The PPNA will be hosting a very special guest for its June 11,2024 event at Bronx House located at 990 Pelham Parkway South Bx NY 10461 . Gustavo Rivera is a NY State Senator representing the 33rd Senate District, who is also the Chairman of Committee on Health. Please join us for this important and informative event.
RiverSpring Admits That It Failed to Provide Required Services, or Failed to Adequately Document the Provision of Services, to Members of Its Managed Long-Term Care Plan
Damian Williams, the United States Attorney for the Southern District of New York, and Naomi Gruchacz, the Special Agent in Charge of the New York Regional Office of the U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”), announced a settlement of a civil fraud lawsuit against RIVERSPRING LIVING HOLDING CORP. and ELDERSERVE HEALTH, INC., d/b/a RiverSpring at Home (“RIVERSPRING”), New York not-for-profit corporations that, among other things, administer a Managed Long Term Care Plan (the “RiverSpring MLTCP”) for Medicaid beneficiaries. In connection with the RiverSpring MLTCP, RIVERSPRING arranges for health and long-term care services and is reimbursed by Medicaid through per-member payments on a monthly basis (“Capitation Payments”).
The settlement resolves allegations that RIVERSPRING submitted false claims to Medicaid for months during which RIVERSPRING failed to provide, or failed to adequately document, certain long-term care services to RiverSpring MLTCP members as obligated by the applicable contract between RIVERSPRING and the New York State Department of Health (“DOH”).
Under the terms of the settlement approved today by U.S. District Judge P. Kevin Castel, RIVERSPRING must pay a total sum of $10,159,130.95, with $4,063,652.38 paid to the United States and the remaining amount paid to the State of New York. As part of the settlement, RIVERSPRING admits that it either did not provide RiverSpring MLTCP members with qualifying services as required by the applicable contract with DOH or did not adequately maintain documentation of the provision of such services during some or all of their enrollment in the RiverSpring MLTCP. As a result, RIVERSPRING obtained Medicaid payments to which it was not entitled.
U.S. Attorney Damian Williams said: “RiverSpring collected millions of dollars in Medicaid payments to provide long-term care services as part of its managed care plan, but in many cases either failed to deliver these services or failed to maintain adequate documentation showing that it did so. This Office is committed to holding recipients of government health care funds accountable when they fail to provide the care and services the government pays them to provide.”
HHS-OIG Special Agent in Charge Naomi Gruchacz said: “As a part of this settlement, the defendants acknowledged that they obtained funds from the Medicaid program to which they were not entitled. Individuals and entities that participate in the federal health care system are required to obey the laws meant to preserve the integrity of program funds and the provision of appropriate, quality services to patients.”
As alleged in the Complaint filed in Manhattan federal court:
RIVERSPRING administers a managed long-term care plan for Medicaid beneficiaries pursuant to applicable contracts with DOH (the “Contract”). To be eligible for enrollment into a managed long-term care plan, a Medicaid beneficiary must, among other things, be assessed as needing at least one of the community-based long-term care services listed in the Contract (“Qualifying Services”) for more than 120 days from the effective date of enrollment. These services include nursing services in the home, therapies in the home, home health aide services, personal care services in the home, and adult day health care. In order to receive Capitation Payments from Medicaid for members of the RiverSpring MLTCP, RIVERSPRING was required to ensure that RiverSpring MLTCP members received Qualifying Services during their enrollment or otherwise remained appropriately enrolled in the RiverSpring MLTCP consistent with the Contract and DOH disenrollment practices. In exchange for arranging and providing these services, RIVERSPRING received Capitation Payments averaging between $4,000 and $4,500 for each member.
As part of the settlement, RIVERSPRING admits, acknowledges, and accepts responsibility for the following conduct:
In connection with the filing of the lawsuit and settlement, the Government joined a private whistleblower lawsuit that had been filed under seal pursuant to the False Claims Act.
Mr. Williams thanked HHS-OIG for its assistance. Mr. Williams also thanked the Medicaid Fraud Control Unit of the New York State Attorney General’s Office for its investigative efforts and work on the case.
A Huntington Beach, California, man was arrested on federal charges relating to sending threats to individuals and knowingly making false bomb threats. Kevin Dunlow, age 62, is charged in a complaint unsealed in the U.S. District Court of the Eastern District of North Carolina following his arrest in California. He will have his initial appearance, and his detention hearing will be set at a later date.
“Hate-fueled, violent threats endanger the safety of individuals and entire communities,” said Attorney General Merrick B. Garland. “This defendant is accused of making explicit and detailed threats, ranging from making a bomb threat against the Wake County Sheriff’s Office, to threatening an elected official, to telling a Rabbi, ‘I am coming to the Temple to kill all the Jews and the children.’ The Justice Department will prosecute anyone who makes illegal threats motivated by antisemitism or bias of any kind.”
“We will not normalize violent threats in America, whether targeting law enforcement, elected officials, or average citizens,” said U.S. Attorney Michael F. Easley Jr for the Eastern District of North Carolina. “The complaint alleges the defendant made violent threats against people of faith, cops, and public servants. These cases will always receive our highest attention.”
According to the affidavit in support of the criminal complaint, Dunlow made numerous threats targeting multiple entities and individuals, including an elected official, members of law enforcement, and several synagogues located in North Carolina, while residing in California at the time the threats were made. On or about May 7, Dunlow allegedly stated, “Jews didn’t deserve to live. Jews didn’t deserve to be on this earth. I’m going to kill the Jews. I’m coming to the Temple to kill all the Jews and the children.”
In addition, Dunlow allegedly made a false bomb threat to the Wake County, North Carolina, Sheriff’s Office.
Dunlow is charged with illegally using any form of communication to send a threat to harm or kidnap another person intentionally, and he is charged with illegally knowingly making false reports about bombs. If convicted, Dunlow faces five years in prison for each charge.
U.S. Attorney Michael Easley for the Eastern District of North Carolina made the announcement.
The FBI Charlotte Field Office is investigating the case, with assistance from the FBI Los Angeles Field Office and the Justice Department's National Security Division.
Assistant U.S. Attorney Gabriel Diaz for the Eastern District of North Carolina is prosecuting the case.
A criminal complaint is merely an accusation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
New York Attorney General Letitia James and New York State Department of Environmental Conservation (DEC) Interim Commissioner Sean Mahar filed a lawsuit against Anthony Labriola and his two affiliate companies—ALAC Realty, LLC (ALAC Realty) and ALAC Contracting Corp. (ALAC Contracting)—for illegally building a storage lot to park heavy-duty construction vehicles and store equipment on a protected area along the Carlls River in West Babylon, Suffolk County. Labriola and his companies removed trees and other vegetation from, then graded, a designated “buffer area” adjacent to wetlands of the Carlls River, the fourth longest river on Long Island. These wetlands have DEC’s highest classification for the benefits they offer, including providing wildlife habitats, and flood control and protecting water quality on Long Island.
Despite a years-long enforcement effort by DEC, Labriola and his companies have refused to remove equipment, restore the site, and pay outstanding penalties. Attorney General James and DEC are seeking to require Labriola to clean up the site, replant it with native vegetation, and for Labriola and his companies to pay at least $591,000 in combined civil penalties.
“New York’s freshwater wetlands are a valuable natural resource, particularly in highly developed areas like western Suffolk County, providing wildlife habitats, flood control, and water quality protection. It is important to protect their benefits for current residents and generations to come,” said Attorney General James. “Anthony Labriola and his companies blatantly violated our environmental laws and continued to evade enforcement efforts, but now we are going to make sure he restores what he has damaged. I want to thank DEC for their continued partnership in defending our natural resources.”
“Freshwater wetlands help protect water quality, provide habitats for wildlife, and promote community resiliency, among many other benefits, and illegal construction and removal of vegetation from regulated areas in and around wetlands can negatively impact the environment and communities long after the initial damage,” said DEC Interim Commissioner Sean Mahar. “DEC is working closely with Attorney General James to hold Anthony Labriola accountable for his illegal actions and require this contractor to restore damage to these wetlands, which are critical to the sustained protection of Long Island’s sole source aquifer.”
Freshwater wetlands throughout the state control flooding and provide valuable habitats for a diverse array of wildlife, among other benefits. To protect these wetlands and surrounding areas, the New York Freshwater Wetlands Act prohibits removing trees and vegetation, placing fill, or building commercial facilities on designated wetlands and protected adjacent “buffer areas” without a permit from DEC.
New York’s wetlands are classified on a scale ranging from Class I wetlands, which provide the most environmental benefits, to Class IV wetlands, which provide the least. These benefits refer to the work wetlands do for the surrounding community, such as storing flood and storm surge water. The Carlls River wetlands are Class I wetlands, and particularly valuable to the Long Island environment because of their biological diversity and role in protecting Long Island’s sole source aquifer.
In February 2015, DEC issued a notice of violation to Labriola after discovering that he had illegally cleared trees and vegetation and built a parking lot on top of the protected Carlls River wetlands-adjacent buffer area on a property his company owns at 420 Falmouth Road in West Babylon. Despite DEC’s enforcement efforts and Labriola's agreement to remove the construction equipment from the protected area and revegetate it with native plantings, Labriola repeatedly failed to comply, and instead continued to use the area illegally as parking and storage for his construction business, ALAC Contracting. The DEC estimates that by storing his construction vehicles, equipment, and materials on the illegally utilized area, Labriola and his companies have to date saved nearly $150,000 that they would have had to pay to use commercial space in the vicinity.
Site at 420 Falmouth Road in 2010, Before Illegal Construction
Site at 420 Falmouth Road in 2024, After Illegal Construction
For years of violating the consent order with DEC, Attorney General James and DEC Interim Commissioner Mahar are seeking an injunction requiring Labriola and ALAC Realty to completely remove illegally stored vehicles and equipment, revegetate the wetland-adjacent area with native trees and other plantings as previously agreed, and pay civil penalties totaling no less than $371,000. The OAG and DEC also seek to compel ALAC Contracting to pay civil penalties of no less than $220,000 and to remove all of its vehicles and equipment from the regulated area covered by DEC’s consent order with Labriola and ALAC Realty.
Attorney General James thanks DEC for their continued partnership in protecting New York’s natural resources.
The matter is being handled for DEC by Long Island Regional Attorney Craig Elgut, Regional Manager in the Bureau of Ecosystem Health Kevin Jennings, and Regional Enforcement Coordinator Chris Spies.
