Governor Hochul Announces Progress on Addressing the Opioid and Overdose Epidemic Across New York

Estimated Overdose Deaths Declined in New York According to New Federal Data

Over $335 Million in Opioid Settlement Funds Made Available for New Strategies to Address Substance Use Disorder and Overdoses

Distributed Nearly 700,000 Life-Saving Naloxone Kits and Nearly 20 Million Test Strips

New York Lights State Landmarks in Recognition of National Fentanyl Prevention and Awareness Day

Governor Kathy Hochul today provided an update on New York’s ongoing efforts to combat the opioid and overdose epidemic that is impacting states across the nation. Estimated overdose deaths in areas of New York State outside New York City declined 9 percent in the 12-month period ending March 2024 compared to the prior 12-month period, according to new provisional data released by the Centers for Disease Control and Prevention (CDC). Estimated overdose deaths in New York City declined 3.1 percent in the same period. Following the release of this data, Governor Hochul highlighted that New York is continuing to take aggressive action to reduce overdose deaths statewide – including new, innovative approaches to deliver supportive services to New Yorkers struggling with addiction.

“I’m committed to keeping New Yorkers safe and turning the tide against an overdose epidemic that has taken far too many neighbors, friends and family members in New York and across the nation,” said Governor Hochul. “We'll continue taking aggressive action and deploying new resources that will save lives and ensure New Yorkers struggling with addiction get the services and support they need.”

According to the newly released provisional data, the CDC estimated 3,253 drug overdose deaths in areas of New York State outside New York City during the 12-month period from April 2023 to March 2024. This represents a 9 percent decrease compared to the estimated 3,575 overdose deaths in those parts of the state from April 2022 to March 2023.

Also according to that data, the CDC estimated 3,123 drug overdose deaths in New York City during the 12-month period from April 2023 to March 2024. This represents a 3.1 percent decrease compared to the estimated 3,223 overdose deaths in New York City from April 2022 to March 2023.

Since this is provisional data, it is subject to further revisions by federal officials in the coming months based on final reporting.

More Than $335 Million in Opioid Settlement Funds Made Available

As part of continued efforts to address this crisis, Governor Hochul highlighted New York’s nation-leading work to distribute opioid settlement funds to local communities. Settlement funds are used to invest in addiction ​prevention, recovery services, harm reduction and other resources that can play a role in reducing overdose deaths.

As of August 1, New York has made more than $335 million in settlement funds available since January 2023 – making this funding available faster than any other state in the nation. NYS OASAS is the lead agency responsible for oversight of New York’s Opioid Settlement Fund. To guide distribution of this funding, New York established the Opioid Settlement Fund Advisory Board, which provides recommendations on the best use of this funding to support the various services across New York State.

Delivering New Resources to Support Individuals Impacted by Addiction and Decrease Overdoses

Swift distribution of settlement funding and new State funding have enabled New York to advance a wide array of community investments and new initiatives that will help save more lives and address the needs of New Yorkers struggling with addiction. Governor Hochul highlighted several examples of these efforts:

• Providing more than $100 million to municipalities across the state to support efforts to address the opioid and overdose crisis on a local level.
• Funding new programs to increase access to medication for addiction treatment and other healthcare services, including comprehensive integrated outpatient programs, new opioid treatment programs, and increased access to low-threshold buprenorphine.
• Providing a total of more than $12 million to Recovery Community and Outreach Centers across the state, which help struggling New Yorkers access more services, support and information about addiction and recovery.
• Significantly increasing community-level outreach and engagement efforts that connect at-risk individuals with the harm reduction and treatment services they need.
• Expanding the addiction services workforce by recruiting and training more New Yorkers for jobs that enable them to help fellow New Yorkers struggling with addiction, including providing funding to medical schools and other colleges to support a new scholarship program.
• Establishing Mobile Medication Units which provide medication for addiction treatment and other services and resources, and are designed to bring services directly to underserved communities and address barriers that keep some people from seeking treatment.
• Certified Community Behavioral Health Clinics (CCBHCs), which provide an array of coordinated services to address substance use and/or mental health, including crisis intervention, screening and assessments, and treatment planning.

Distributed Nearly 700,000 Life-Saving Naloxone Kits Statewide

Along with deploying new services and resources to support New Yorkers struggling with addiction, the State has taken nation-leading action to distribute naloxone kits that can save lives during an overdose emergency.

Through combined efforts by NYS DOH, NYS OASAS and other partners, New York has distributed nearly 700,000 naloxone kits statewide in the last 18 months – including many through a first-in-the-nation online ordering portal. This portal also provides individuals and organizations the opportunity to order fentanyl and xylazine test strips. To date, more than 11.3 million fentanyl test strips and 8.3 million xylazine test strips have been distributed through this effort. These supplies can be ordered through the OASAS website.

Additionally, New York recently began providing free access to naloxone kits to domestic violence shelters and service providers across the state.

New Yorkers struggling with an addiction, or whose loved ones are struggling, can find help and hope by calling the state’s toll-free, 24-hour, 7-day-a-week HOPEline at 1-877-8-HOPENY (1-877-846-7369) or by texting HOPENY (Short Code 467369).

Recognizing National Fentanyl Prevention and Awareness Day

To recognize National Fentanyl Prevention and Awareness Day, the following New York State landmarks will be lit purple today:

• One World Trade Center
• Governor Mario M. Cuomo Bridge
• Kosciuszko Bridge
• The H. Carl McCall SUNY Building
• State Education Building
• Alfred E. Smith State Office Building
• Empire State Plaza
• State Fairgrounds - Main Gate & Expo Center
• Niagara Falls
• The "Franklin D. Roosevelt" Mid-Hudson Bridge
• Albany International Airport Gateway
• MTA LIRR - East End Gateway at Penn Station
• Fairport Lift Bridge over the Erie Canal
• Moynihan Train Hall
• Walkway Over the Hudson State Historic Park

Housing Lottery Launches for 285 East 163rd Street in Concourse Village, The Bronx

 

The affordable housing lottery has launched for 285 East 163rd Street, a six-story residential building in Concourse Village, The Bronx. Designed by Anthony Cucich Architect and developed by Genci Popaj under the 285E163RDNY LLC, the structure yields 36 residences. Available on NYC Housing Connect are 35 units for residents at 130 percent of the area median income (AMI), ranging in eligible income from $103,200 to $218,010.

Units come with name-brand kitchen appliances, countertops, and finishes, air conditioning, hardwood floors, and energy-efficient appliances. Amenities include a shared laundry room and elevator.

At 130 percent of the AMI, there are 30 one-bedrooms with a monthly rent of $3,010 for incomes ranging from $103,200 to $181,740; and five two-bedrooms with a monthly rent of $3,535 for incomes ranging from $121,200 to $218,010.

Prospective renters must meet income and household size requirements to apply for these apartments. Applications must be postmarked or submitted online no later than October 21, 2024.

NYS Office of the Comptroller DiNapoli Audit: ESD Needs to Increase Transparency of Its Real Estate Holdings and Sales of Properties Below Fair Market Value

 

The State’s Empire State Development agency (ESD) has not been meeting statutory requirements to provide accurate, annual reports of its real estate holdings, and has sold several for as little as $1 with insufficient information about the economic benefits of the transfer compared to the fair market value of the property, a new audit from State Comptroller Thomas P. DiNapoli found.

“ESD has to be more transparent about the real estate transactions it makes,” DiNapoli said. “That should start with an accurate accounting of its real estate portfolio and better disclosure explaining the economic benefits to New York’s taxpayers for sales of properties below their fair market value.”

ESD is a state public authority empowered to promote economic development, business investment and job creation in New York. The Public Authorities Law (PAL) requires it to publish, at least annually, a report listing all real property it holds and full descriptions of properties that were disposed of. PAL also requires public authorities to dispose of properties for fair market value, with exceptions. When proposing below-market transfers, authorities must provide the following information to their boards and the public: a description of the property; an appraisal of the fair market value of the property; a description of the purpose of the transfer; and a reasonable statement of the kind and amount of the benefit to the public resulting from the transfer.

DiNapoli’s audit found that ESD did not meet PAL requirements and only published a detailed report on its real estate portfolio in December 2022 after the current audit began. Before that report was published, ESD had provided auditors with five inaccurate or incomplete versions of its property portfolio. Those repeated inaccuracies raise concerns that the published report may still not correctly account for ESD’s holdings or their disposal.

ESD reported that as of June 2023, it owned 130 properties and that 71 (55%) are vacant. Three of the vacant properties are former correctional facilities in the New York City area (Downstate, Bayview, and Lincoln). ESD identified those properties as having potential for conversion to housing (including affordable housing) and issued requests for proposals for them. Another 28 vacant properties are in and around Niagara Falls and are owned by ESD’s subsidiary, the USA Niagara Development Corporation (USAN). Only one of these is reported by ESD to have definitive development plans.

USAN purchased properties as part of a strategic land acquisition program funded through the second phase of the state’s Buffalo Billion initiative, including 31 properties acquired for the fair market value of $14.7 million in Niagara Falls. USAN created a plan to develop them into new mixed-use properties.

Auditors found that from April 2019 to May 2023, ESD disposed of 14 properties, including four that were sold at or above their market value and 10 that were sold or transferred below their market value. While these 10 property transactions were generally in compliance with PAL requirements, the seven that were disposed of by USAN did not include detailed information as to the anticipated economic benefits of the projects compared to the value received and the fair market value. As of June 2023, USAN had disposed of seven properties for a total of only $3 after purchasing them for $1.36 million.

For each of these disposals, USAN presented information that complied with the minimum PAL requirements to its board for approval. However, the information lacked any detail, beyond broad generalizations about new developments, to allow for an effective evaluation of the transactions by the board prior to their approval. For example, the expected benefits of the projects included job creation, but failed to provide any specific information on the number or type of jobs that would result from the projects. The information also included vague statements, such as “new development” and “continuation of tourism-related economic and recreational activity,” with limited or no details.

DiNapoli’s audit recommended that ESD take steps to ensure the accuracy of its reports on its real estate portfolio and its disposal of properties, and that it provide sufficiently detailed information for proposed transfers of properties, especially those below fair market value.

In response to the audit’s preliminary findings, ESD officials stated they established new management of its real estate holdings and said it initiated quarterly meetings regarding the properties and their disposition.

Audit

Empire State Development: Real Property Portfolio

MAYOR ADAMS ISSUES ORDER REQUIRING CITY AGENCIES TO REVIEW CITY OWNED AND CONTROLLED LAND FOR POTENTIAL HOUSING DEVELOPMENT SITES

 

Part of Adams Administration’s Pledge to Use Every Possible Tool to Create More Affordable Housing and Deliver 500,000 New Housing Units by 2032

New York City Mayor Eric Adams today announced the issuance of executive order 43 requiring city agencies to review their city owned and controlled land for potential housing development sites. As New York City faces a generational affordable housing crisis with just a 1.4 percent rental vacancy rate, the Adams administration is proposing bold, forward-thinking solutions and using every possible tool available to deliver the affordable housing that New Yorkers need. The executive order will help support the Adams administration’s bold “moonshot” goal of building 500,000 new homes by 2032.

 

“If there’s any land within the city’s control that has even the remotest potential to develop affordable housing, our administration will take action,” said Mayor Adams. “To solve a generational affordable housing crisis, we must bring new innovative ideas to the table and activate all city agencies, whether they are directly involved in creating housing or not, to help deliver for New Yorkers. Today’s executive order is one of the many ways we will continue to exhaust every option to meet this crisis head on and fulfil our pledge of building 500,000 new housing units by 2032.”

 

“Today, we take a significant step forward in our mission to tackle New York City’s housing crisis head-on,” said First Deputy Mayor Sheena Wright. “By directing city agencies to review and assess all city-owned and controlled land for potential housing development, we are unlocking new opportunities to build more affordable housing where they are needed most. This is a crucial component of our broader strategy to deliver 500,000 new housing units by 2032 and to ensure that every New Yorker has access to safe, affordable housing.”

 

“Today, this administration doubles down on its commitment to address the city’s historically low 1.4 percent vacancy rate and use every tool in our toolkit to deliver the housing New Yorkers deserve,” said Deputy Mayor for Housing, Economic Development, and Workforce Maria Torres-Springer. “Building off our ‘City of Yes for Housing Opportunity’ proposal and wins in Albany to increase housing production, this whole of government response will allow us to develop underutilized land. I’m grateful for every agency doing their part.”

 

“The mayor’s executive action announced today will add to our administration’s short-, medium-, and long-term strategies to tackle the city’s housing issues,” said Deputy Mayor for Health and Human Services Anne Williams-Isom. “We’re helping more people than ever access CityFHEPS vouchers, streamlining our regulatory architecture to help build a little more housing in every borough, and, with this executive order, evaluating all sites owned by the city for potential inclusion in our affordable housing efforts. Ultimately, every individual, family, and child deserves a permanent home and this administration will use every tool to make that goal a reality.”

 

Effective immediately, the executive order establishes the City Housing Activation Task Force, with representatives from mayoral agencies and other public entities. The task force will review land under the ownership and control of the city to identify potential sites for housing development, and develop guidelines to ensure agency policies promote housing production. All locations that can be used to further housing production or on adjacent or nearby sites without disruption to critical municipal operations will be considered.

 

“As our city faces a critical affordable housing shortage, we are proud to be part of this innovative, all-of-city approach to tackling the problem,” said New York City Department of Citywide Administrative Services Commissioner Louis A. Molina. “Through an intensive review of city-owned and controlled land, we’re committed to leveraging every asset at our disposal to contribute to this ambitious goal of 500,000 new homes by 2032 and support this bold vision to ensure that every New Yorker has access to affordable housing.”

 

“Housing policy and education policy are closely intertwined,” said New York City Public Schools Chancellor David C. Banks. “Today’s announcement is a significant step toward making our city affordable for all New Yorkers, including the next generation. We want families to raise their children in our city and send them to New York City Public Schools, and this executive order helps us work toward that goal.”

 

“In the midst of a profound affordable housing crisis, we applaud this executive order from Mayor Adams as the administration leaves no stone unturned in its efforts to develop new housing and lower costs for New Yorkers,” said New York City Department of Environmental Protection (DEP) Commissioner Rohit T. Aggarwala. “DEP has already successfully worked with our partners at HPD to develop housing and we will continue to do so under this direction from Mayor Adams.”

 

“Mayor Eric Adams’ new executive order is an important step in addressing New York City's affordable housing crisis,” said New York City Department of Parks and Recreation (NYC Parks) Commissioner Sue Donoghue. “This effort ensures that we can carefully balance the need for housing with the thoughtful use of the valuable facilities under NYC Parks’ jurisdiction. By evaluating those park facilities that may support housing development, without compromising green spaces, we can advance Mayor Adams’ ambitious goal of building 500,000 new homes by 2032 while maintaining the quality of life for all New Yorkers.”

 

“The ‘City of Yes’ calls for a little more housing in every single neighborhood, and every single neighborhood is exactly where the New York City Department of Sanitation operates,” said New York City Department of Sanitation Commissioner Jessica Tisch. “The Adams administration is innovating around the housing crisis, and the Department of Sanitation will begin its review immediately.”

 

“Developing new affordable housing is critical to making our city more livable for New Yorkers,” said New York City Department of Transportation Commissioner Ydanis Rodriguez. “We look forward to participating in this review and thank Mayor Adams and the administration for taking every step possible to deliver new housing while balancing the city’s critical operations.”

 

“The Adams Administration has made it clear that we need to leave no stone unturned when it comes to building more housing, and this new executive order will allow for creative solutions to addressing the housing crisis,” said New York City Economic Development Corporation (NYCEDC) President and CEO Andrew Kimball. “At NYCEDC, we remain committed to working alongside our city agency partners and the private sector to build more housing throughout New York City and make this city an even better place to live, work, play, and learn.”

 

“Adding to New York City's affordable housing stock is absolutely necessary to combat the current housing crisis,” said New York City Housing Authority (NYCHA) Chief Executive Officer Lisa Bova-Hiatt. “It is critical that we think outside the box and utilize every tool at our disposal in addressing the shortage in housing options, just as NYCHA is using the Public Housing Preservation Trust and PACT program to renovate properties across our portfolio in the face of a nearly $80 billion capital need. NYCHA commends Mayor Adams and his administration for looking inward for meaningful solutions to this challenge, and reviewing city owned land in an effort to build more affordable housing for New Yorkers in need.”

 

“Safe, affordable, and accessible housing is a critical part of the foundation for better mental and physical health,” said New York City Department of Health and Mental Hygiene Commissioner Dr. Ashwin Vasan. “Ensuring healthier, longer lives for New Yorkers demands we consider any and all available resources that can support more high-quality and equitably-distributed housing.”

 

“Housing is essential to good health,” said NYC Health + Hospitals President and CEO Mitchell Katz, MD. “NYC Health + Hospitals’ Housing for Health initiative will create over 650 new affordable homes on hospital land. We are grateful to Mayor Adams for expanding this effort to all city-owned land to help even more New Yorkers find home.”

 

“Public safety is made possible by many factors, including safe, affordable housing,” said Fire Department of the City of New York (FDNY) Commissioner Robert Tucker. “Creating new locations for potential housing will help enhance the success of our city. FDNY joins Mayor Adams in his mission of exploring all avenues for providing such housing to New Yorkers.”

 

“This administration understands that reinvigorating our economy and making the city more livable requires the same level of creative, intelligent planning that we dedicate to enhancing public safety and improving quality of life for hardworking New Yorkers,” said New York City Police Department Commissioner Edward A. Caban. “Ongoing partnerships with our sister agencies, as well as with all the people we serve, remain essential because every mission — including the quest to create more affordable housing — is a shared responsibility.”

 

“Mayor Adams’ executive order is a bold, transformative decision that will streamline our ongoing efforts to build more affordable housing in every neighborhood,” said New York City Department of Housing Preservation and Development (HPD) Commissioner Adolfo Carrion, Jr. “HPD stands ready to work collaboratively with all government agencies to unlock the housing opportunities and leverage the valuable resources of city-owned land as we work to solve the housing crisis."

 

"'City of Yes for Housing Opportunity' is all about ensuring that every neighborhood helps solve our housing crisis, and we are ready to roll up our sleeves and work with our sister agencies to build new income-restricted, affordable housing on city-owned land,” said New York City Department of City Planning Director Dan Garodnick. “Initiatives like this demonstrate our commitment to turning the tide on our housing shortage and building the homes that New Yorkers need.”

 

Since the start of his administration, Mayor Adams has made record investments towards creating and preserving affordable housing. Mayor Adams announced back-to-back record breaking years in both creating and connecting New Yorkers to affordable housing. In June, the Adams administration delivered an on-time, balanced, and fiscally-responsible $112.4 billion Fiscal Year (FY) 2025 Adopted Budget that invests $2 billion in capital funds across FY25 and FY26 to HPD and NYCHA’s capital budgets. In total, the Adams administration has committed a record $26 billion in housing capital in the current 10-year plan as the city faces a general housing crisis. Last month, Mayor Adams and others announced a landmark $500 million investment from the Battery Park City Authority’s Joint Purpose Fund to build and maintain affordable housing. This spring, thanks to Mayor Adams’ vision and leadership, the city celebrated the largest 100 percent affordable housing project in 40 years with the Willets Point Transformation. 

 

Further, the Adams administration is using every tool available to address the city’s housing crisis. Earlier this month, Mayor Adams announced multiple new tools, including a $4 million state grant, to help New York City homeowners create accessory dwelling units (ADUs) that will not only help them to afford to remain in the communities they call home, but also to build generational wealth for families. 

 

This year, Mayor Adams and members of the administration successfully advocated for new tools in the 2024 New York state budget that will spur the creation of urgently needed housing. These include a new tax incentive for multifamily rental construction, a tax incentive program to encourage office conversions to create more affordable units, lifting the arbitrary “floor-to-area ratio” cap that held back affordable housing production in certain high-demand areas of the city, and the ability to create a pilot program to legalize and make safe basement apartments.  

 

Under Mayor Adams’ leadership, the city is fulfilling its 2024 State of the City commitment to build more affordable housing, including staying ahead of schedule on advancing two dozen affordable housing projects on city-owned land this year through the “24 in ‘24” initiative, reopening the Section 8 Housing Choice Voucher program waitlist after being closed to general applications for nearly 15 years, and creating the Tenant Protection Cabinet to coordinate across agencies to better serve tenants. The city has also taken several steps to cut red tape and speed up the delivery of much-needed housing, including through the “Green Fast Track for Housing,” a streamlined environmental review process for qualifying small- and medium-sized housing projects, the “Office Conversion Accelerator,” an interagency effort to guide buildings that wish to convert through city bureaucracy, and other initiatives of the Building and Land Use Approval Streamlining Taskforce. 

Justice Department Finds Kentucky Unnecessarily Institutionalizes Louisville Residents with Serious Mental Illness in Psychiatric Hospitals

 

The Justice Department announced that it has reasonable cause to believe that the Commonwealth of Kentucky (Kentucky) is violating the Americans with Disabilities Act (ADA) in the Louisville/Jefferson County Metro area by unnecessarily segregating adults with serious mental illness in psychiatric hospitals, rather than providing care in integrated community settings.

“People with serious mental illnesses in Louisville are caught in an unacceptable cycle of repeated psychiatric hospitalizations because they cannot access community-based care,” said Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division. “We thank Kentucky for its full cooperation with our investigation, including readily providing access to staff, documents, and data. We also recognize that Kentucky has already begun taking important steps to expand access to a range of key services, including crisis response services; medication management supports; and housing and employment supports. Our goal is to work collaboratively with Kentucky so that it implements the right community-based mental health services and complies with the ADA. The Justice Department will continue to safeguard the rights of people with disabilities to ensure that they can fully participate in and contribute to their communities.”

“These findings demonstrate that the Commonwealth of Kentucky fails to provide adequate community-based mental health services for individuals with serious mental illness in the Louisville Metro area,” said U.S. Attorney Michael A. Bennett for the Western District of Kentucky. “Beyond the violations, however, these findings are also about recognizing the dignity and potential of every individual who has mental illness.”

The department’s investigation found Kentucky fails to provide access to community-based mental health services for many people with serious mental illness who need them, including services such as: mobile crisis response, crisis stabilization and crisis respite, case management, Assertive Community Treatment, Permanent Supportive Housing, supported employment and peer support. Instead, Kentucky relies unnecessarily on psychiatric hospitals in violation of the ADA. Each year, thousands of people are admitted to psychiatric hospitals in Louisville, and more than a thousand people experience multiple admissions to these restrictive and often traumatizing settings. With the right community-based services, many of these hospitalizations could be prevented. Kentucky can remedy this violation by expanding community-based services and implementing processes to ensure that individuals can receive those services.

The lack of community-based services has also left law enforcement as routine responders to mental health crises, contributing to avoidable law enforcement encounters and incarceration.

Deficiencies in Louisville Metro Government’s emergency response system also contribute to these outcomes. In a separate investigation, the Justice Department concluded, in March 2023, that the Louisville Metro Government and Louisville Metro Police Department violated the ADA by subjecting people with behavioral health disabilities to an unnecessary police response. The department and Louisville are currently negotiating a consent decree to resolve these and other issues.

Individuals with information relevant to this matter can contact the department by emailing Community.Kentucky@usdoj.gov.

Additional information about the Civil Rights Division of the Justice Department is available at www.justice.gov/crt/rights-persons-disabilities and www.ada.gov.

Additional information about the U.S. Attorney’s Office for the Western District of Kentucky’s Civil Rights Program is available at www.justice.gov/usao-wdky/civil-rights-program.

U.S. Attorney Announces $600,000 False Claims Act Settlement With Medical Practice And Its Owners For Improper Medicare And Medicaid Billing

 

Orange Medical Care Admits Submitting Claims for Payment Where Services Were Rendered by Nurse Practitioners or Physician Assistants Not Enrolled with Medicare and Medicaid and Doctors Had No Personal Involvement or Supervision in Treatment

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 Department of Health and Human Services, Office of Inspector General (“HHS-OIG”), announced that the United States has filed and simultaneously settled a civil fraud lawsuit against ORANGE MEDICAL CARE, P.C. (“ORANGE MEDICAL”) and its owners, ASHIKKUMAR A. RAVAL and MANISH A. RAVAL (together, the “RAVALS” and with ORANGE MEDICAL, the “Defendants”). 

The RAVALS are physicians who own and operate ORANGE MEDICAL, a family medicine practice that provides primary care services to patients in Newburgh, New York.  The settlement resolves claims that ORANGE MEDICAL and the RAVALS fraudulently billed Medicare and Medicaid by submitting claims for primary care services that were not rendered or supervised by the physician identified in the claim for payment and had, in fact, been rendered by non-credentialed providers. 

Under the settlement approved Saturday, August 17, 2024, by U.S. District Judge Paul Gardephe, ORANGE MEDICAL and the RAVALS will pay $268,800 to the U.S. and have admitted and accepted responsibility for conduct alleged in the Complaint as further described below.  ORANGE MEDICAL and the RAVALS have also agreed to pay $331,200 to the State of New York to resolve the State of New York’s claims, for a total recovery of $600,000.  The settlement amount is based on the Office’s and the State of New York’s assessment of ORANGE MEDICAL’s and the RAVALS’ ability to pay based on the financial information they provided.  The parties have also executed a Consent Judgment in the amount of $1,646,835, which may be enforced if the Defendants do not make the payments required under the settlement agreement. 

U.S. Attorney Damian Williams said: “Orange Medical and the Ravals submitted false claims to Medicare and Medicaid, failing to accurately identify who was involved in their patients’ treatment.  This Office is committed to ensuring that individuals and entities billing federal health care programs do so in an honest manner.” 

HHS-OIG Special Agent in Charge Naomi Gruchacz said: “As a part of this settlement, the defendants acknowledged that Orange Medical obtained funds from the Medicare and Medicaid programs for claims that did not comply with those programs’ billing rules.  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: 

From November 2006 through December 2022, ORANGE MEDICAL and the RAVALS submitted claims to Medicare and Medicaid that listed one of the RAVALS as the rendering provider even though the services had been rendered by non-credentialed providers, without the direct supervision of the RAVALS.  On many such occasions, the RAVALS were traveling outside of the U.S. at the time the patient received the treatment.

As part of the settlement, ORANGE MEDICAL and the RAVALS admitted and accepted responsibility for certain conduct alleged by the U.S., including the following:

• ORANGE MEDICAL and the RAVALS understood that they were prohibited by relevant federal healthcare program rules from submitting claims for reimbursement to Medicaid in the State of New York for primary care services if the physician listed as the rendering provider on the claim for reimbursement had not actually rendered the services and, with respect to Medicare, if the services were not, at minimum, rendered “incident to” medical services actually provided by the physician listed on the claim. ORANGE MEDICAL and the RAVALS further understood that, in order to receive reimbursement from Medicaid, a healthcare provider must be enrolled as a provider in the Medicare or Medicaid program at the time the services are rendered.

• Nonetheless, ORANGE MEDICAL and the RAVALS frequently submitted claims to Medicaid and Medicare for primary care services that listed Manish Raval or Ashikkumar Raval as the rendering provider, even though they had not rendered the services for which reimbursement had been sought.  In fact, the services had been performed by providers who had not enrolled in the Medicare or Medicaid programs.  Further, the providers that had rendered the services were often not physicians, but instead nurse practitioners or physician assistants.  On many such occasions, the RAVALS had no personal involvement or supervision in the treatment of the patient and were traveling outside of the U.S. at the time that the services were furnished.
• ORANGE MEDICAL and the RAVALS also altered patient records to reflect falsely that one of the RAVALS had seen a patient when, in fact, the patient had been seen by a different provider. 

• As a result of the conduct described above, ORANGE MEDICAL received reimbursements from Medicare and Medicaid for primary care claims that did not comply with those programs’ billing rules.

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 praised the outstanding investigative work of HHS-OIG, and he thanked the Medicaid Fraud Control Unit at the New York State Attorney General’s Office for its extensive collaboration in the investigation and resolution of this case.