Attorney General James Announces Settlement in Medicaid Fraud Investigation of Central New York Doctor

 

Ahmad Mehdi, M.D. Agrees to Pay $568,750 to Medicaid Program 

New York Attorney General Letitia James today announced that her office, in conjunction with the U.S. Attorney’s Office for the Northern District of New York, has reached a settlement with Ahmad M. Mehdi, M.D. and Ahmad M. Mehdi, M.D., P.C. This settlement resolves an investigation involving Medicaid overpayments for “up-coded” medical services, as well as Medicaid payments for smoking cessation counseling that were not sufficiently documented. “Up-coding” is the improper practice of claiming reimbursement for enhanced and more lucrative procedures than were in fact performed. As part of a joint settlement, Mehdi has agreed to reimburse $260,000 to the state Medicaid program and to pay a penalty amount of $308,750. In the companion civil settlement agreement with the U.S. Attorney, Mehdi will pay $331,250 to the federal government to settle up-coding and smoking cessation claims, and certain claims arising under the Controlled Substances Act. 

“Every dollar scammed from Medicaid is a dollar not spent caring for New Yorkers with actual medical needs,” said Attorney General James. “I am proud of the work my team did, together with the U.S. Attorney’s Office for the Northern District of New York, in uncovering these false claims and securing these funds. Let this settlement be a clear message: We have zero tolerance for lying to Medicaid, and we will hold those who do accountable.”

“The U.S. Attorney’s Office will continue to work with state and federal enforcement partners to maintain the integrity of public programs and safeguard federal healthcare dollars,” said U.S. Attorney for the Northern District of New York Carla B. Freedman. “This settlement should deter anyone thinking about abusing federal healthcare programs for their own benefit.” 

Dr. Mehdi is the principal owner of Ahmad M. Mehdi, M.D., P.C., a general medical practice with offices located in Groton and Tully, New York.  

Between January 1, 2012, through September 17, 2018, Dr. Mehdi engaged in up-coding of billings for medical services and billed for smoking cessation counseling services that were not sufficiently documented. He submitted, or caused to be submitted, those claims for payment to the Medicaid program and to various Medicaid Managed Care entities, and these government payors relied on those fraudulent claims to pay him. 

An audit and investigation conducted by the Office of the Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) in conjunction with the U.S. Attorney’s Office for the Northern District of New York, uncovered the fraudulent claims. 

The OAG MFCU investigation was conducted by Senior Auditor-Investigator Carri Merry, under the supervision of Regional Chief Auditor Dejan Budimir, and Detective Patrick Lynch, under the supervision of Detective Supervisor Christopher Burns and Deputy Chief-Commanding Officer William Falk. The investigation and settlement were handled by MFCU’s Syracuse Regional Director Ralph D. Tortora, III. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. MFCU is a part of the Division for Criminal Justice, which is led Chief Deputy Attorney General José Maldonado and overseen by First Deputy Attorney General Jennifer Levy. 

Attorney General James thanks the U.S. Attorney’s Office for the Northern District of New York for its collaboration in the investigation, litigation, and resolution of this matter. 

Reporting Medicaid Provider Fraud: MFCU defends the public by addressing Medicaid provider fraud and protecting nursing home residents from abuse and neglect. If you have information about Medicaid provider fraud or know about abuse or neglect of a nursing home resident, please file a confidential complaint online or call the MFCU hotline at (800) 771-7755. If the situation is an emergency, please call 911. 

MFCU’s total funding for federal fiscal year (FY) 2023 is $65,717,936. Of that total, 75 percent, or $49,288,452, is awarded under a grant from the U .S. Department of Health and Human Services. The remaining 25 percent, totaling $16,429,484 for FY 2023, is funded by New York state. Through MFCU’s recoveries in law enforcement actions, it regularly returns more to the state than it receives in state funding.

New York Lawyer Pleads Guilty To Participating In Trip-And-Fall Fraud Scheme

 

 Damian Williams, the United States Attorney for the Southern District of New York, announced that MARC ELEFANT, a New York lawyer, pled guilty today to one count of conspiracy to commit wire fraud in connection with a scheme to obtain millions of dollars in fraudulent insurance reimbursements and other compensation from fraudulent trip-and-fall accidents.  ELEFANT is the third defendant to plead guilty this year.  Two other defendants — ADRIAN ALEXANDER, the owner of a litigation funding company, and SADY RIBEIRO, a New York-licensed pain management doctor and surgeon — pled guilty earlier this year.  ALEXANDER pled guilty to one count of conspiracy to commit wire fraud on August 30, 2022.  RIBEIRO pled guilty to one count of conspiracy to commit wire fraud and one count of conspiracy to commit mail fraud on September 29, 2022.  All defendants pled guilty before U.S. District Judge Sidney H. Stein.

U.S. Attorney Damian Williams said: “We expect lawyers to follow the rules and act ethically on behalf of their clients, but attorney Marc Elefant acted only for himself, abusing his professional license and position of trust to steal over a million dollars from New York City businesses and their insurance companies through a massive trip-and-fall fraud scheme.  Elefant and his co-conspirators preyed upon the most vulnerable members of society in order to enrich themselves.  Elefant now awaits sentencing for his reprehensible crime.”

According to the Indictment, the Superseding Information filed against ELEFANT, other documents filed in this case, and statements made in court:

MARC ELEFANT, among others, was involved in an extensive fraud scheme through which fraud scheme participants defrauded businesses and insurance companies by staging trip-and-fall accidents and filing fraudulent lawsuits arising from those staged trip-and-fall accidents.

The fraud scheme participants recruited individuals (the “Patients”) to stage or falsely claim to have suffered trip-and-fall accidents at particular locations throughout the New York City area (the “Accident Sites”).  In the course of the fraud scheme, scheme participants recruited more than 400 Patients.  In the beginning, scheme participants would instruct Patients to claim they had tripped and fallen at a particular location, when in fact, the Patients had suffered no such accidents.  Eventually, at the direction of the lawyers who filed fraudulent lawsuits on behalf of the Patients, scheme participants began to instruct Patients to stage trip-and-fall accidents, i.e., to go to a location and deliberately fall.  Common Accident Sites used during the fraud scheme included cellar doors, cracks in concrete sidewalks, and purported “potholes.”

After the staged trip-and-fall accidents, Patients were referred to specific attorneys, including ELEFANT, who would file personal injury lawsuits (the “Fraudulent Lawsuits”) against the owners of the Accident Sites and/or insurance companies of the owners of the accident sites (the “Victims”).  The Fraudulent Lawsuits did not disclose that the Patients had deliberately fallen at the accident sites or, in some cases, had not fallen at all.  During the course of the fraud scheme, the defendants, together with others known and unknown, attempted to defraud the Victims of more than $31,000,000.

The Patients were also instructed to receive ongoing chiropractic and medical treatment from certain chiropractors and doctors, including RIBEIRO.  The fraud scheme participants advised the Patients that if they intended to continue with their lawsuits, they were required to undergo surgery.  As an incentive to getting surgery, the recruited Patients were offered a payment of typically between $1,000 and $1,500 after they completed surgery (“Post-Surgery Payments”).  Patients generally were told to undergo two surgeries.  Doctors in the fraud scheme were expected to, and in fact did, conduct these surgeries regardless of the legitimate medical needs of the Patients.  

Members of the fraud scheme often recruited individuals who were extremely poor as Patients — individuals desperate enough to submit to surgeries in exchange for the small Post-Surgery Payments.  For example, it was common for Patients to ask for food when they would appear for their intake meetings with the lawyers.  Many of the Patients did not have sufficient clothing to keep them warm during the wintertime and had poor-quality shoes.  Members of the fraud scheme also recruited Patients who were drug addicts.  It was also common for scheme participants to recruit Patients from homeless shelters in New York City.

The Patients’ legal and medical fees were usually paid for by litigation funding companies (the “Funding Companies”), including a company owned by ALEXANDER.  Funding Companies were used even if the Patient maintained medical coverage through an insurance company or a government-subsidized program.  The Funding Companies also paid the fraud scheme organizers and participants referral fees, typically $1,000 to $2,500, for each Patient who signed a funding agreement.  In exchange for funding Patients’ medical and legal costs, the Funding Companies charged the Patients high interest rates, sometimes up to 50% on medical loans and up to 100% on personal loans.  The interest rates were so high that oftentimes the majority (if not all) of the proceeds that were awarded in the Fraudulent Lawsuits were paid to the Funding Companies, lawyers, including ELEFANT, doctors, and others, with the Patients receiving a much smaller percentage of the remaining recovery.

ELEFANT, 51, of Long Island, New York, pled guilty to one count of conspiracy to commit wire fraud, which carries a maximum sentence of five years in prison.  As part of his plea agreement, ELEFANT agreed to forfeit $955,281 to the United States and to make restitution in the amount of $1,486,000.

The maximum potential sentence in this case is prescribed by Congress and is provided here for informational purposes only, as any sentencing of the defendant will be determined by the judge.  ELEFANT is scheduled to be sentenced on January 25, 2023, by U.S. District Judge Sidney H. Stein.     

Mr. Williams praised the outstanding investigative work of the Federal Bureau of Investigation.  Mr. Williams also thanked the National Insurance Crime Bureau for their assistance in the investigation.

Bronx River Art Center - BRAC Halloween Party Extravaganza - Sat, Oct 29, 2022

 

BRONX RIVER ART CENTER Celebrating 35 Years of Bringing Arts & Cultural Programs to the Bronx

SCARY NIGHT AT BRAC A Halloween Extravaganza

Saturday, October 29th, 4:30 to 8:00 PM

Dear Students, Parents, and Guardians: Please join us this Saturday, October 29th for our Halloween party starting at 4:30 pm. Scary stories with the SpeakEasy Bookmobile, music, and sweets await! Come wearing your best Halloween costume: the three best ones will get a surprise gift!

Free Event - Click Here to RSVP

BRAC COVID-19 Protocols

Proof of vaccination will be required upon entering building for all persons over age 6. Use of masks during classes is required. For general questions about classes, please email education@bronxriverart.org.

KRVC - Happy Halloween 2022! - Parade & Parties!

 

BOO! on Mosholu

KRVC's Annual Halloween Party is BACK! Look forward to seeing you! KRVCDC.ORG @krvcbronx

Statement from Comptroller Brad Lander on Leadership of the Board of Education Retirement System

 

The Board of Education Retirement System (BERS) Board of Trustees voted last week against a resolution from the Comptroller, which was also supported by the NYC Department of Education, to remove the Executive Director and demote the Deputy Executive Director of the pension fund following an investigation that found “egregious misconduct.” The Comptroller submitted the resolution after the NYC Special Commissioner for Investigation for the New York City School District found in August that the Deputy Executive Director of BERS lied to investigators and made false representations in order to seek a substantial increase in his salary, and that the Executive Director awarded the increase without sufficient due diligence, and then immediately requested a substantial increase in his own salary from the BERS Board.

“If a member of the BERS leadership lies to investigators, how can we trust what they tell trustees, members, or the public? If the executive director refuses to hold his deputy accountable for securing personal enrichment through false statements, how can we trust either of their leadership? As fiduciaries, we must be able to trust in the integrity of the executive staff — so that we can make the best decisions possible on behalf of the nearly 60,000 school crossing guards, secretaries, paraprofessionals, and other non-teacher public school retirees and beneficiaries we serve,” said Comptroller Brad Lander.

The Comptroller serves as custodian, trustee and investment advisor to the Board of Education Retirement System, as well as the City’s top fiscal watchdog and fiduciary to the other four city pension funds. The Board of Education Retirement System is the pension fund for non-pedagogical employees of the New York City public schools.

The BERS board is meeting again on Tuesday, October 25 to continue the discussion of disciplinary measures.

Chinatown Meat Distributor Required To Pay $250,000 Civil Penalty For Violating Food Safety Consent Decree

 

 Damian Williams, United States Attorney for the Southern District of New York, and Paul Kiecker, Administrator of the Food Safety and Inspection Service of the U.S. Department of Agriculture (“USDA-FSIS”), announced today that a federal district court has approved an agreement (“Agreement”) resolving violations by defendants CHUNG SHING MEATS, INC., a/k/a “New Chung Hing Meats, Inc,” WING HONG CHEUNG, MIAO HE FENG, YIU KWAN CHEUNG, and TIAN LUN FENG (collectively, the “defendants”) of a previously entered judicial consent decree requiring defendants to comply with food safety laws at their meat distributorship in Chinatown, Manhattan.  Today’s Agreement imposes a $250,000 civil penalty on defendants, which equals the highest civil penalty ever imposed for such violations.

U.S. Attorney Damian Williams said:  “This Office has zero tolerance for defendants who continue in their ways after entering into consent decrees in which they commit to come into compliance.  Such conduct is all the worse where, as here, the consent decree was designed to protect the public health.  The significant financial penalty should serve as notice to all defendants that they must live up to their commitments and comply with the law.”

FSIS Administrator Paul Kiecker said: “FSIS’s authority to enforce the Federal Meat Inspection Act and the Poultry Products Inspection Act is clear.  Our inspection personnel and investigators are on the job daily, verifying that establishments are providing consumers with safe, wholesome, and accurately labeled food.  We remain committed to public health, and this civil penalty shows that we will take swift action to protect American consumers.”

The Federal Meat Inspection Act (“FMIA”) and Poultry Products Inspection Act (“PPIA”) protect public health by ensuring the nation’s commercial supply of meat and poultry is safe, wholesome, and accurately labeled and packaged.  These requirements allow consumers to have confidence in the safety of their meat and poultry products and permit public health officials to trace problems to their source.

In 2019, this Office filed a civil complaint against defendants, alleging that they routinely prepared and sold meat and poultry products at 19 Catherine Street, New York, New York, without meeting the federal inspection requirements of the FMIA and the PPIA, including by misbranding or repackaging meat and poultry products without the marks of federal inspection.  USDA-FSIS had identified FMIA and PPIA violations by the defendants that included selling uninspected or misbranded roast pork, pork chops, roast ducks, beef brisket, chickens, and other beef, poultry, and pork products.  In all, USDA-FSIS’s inspections had uncovered over 400 pounds of meat and poultry products sold or offered for sale in violation of the FMIA and PPIA.

Contemporaneously with the 2019 complaint, defendants agreed to resolve the violations by entering into a consent decree that required them to comply with the FMIA and PPIA.  Among other things, the consent decree included a permanent injunction prohibiting defendants from “selling, transporting, offering for sale or transportation, or receiving for transportation, any meat, meat food products, poultry, or poultry products required to be inspected and passed by USDA-FSIS that have not been inspected and passed by USDA-FSIS federal inspectors,” and requiring defendants to “prepare and maintain, for each product containing meat, meat food products, poultry, or poultry products, ... business records of all transactions ...”  The consent decree included financial penalties that would apply if defendants violated these obligations.  On January 7, 2020, the federal district court approved the consent decree, making it a binding court order.

Defendants, however, have repeatedly violated the consent decree.  As stated in the Agreement approved by the court today:

• “... Defendants [have] admitted to selling a total of 787.62 pounds of non-federally inspected and misbranded meat and poultry between August 3, 2020, and January 26, 2021, in violation of Paragraph 4(a) of the Consent Decree”
• “... Defendants [have] further admitted that New Chung Hing had generally failed to keep requisite purchase invoices post-dating the Consent Decree, in violation of Paragraph 5 of the Consent Decree”

The Agreement requires defendants to pay $250,000 as a civil penalty for these violations of the Consent Decree.  This penalty equals the highest civil penalty ever imposed for violations of a USDA-FSIS consent decree under these food safety statutes, reflecting the gravity of defendants’ violations.

Mr. Williams thanked the USDA-FSIS for its efforts on this matter. 

Governor Hochul and Attorney General James Announce Major Expansion in Red Flag Law Usage to Protect New Yorkers from Gun Violence

 Extreme Risk Protection Orders More Than Doubled Since Expansion of Red Flag Law - More Than 1,900 Issued in Four Months

Attorney General's FY23 Budget To Increase by $4.6 Million To Support ERPO Requests Made by New York State Police

Progress Comes After Governor Hochul Issued Executive Order and Secured New Law To Strengthen Red Flag Law Implementation

 Governor Kathy Hochul and Attorney General Letitia James today announced a major expansion in usage of New York State's Red Flag Law to further protect New Yorkers from gun violence. Following an executive order and legislation signed by Governor Hochul to strengthen implementation of the law, courts across the State have issued 1,908 Extreme Risk Protection Orders, more than doubling the number of orders issued since the law became effective on August 25, 2019. Governor Hochul and Attorney General James also announced a $4.6 million increase to the Attorney General's FY23 budget to further support the New York State Police's efforts to obtain Extreme Risk Protection Orders when individuals pose a danger to themselves or others.

"Protecting New Yorkers is my top priority, and the expansion of the Red Flag Law is taking dangerous, deadly weapons away from those who pose a threat to themselves or others and preventing violence and tragedy," Governor Hochul said. "Working closely with the Attorney General and the State Police, we will continue to work to ensure effective implementation of the law to combat gun violence and save lives."

"Keeping guns away from dangerous individuals is a common sense way to save New Yorkers' lives," said Attorney General James. "Extreme risk protection orders have helped avert tragedies and protect communities. These funds will allow my office to better support our partners in the New York State Police, promote public safety, and help save more lives throughout our state. I thank Governor Hochul for taking this action, and we'll continue to work together to combat crime and keep New Yorkers safe."

The Red Flag Law, also known as the Extreme Risk Protection Order (ERPO) law, prevents individuals who show signs of being a threat to themselves or others from purchasing or possessing any kind of firearm. The Red Flag Law provides procedural safeguards to ensure that no firearm is removed without due process while helping to prevent tragedies, like the school shooting in Parkland, Florida, and the racist mass shooting in Buffalo.

Governor Hochul and Attorney General James announced the substantial increase in the Red Flag Law's use and new funding to support State Police efforts to implement the Law. Currently, Troopers make applications to the court for an ERPO on their own, but with the drastic increase in applications, there is a need for consistent legal representation to ensure the process to remove firearms from potentially dangerous individuals works effectively. The additional $4.6 million will allow the Attorney General's Office to add dozens of staff positions to represent the State Police and bolster their efforts to obtain these orders and better protect New Yorkers.

Last week, Governor Hochul and Attorney General James released a report on the role of online platforms in the Buffalo mass shooting. In accordance with a referral from the Governor, the Office of the Attorney General reviewed thousands of pages of documents and social media content to examine how the alleged shooter used online platforms to plan, prepare, and publicize his attack.

The State Division of Criminal Justice Services partnered with Everytown for Gun Safety to host a webinar in late August to educate law enforcement about their responsibilities under the new law. More than 800 people registered for the training, which is available to the public and has been viewed nearly 2,400 times since being posted in early September.

The number of total ERPOs issued more than doubled since June 1 — going from 1,552 between August 25, 2019 and June 1, 2022 to 3,460 as of October 1, 2022 — an increase of 1,908 ERPOs.

Final ERPOs have increased from 614 to 1,410, an increase of 130 percent, and temporary ERPOs have increased from 938 to 2,050, an increase of 119 percent. The average number of ERPOs issued a month increased to 403 from June 2022 through October 2022, compared to just 45 per month from October 2019 through May 2022.

Mayor Eric Adams Celebrates Healthy Lifestyle Month in the State of New York

 

Healthy Lifestyle can prevent most deadly diseases, reverse chronic illnesses, close health disparities, improve quality of life and increase longevity. Saturday was the day for Senator Luis Sepulveda to officially inaugurate his historic bill in designating October as Healthy Lifestyle Month. Senator Luis Sepulveda was one of the speakers promoting a healthier lifestyle as the senator described his own bodily experience before changing to a healthier eating and lifestyle. He said he was 209 pounds and lost 42 pound in just four and a half months because of a healthier lifestyle and eating. The senator presented Sheikh Musa Drammeh the creator of Lifestyle Lifespan that coordinates New York Healthy Lifestyle campaign which was adopted by NYCDOE in the Bronx in 2020. with a proclamation from the State Senate.

Mayor Eric Adam was among the other speakers who also has become a healthier person from the Healthy Lifestyles program, as he also gave thanks to Sheikh Musa Drammeh, who said that a Plant based option of food is available at NYCHHC facilities, which is good looking and tastes good. He added that eighty percent of dollars go to treatment not prevention. He has started a Meatless Monday in the public schools, and wants to know why there are so many fast food places in minority areas, but not in Park Slope. He commended Senator Luis Sepulveda and Assemblyman Kenny Burgos for their work in the state legislature on behalf of Healthy Lifestyles and Healthy Eating. 

Senator Luis Sepulveda tells of how the Healthy Lifestyles Lifespan program helped turn his life around before he developed life long health problems.

Senator Luis Sepulveda presents Sheikh Musa Drammeh and Edna D. Thomas-Granger of Peace December a citation for the Healthy Lifestyles Lifespan program. 

Mayor Adams speaks about his own poor health in his younger days, but he is now following the Healthy Lifestyle Lifespan program and never has felt better.

Mayor Adams is seated between Edna D. Thomas-Granger and Mr. Steven Ritz of the Green Bronx Machine as they watch a film by the Green Bronx Machine on Healthy Lifestyles now in the Bronx.

Dr. Gloria Bent of the Health and Hospitals Corporation speaks about why a healthier eating and lifestyle is better for everyone.

Speakers and Mayor Adams stand in front of the Healthy Lifestyles banner as they symbolize the Bronx X. 

Assemblyman Kenny Burgos tells why he supports the Healthy Lifestyles Lifespan program.