increase brought the City’s unemployment rate to 4.3 percent — the lowest on record — and 0.4 percent below the nation’s unemployment rate. 
  • Most of these new jobs, however, were low-wage industries, which have average salaries of just $42,000. Low-wage industries accounted for 47.8 percent of job creation, followed by medium-wage (35.7 percent) and high-wage (16.5 percent). This continues a years-long trend of dominant low-wage job creation. 
  • In addition, the City’s employment-to-population ratio rose to a record-high of 57.7 percent, up from 56.4 percent in the last quarter of 2016
Wages jumped, while income from other sources fell 
  • Personal income taxes withheld from paychecks, which are used as a proxy for wages, grew 7.2 percent year-over-year to about $2.7 billion.
  • Average hourly earnings, another proxy for personal income, increased by 3.4 percent year-over-year to $35.05 in the first quarter of 2017.
  • In contrast, estimated tax payments — which reflect trends in non-wage income, including interest, rental income, and capital gains — fell 18.9 percent year-over-year to just $656 million.
Venture capital investment continued to drop 
  • Venture capital investment in the New York Metro Area dropped 44.9 percent in the first quarter of 2017 to just $1.5 billion. This represents the fourth consecutive quarter of falling venture capital investment in New York.
  • In addition, the New York Metro Area fell to fourth place in overall venture capital investment, being surpassed by the New England region.
  • The number of venture capital deals in New York fell to 154 from 178 a year ago, and the New York Metro Area’s share of venture capital investment fell from 17.2 percent to 10.7 percent year-over-year. 
New York’s housing market showed mixed signs 
  • New commercial leasing activity in Manhattan exceeded 7.6 million square feet, 16 percent higher than the first quarter of 2016.
  • Despite this increase, Manhattan’s overall office vacancy increased to 9.4 percent.
  • Residential real estate in Manhattan improved, with average sales prices, average price per square foot, and the number of sales increasing compared to the first quarter of 2016. The listing inventory, however, increased 6.6 percent and the absorption rate grew to 6.1 months.
  • Housing market conditions tightened in Brooklyn and Queens. Both boroughs saw prices increase, sales expand, and inventories drop.
Leading economic indicators point to growth
  • Business conditions in the New York City Metro Area improved between the end of 2016 and the beginning of 2017.
  • The ISM six-month outlook rose to 71 percent in the first quarter of 2017, the highest level of optimism since mid-2015.
  • Initial unemployment claims in New York City fell for the tenth consecutive quarter, decreasing 3.5 percent year-over-year.
  • Total building permits in New York City almost tripled year-over-year, signaling a demand in construction and an increase in construction jobs. This increase coincided with the agreement on a program to replace the expired 421-a tax abatement.

Bronx Chamber of Commerce - Prestigious Bronx Business And Leadership Opportunity




Prestigious Bronx Business
And Leadership Opportunity
 
For the first time, Members and Friends of the Bronx Chamber of Commerce have the opportunity and are requested to nominate successful professionals to serve on the Board of Directors of The Bronx Chamber of Commerce.

The members of the Board of Directors are prominently featured for special recognition in the Annual Bronx Business Directory & Resource Guide with their name, title, company, and photo. The members of the Board of Directors are also listed on the official stationery and website of the Bronx Chamber of Commerce.

The Board of Directors of the Bronx Chamber of Commerce is the policy making body of the Bronx Chamber of Commerce. The members of the Board of Directors are prominent individuals and professionals in the business community and highly recognized for their business acumen, integrity and ethics.

Following are specific duties and responsibilities of the members of the Board of Directors:

 I.    Serve as an Ambassador and promote membership to the Bronx Chamber of Commerce to business associates, colleagues, and vendors with the clear understanding that a strong and successful Bronx Chamber of Commerce directly benefits each individual member and the entire business community of The Bronx.
 
 II.    Attend at least 2 quarterly meetings of the Board of Directors which usually take place in conjunction with another event sponsored by the Bronx Chamber of Commerce such as a Heritage Luncheon, Business Expo or Annual Holiday Party.
 
 III.  Serve as an example to the membership by attending networking events, greet attendees and speak highly of the Bronx Chamber of Commerce.
 
 IV.  Serve on at least one or more committees of the Bronx Chamber of Commerce to interact with fellow members to share ideas, common interests and promote the Strategic Plan of the Bronx Chambers of Commerce.
 
 V.   Provide financial support to the Bronx Chamber of Commerce as a Corporate Sponsor or Small Business Sponsor and/or encourage other members to be a Corporate Sponsor or Small Business Sponsor.
To process your nominations, please forward name, contact information and biography up to 150 words for each nominee before June 1, 2017.  
 
Please forward your nominations to Nunzio Del Greco, President and CEO via email: Nunzio@BronxChamber.org
 
The Bronx Chamber of Commerce is one of the most influential, professional and successful organizations and voice for over 30,000 businesses in Bronx County. Professionals and companies are drawn to the successful companies and active members affiliated with The Bronx Chamber of Commerce. Membership includes businesses ranging from large corporations, Cultural Institutions, Universities and Colleges, Hospitals and Medical Centers, non-profits, and mid-sized to small companies.
 
I look forward to receiving your nominations!
 
Sincerely,
 
Nunzio Del Greco
President and CEO
Bronx Chamber of Commerce
"The Network for Business Success"
1200 Waters Place, Suite 106
Bronx, NY 10461
718-828-3900
Nunzio@bronxchamber.org
 
"You never know where your next big deal is going to come from"

32BJ SEIU ENDORSES ASSEMBLYMEMBER MARK GJONAJ


  Local 32BJ of the Service Employees International Union, the largest property service workers union in the country, representing more than 82,000 New Yorkers, has endorsed Assemblyman Mark Gjonaj in his campaign for the 13th Council District. 

“Assemblymember Mark Gjonaj has consistently placed issues important to our members at the forefront of his work in the Assembly, standing up for immigrant rights and fair wages. His dedication and commitment to our members and their families is why we proudly give our endorsement to Assemblymember Gjonaj and look forward to working together to help working families in New York thrive,” said Hector Figueroa, President of 32BJ SEIU.

“I am honored that the members of 32BJ SEIU have decided to support my candidacy. Our building superintendents, doormen, and building employees go above and beyond, dedicating their lives to ensuring residents have a safe and clean place to call home.  Having the support of a community who has always looked out for the betterment of others means a lot to me. I look forward to working alongside them in the fight to ensure a better quality of life for all New Yorkers,” said Assemblymember Mark Gjonaj, candidate for New York City Council’s 13th District.  

Assemblyman Mark Gjonaj is running for City Council to represent the 13th Council District. He currently represents the 80th Assembly District, which encompasses the neighborhoods of Allerton, Bedford Park, Morris Park, Mosholu Parkway, Norwood, Pelham Gardens, Pelham Parkway and Van Nest sections in The Bronx. He serves as Chair of the Subcommittee on Micro Business and is a member of several committees: Banks; Local Governments; Real Property Taxation; Small Business; Tourism, Parks, and Sports Development; and Puerto Rican/Hispanic Task Force. 

EDITOR'S NOTE:
This is now the second large union to endorse a candidate in the 13th Council district race. The United Firefighters Union has endorsed former firefighter John Marano. 

Prince Royce, Funk Flex, Selenis Leyva, Dr. Manny Villafana Set to Join Bronx Walk of Fame As BP Diaz Launches Bronx Week 2017



























Bronx Borough President Ruben Diaz Jr. was joined by hundreds of proud Bronxites and Bronxites-at-heart for the official kick-off of "Bronx Week 2017" at The Bronx County Building's Veterans' Memorial Hall.
 
During the celebration, Borough President Diaz announced that Prince Royce, Funkmaster Flex, Selenis Leyva and Dr. Manny Villafaña would be honored as the newest members of the Bronx Walk of Fame, celebrating its 20th year.
 
"Bronx Week is a celebration of everything that makes our borough such an amazing place, and nothing is more important to that celebration than the people who are proud to call The Bronx their home," said Bronx Borough President Ruben Diaz Jr. "Every year, we are proud to welcome back the sons and daughters of The Bronx to celebrate their accomplishments and induct them to the Bronx Walk of Fame. This year we have four amazing honorees, and I am thrilled to join the people of The Bronx in congratulating them on this tremendous honor."
 
"This is the time of year when the entire borough comes together to exhibit pride and show the rest of the world what a great place The Bronx truly is. We give our honorees a big hometown welcome as we celebrate their accomplishments!" says Olga Luz Tirado, executive director of The Bronx Tourism Council.
 
Since releasing his triple-platinum self-titled debut album in 2010, Bronx-born singer and songwriter Prince Royce has become a bona fide Latin music superstar by bringing a mix of Bachata music and contemporary R&B to the Spanish-speaking world. He has scored fifteen No. 1 hits collectively on Latin radio charts, won 22 Latin Billboard Awards, 19 Premio Lo Nuestro Awards (Univision), 19 Juventud Awards and nine Latin Grammy nominations. His current hit single Déjà vu, a duet with Shakira, is his fifteenth #1 on Billboard's Tropical Songs chart and has ranked him at number three among artists that have garnered the most number ones in the history of this chart, earning him a new record as the fastest artist to achieve this milestone.
 
Funkmaster Flex is one of hip-hop's most recognizable DJs and a legend in the industry. In 1992, as the genre was enjoying a resurgence in popularity, he launched the first-ever hip hop radio show on New York City's HOT97 radio station. Today, Funkmaster Flex's show is so influential that you are said to have made it in the hip-hop world when he plays one of your tracks. In addition to his radio career he has released numerous mixtapes and has worked with the likes of 50 Cent, Fat Joe, Remy Ma, Ja Rule, Mary J. Blige, LL Cool J and more.
 
Born and raised in The Bronx, New York, Selenis Leyva is a proud Latina of Cuban and Dominican descent and a world-renowned actress. She is earning critical praise as one of the breakout stars of the Netflix hit series "Orange Is the New Black", which recently won its third consecutive Screen Actors Guild Award for "Best Ensemble Cast in a Comedy Series." Leyva will reprise her role as series regular (and fan favorite!) Gloria Mendoza when the hit series returns for a fifth season on June 9th. In addition to Orange, Selenis will star as Peter Parkers teacher Ms. Warren in the blockbuster franchise film "SPIDERMAN HOMECOMING," premiering in July.
 
Manny Villafaña, PhD, was born and raised in the South Bronx and is a graduate of Cardinal Hayes High School. As a young professional, he began his career in medical devices in the 1960's as a salesman, and has since launched seven public companies. He has been granted multiple pacemaker, heart valve and stent patents that have completely transformed the industry of cardiac surgery. Dr. Villafaña's innovative designs have saved and enhanced countless lives and have earned him the nickname "Cardiac Kahuna." He is also globally recognized as a "Living Legend of Medicine," a title awarded to him in 2006 by the World Society of Cardio Thoracic Surgeons.

The celebration featured music by "Everything Covered" and samples of some of the best food and drink The Bronx has to offer, including the Bronx Brewery, Kingsbridge Social Club, Port Morris Distillery, Gino's Pastry Shoppe, Bronx Drafthouse, Woops!, Chelsea Craft Brewing Company, Delicioso Coco Helado and Made in Puerto Rico.
 
Now in its 46th year, Bronx Week is the annual celebration of everything that makes The Bronx a great place to live, work and raise a family.
 
For more information about Bronx Week 2017, visit www.ilovethebronx.com.