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Wednesday, June 2, 2021
GrowNYC June Volunteer Newsletter
Assemblymember Pichardo: Threatening an individual with deportation is a form of extortion
“The acts of extortion and coercion—forcing another person to give up their property or change their habits by intimidation —are illegal under New York penal law. While these methods of intimidation often include threatening to press criminal charges, the act of threatening to call immigration authorities on an individual was not included in this definition, despite the fact that the consequences of deportation can be just as severe. That’s why I helped pass a bill which designates the threat of deportation as a crime on the same level as extortion and coercion (A.3412-A).
“Simply put: immigration status is not a bargaining tool. Using an individual’s immigration status against them is just as much a form of intimidation and blackmail as threatening to press criminal charges. Undocumented New Yorkers contribute so much to our communities and our economy. They should never have to live in fear of having their lives ripped out from under them. I’ll always do everything I can to protect and support New York’s vulnerable populations.”
Manhattan U.S. Attorney Files Suit Against Eleven Skilled Nursing Facilities And Their Management Company, Owner, And A Senior Employee For Fraudulently Billing Medicare For Unnecessary Services
Suit Alleges That Eleven New York-Based Facilities Fraudulently Inflated Medicare Reimbursements by Prolonging Patient Stays Without Regard to Patients’ Medical Needs and Billing for Excessive Rehabilitation Therapy That Patients Did Not Need
Audrey Strauss, the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the New York Regional Office of the U.S. Department of Health and Human Services, Office of the Inspector General (“HHS-OIG”), announced today that the United States has filed a civil healthcare fraud lawsuit against ISSAC LAUFER, TAMI WHITNEY, MONTCLAIR CARE CENTER, INC., EAST ROCKAWAY CENTER LLC, EXCEL AT WOODBURY FOR REHABILITATION AND NURSING, LLC, LONG ISLAND CARE CENTER INC., TREETOPS REHABILITATION & CARE CENTER LLC, SUTTON PARK CENTER FOR NURSING & REHABILITATION, LLC, SUFFOLK RESTORATIVE THERAPY & NURSING, LLC, OASIS REHABILITATION AND NURSING, LLC, FOREST MANOR CARE CENTER, INC., SURGE REHABILITATION & NURSING LLC, QUANTUM REHABILITATION & NURSING LLC, and PARAGON MANAGEMENT SNF LLC (collectively the “Defendants”). The lawsuit seeks damages and civil penalties under the False Claims Act for fraudulently billing Medicare for unreasonable and unnecessary services provided to patients at eleven skilled nursing facilities located in New York (the “Facilities”).
The complaint alleges that, during the period from at least January 2010 through September 2019, Defendants systematically kept patients at the Facilities longer than necessary in order to maximize the amount billed to Medicare for the patients’ stays. During those stays, the Facilities systematically put patients on higher levels of rehabilitation therapy than necessary based on their actual clinical needs in order to bill Medicare at the highest rate. ISSAC LAUFER, who is a part owner of ten of the eleven Facilities and operates all eleven Facilities through PARAGON MANAGEMENT SNF LLC, and TAMI WHITNEY, the Coordinator of Rehabilitation Services for the Facilities, instructed and pressured staff to engage in these fraudulent practices. As a result, according to the complaint, the Facilities submitted, or caused to be submitted, false claims for payment for rehabilitation services that were unreasonable and unnecessary, or in some cases, did not even involve the provision of skilled therapy.
U.S. Attorney Audrey Strauss said: “As alleged, ISSAC LAUFER, TAMI WHITNEY and the skilled nursing facilities ISSAC LAUFER owns and/or operates prioritized profits above their obligation to focus on their patients’ actual medical needs. In clear violation of the governing regulations, the Defendants fraudulently inflated their Medicare reimbursements by unnecessarily prolonging patient stays and billing for therapy that offered little or no clinical benefit. This Office will continue vigorously to pursue companies and individuals who engage in these practices at the expense of the public fisc.”
HHS-OIG Special Agent in Charge Scott J. Lampert said: “The Medicare program is designed to protect both beneficiaries and taxpayers. When medical providers bill for unnecessary or improper services, patient care is put at risk and the financial integrity of our federal health care system is compromised. Working with our law enforcement partners, we will continue to ensure that medical providers are held accountable for their billing practices and the services they provide.”
The following allegations are based on the Complaint that was filed in White Plains federal court today:
The eleven facility defendants are skilled nursing facilities located in the New York metropolitan area. LAUFER is a part owner of ten of the eleven Facilities and operates all eleven Facilities through PARAGON MANAGEMENT SNF LLC. WHITNEY is the Coordinator of Rehabilitation Services for the Facilities and as such is involved in decisions regarding the provision of, and billing for, rehabilitation services.
From at least January 2010 through September 2019, the Defendants systematically kept Medicare patients at the Facilities longer than reasonable or necessary, and put those patients on higher levels of rehabilitation therapy than reasonable or necessary. These practices were designed to increase the amounts billed to Medicare beyond what was justified based on patients’ clinical needs. In some instances, the Facilities went so far as to intentionally limit patients’ progress in order to create the appearance of a continued need for services. In one instance, WHITNEY reported to LAUFER that the Facilities should not allow patients to go to the bathroom by themselves because they would then “think they are ready to go home.”
LAUFER and WHITNEY directed the Facilities to engage in this conduct. Specifically, WHITNEY carefully tracked the length of stay for each Medicare patient and expected staff at the Facilities to justify discharges scheduled to take place before the patient’s stay approached 100 days—the maximum compensable by Medicare. Together with management at the Facilities, WHITNEY devised strategies for extending patient stays, including giving patients unnecessary tests to gauge their balance proficiency at the point they were ready for discharge to create a pretext for extending their stays. WHITNEY reported on the success of these “discharge prevention” measures to Laufer, noting both areas where these measures succeeded and those where the Facilities had to work harder to prolong patient stays—such as for patients who were “younger and smarter” or “high level.” LAUFER, in turn, received daily updates from the Facilities reporting the number of Medicare patients who had been discharged, and, on a number of occasions, instructed WHITNEY to curb discharges. LAUFER gave these instructions without any information about the patients’ clinical needs and made explicit that they were designed to increase revenue.
WHITNEY, with LAUFER’S knowledge, also instructed the Facilities to provide virtually all Medicare patients with therapy at the “Ultra High”—i.e., highest billing—level, without regard to the patients’ needs or whether, due to their conditions, they could benefit from this intense therapy. To qualify for the Ultra High level, a patient must receive at least 720 minutes of skilled therapy services (i.e., physical, occupational or speech therapy requiring the services of a trained therapist) per week. Employees understood that there was virtually no wiggle room when it came to determining how much rehabilitation therapy a patient would receive. The pressure to provide this level of therapy in turn led the Facilities to bill for services that did not actually qualify as skilled therapy and thus were not eligible for Medicare reimbursement (such as simply moving the limbs of patients with severe cognitive impairments or assisting with routine self-care tasks).
LAUFER and WHITNEY’S efforts to keep Medicare patients at the Facilities for as close as possible to 100 days and to provide almost all patients, without regard to need, with therapy at the Ultra High level succeeded. During the relevant period, the Facilities were significant outliers, compared to other skilled nursing facilities, with respect to Medicare patients’ average length of stay and levels of rehabilitation therapy.
These practices resulted in the Facilities submitting claims to Medicare for rehabilitation therapy that was not reasonable or necessary, was billed at a higher rate than appropriate, or did not involve the provision of skilled services and, accordingly, were ineligible for payment. In addition, the Facilities made or used false statements and records that were material to false claims submitted to Medicare for payment for rehabilitation therapy that was unreasonable, unnecessary, or unskilled.
The Government intervened in a private whistleblower lawsuit before the Honorable Cathy Seibel that had previously been filed under seal pursuant to the False Claims Act.
Ms. Strauss thanked HHS-OIG for its assistance with the case.
Governor Cuomo Announces New York State 7-Day Average Positivity Rate Is Lowest in the Nation
Statewide 7-Day Average Positivity Rate is 0.64%; 58 Consecutive Days of Decline
1,007 Patient Hospitalizations Statewide - Lowest Since October 21
11 COVID-19 Deaths Statewide Yesterday
Citi Field to Expand to Full Capacity for 90 percent of Stadium for New York Mets games beginning Friday, June 11
Governor Andrew M. Cuomo today updated New Yorkers on the state's progress combatting COVID-19. Additionally, the Governor announced that beginning Friday, June 11, Citi Field will expand full capacity sections for vaccinated individuals to 90 percent of the stadium for New York Mets home games. In total, this would enable more than 32,000 to attend games.
"Over half of all New Yorkers have received at least one dose of the COVID-19 vaccine. To think that at this point last year the vaccine was a dream on the horizon is staggering. I am proud to lead the people of this state who have gotten us to where we are," Governor Cuomo said. "New Yorkers are tough and together we have carried each other through this pandemic and we are ever closer to emerging into a better, safer, reimagined state. Those who have not yet received the vaccine should take advantage of ongoing programs and do so for the greater good of New York."
Today's data is summarized briefly below:
- Test Results Reported - 71,019
- Total Positive - 431
- Percent Positive - 0.61%
- 7-Day Average Percent Positive - 0.64%
- Patient Hospitalization - 1,007 (-25)
- Patients Newly Admitted - 93
- Patients in ICU - 252 (-3)
- Patients in ICU with Intubation - 136 (-2)
- Total Discharges - 182,472 (+88)
- Deaths - 11
- Total Deaths - 42,734
- Total vaccine doses administered - 19,149,539
- Total vaccine doses administered over past 24 hours - 68,355
- Total vaccine doses administered over past 7 days - 521,361
- Percent of New Yorkers ages 18 and older with at least one vaccine dose - 65.5%
- Percent of New Yorkers ages 18 and older with completed vaccine series - 57.3%
- Percent of all New Yorkers with at least one vaccine dose - 53.8%
- Percent of all New Yorkers with completed vaccine series - 46.1%
COUNCILMEMBER RUBEN DIAZ UNVEILS EMMANUEL FRIAS STREET CO-NAMING
On Saturday, June 5, 2021, at 11:30 am Council Member Rev. Ruben Diaz will be unveiling the corner of Castle Hill Ave & Quimby Ave as “Emmanuel Frias Way”.
Emmanuel Frias graduated from Long Island University in May 2019, with a degree in Master of Science and a previous Bachelor’s Degree of Science in Kinesiology from the State University of New York College at Cortland. He worked at Castle Hill Medical Center providing patient care, assisting in the development of exercise prescriptions for reconditioning exercise, and educated patients through rehabilitation programs.
Emmanuel Frias was a leader, advocate, and outspoken leader for his patients and the community.
“As the City Councilmember representing the area of Castle Hill, I was able to obtain approval from the City Council to rename the corner of Castle Hill Ave & Quimby Ave as “Emmanuel Frias Way”.
The street renaming ceremony will begin at 11:30 am all are welcome and encouraged to come as we pay tribute to Mr. Emmanuel Frias and celebrate his life. Elected officials, community leaders, friends of Emmanuel, and anyone else who would like to come together to remember Mr. Emmanuel Frias.
Location: Castle Hill & Quimby Avenue Bronx, NY
Date: Saturday, June 5, 2021
Time: 11:30 am
VOTERFEST - Art, Performances, Snacks, Voter Info - June 5th ~ 12-6pm
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6 Defendants Charged With Laundering Millions Of Dollars In Proceeds Derived From Romance Scams
The Defendants Used Shell Companies to Launder Over $3.5 Million in Funds from Victims of Romance Fraud Schemes
Audrey Strauss, United States Attorney for the Southern District of New York, Patrick J. Freaney, Deputy Special Agent in Charge of the New York Field Office of the United States Secret Service (“USSS”), and Jonathan D. Larsen, Special Agent in Charge of the New York Office of the Internal Revenue Service, Criminal Investigation (“IRS-CI”), announced today the unsealing of a complaint charging ABUCHI SHEDRACH FELIX, NADINE JAZMINE WADE, OLUWATOMIWA AKINTOLA, GREGORY OCHIAGHA, HABIBA FAGGE, and OLANREWAYU AJIBOLA with conspiracy to commit money laundering, in connection with their involvement in laundering millions of dollars in proceeds derived from romance fraud schemes.
FELIX, AKINTOLA, and AJIBOLA were arrested last night at Newark Liberty International Airport in Newark, New Jersey. OCHIAGHA was arrested earlier today in the Bronx. WADE and FAGGE are currently fugitives. FELIX, AKINTOLA, AJIBOLA, and OCHIAGHA will be presented in Manhattan federal court later today before U.S. Magistrate Judge Sarah L. Cave.
Manhattan U.S. Attorney Audrey Strauss said: “As alleged, the conspirators preyed on the emotions of their numerous online romance fraud victims to fleece the victims out of millions of dollars. Thanks to the Secret Service and IRS Criminal, the defendants have dates in court to face federal charges.”
USSS Deputy Special Agent-in-Charge Patrick J. Freaney said: “Cyber enabled romance schemes continue to harm innocent and unsuspecting people, and the U.S. Secret Service remains committed to investigating those who perpetuate these acts. In this instance, the conspirators allegedly utilized online aliases and created shell companies in furtherance of their scheme to defraud. Through a collaborative investigative effort by the Secret Service, the Internal Revenue Service, and the New York City Police Department Financial Crimes Task Force, the accused will answer the charges brought against them in the Southern District of New York. For further information on ways to better avoid romance scams, please visit www.secretservice.gov/romancescams.”
IRS-CI Special Agent in Charge Jonathan D. Larsen said: “The arrests of the alleged perpetrators of this $3.5 million scheme deal a death blow to the vast criminal activity in which the defendants were allegedly engaged. IRS Criminal Investigation will continue to aggressively pursue those who profit from illegal activity and ensure they are brought to justice.”
According to the allegations in the Complaint:[1]
Using online aliases, the defendants’ co-conspirators contacted victims on various dating sites, and convinced those victims, under false pretenses, to transfer funds to the defendants and others. One online alias used in the schemes frequently employed the names “Diego Francisco,” “Richard Francisco,” or “Tom Francisco” (the “Francisco Alias”). The conspirators used online photos of a male model when providing victims with photos of the Francisco Alias. After engaging in conversation with the victims via phone, text, and email, the conspirators, posing as the Francisco Alias, would ask victims for money. The reason offered for why the Francisco Alias needed money could vary. In one version of the scheme, the Francisco Alias was supposedly an architect who had traveled to Dubai and needed funds in order to receive several million dollars in payment. In another version of the scheme, the Francisco Alias supposedly worked on an oil rig and needed funds to repair the rig. The Francisco Alias would then instruct the victims to transfer funds to bank accounts controlled by the defendants. The means of transfer varied. For example, in some cases, the Francisco Alias instructed victims to obtain cashier’s checks or money orders made payable to one of the defendants’ companies and then either mail the check to the conspirators – at addresses that included one in the Bronx – or to deposit the cashier’s check directly into a bank account held in the name of one of the defendants’ companies. The Francisco Alias would instruct the victims to send him photographs of any cashier’s checks and any mailing labels.
Each of the defendants created a shell company and opened bank accounts in the name of his or her respective shell company (the “Shell Company Accounts”). The Shell Company Accounts received funds from victims of the romance fraud scheme described above and rapidly depleted those funds through cash withdrawals, cashier’s checks, and the purchase of vehicles, among other means. The Shell Company Accounts received over $4.5 million between in or about 2018 and 2020, over $3.5 million of which came from victims of the romance fraud scheme.
ABUCHI SHEDRACH FELIX, of Newark, New Jersey, NADINE JAZMINE WADE, of Bronx, New York, OLUWATOMIWA AKINTOLA, of Brooklyn, New York, GREGORY OCHIAGHA, of Bronx, New York, HABIBA FAGGE, of Towson, Maryland, and OLANREWAYU AJIBOLA, of Newark, New Jersey, were each charged with one count of conspiracy to commit money laundering, in violation of 18 U.S.C. § 1956(h), which carries a maximum sentence of 20 years in prison. The maximum potential sentence is prescribed by Congress and is provided here for informational purposes only, as any sentencing of the defendants would be determined by a judge.
Ms. Strauss praised the outstanding investigative work of USSS and IRS-CI.
[1] As the introductory phrase signifies, the entirety of the text of the Complaint and the description of the Complaint set forth in this release constitute only allegations, and every fact described should be treated as an allegation.