Monday, December 21, 2020

Governor Cuomo Announces British Airways and Delta Airlines Agree to Test All Passengers Before Entering New York State, and COVID-19 Indicators DECEMBER 21, 2020

 

Asks Virgin Atlantic to Join British Airways and Delta Airlines in Voluntarily Testing Passengers Before Boarding Flights to New York

6,331 Patient Hospitalizations Statewide 

1,095 Patients in the ICU; 613 Intubated 

Statewide Positivity Rate is 5.75%

109 COVID-19 Deaths in New York State Yesterday

 Governor Andrew M. Cuomo today announced that in the wake of a new, highly contagious variant of the COVID-19 virus found in the United Kingdom, British Airways and Delta Airlines have voluntarily agreed to require a COVID-19 test before allowing passengers to board planes traveling from the United Kingdom to New York. With this move, New York joins the list of 120 countries with a similar requirement on flights from the U.K. The Governor has asked Virgin Atlantic, the other airline that runs flights from the U.K. to New York, to do the same. The Governor is also continuing to call on the federal government to impose enhanced travel restrictions, as 120 other countries have done, to avoid the same grave mistakes of the spring where the virus entered New York from Europe with no warning.

"When you do not require flights from the U.K to be tested, you are allowing thousands of U.K. passengers to arrive here every day and based on New York's experience in the spring, I believe this new, highly contagious strain of COVID-19 is already here," Governor Cuomo said. "This is another disaster waiting to happen and all efforts must be placed into averting another crisis. Now, it's on the federal government to do its job, correct the wrongs of the past and take swift action to impose enhanced travel restrictions just as 120 other countries have done." 

Today's data is summarized briefly below:

  • Test Results Reported - 156,510
  • Tested Positive - 9,007
  • Percent Positive - 5.75%
  • Patient Hospitalization - 6,331 (+146)
  • Patients Newly Admitted - 700
  • Hospital Counties - 55
  • Number ICU - 1,095 (+50)
  • Number ICU with Intubation - 613 (+13)
  • Total Discharges - 95,779 (+472)
  • Deaths - 109
  • Total Deaths - 28,709

Acting Manhattan U.S. Attorney Announces Settlement With Substance Abuse Treatment Center And Its Owner For Enrolling Patients Through Kickbacks And Using Falsified Patient Admissions Forms

 

Addiction Care Interventions Chemical Dependency Treatment Centers and Owner Steven Yohay Agree to Pay $6 Million and Admit Misconduct; Yohay to be Excluded from Participating in Federal Healthcare Programs and Must Divest Ownership of ACI

 Audrey Strauss, the Acting 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, Office of Inspector General (“HHS-OIG”), announced today a $6 million settlement of a civil healthcare fraud lawsuit against A.R.E.B.A.-CASRIEL, Inc. d/b/a ADDICTION CARE INTERVENTIONS CHEMICAL DEPENDENCY TREATMENT CENTERS (“ACI”), a substance abuse treatment provider in New York City, and STEVEN YOHAY, ACI’s primary owner and former CEO.  This settlement resolves allegations that ACI and YOHAY provided kickbacks and engaged in fraudulent conduct in connection with the enrollment of Medicaid beneficiaries into ACI’s inpatient treatment program.  Specifically, the Government’s complaint alleges that ACI’s drivers targeted homeless individuals and offered them food, cash, money to purchase drugs, and/or alcohol in order to induce them to enroll in ACI’s inpatient treatment program.  The lawsuit further alleges that ACI paid an individual a kickback in the form of a sham job for which she was compensated more than $75,000 to induce her to refer patients to ACI programs.  The lawsuit also alleges that ACI used medical admissions forms containing photocopied physician signatures to make it appear that new patients had been evaluated by a qualified health care professional as required by law. 

Under the settlement approved December 17 by U.S. District Judge Vernon S. Broderick, ACI agreed to pay $3 million, and YOHAY personally agreed to pay an additional $3 million.  Of the $6 million total, $2.4 million is being paid to the United States and the remaining amount is being paid to the State of New York.  The amount paid by ACI is based on the Office’s assessment of ACI’s ability to pay based on the financial information it provided. 

ACI and YOHAY admitted and accepted responsibility for conduct alleged in the Government’s complaint as further described below.  YOHAY also agreed to divest ownership and control of ACI, and ACI agreed to implement procedures designed to ensure that its patient transportation services comply with legal requirements.  In addition, YOHAY has entered into a Voluntary Exclusion Agreement with HHS-OIG, under which he will be excluded from participation in Medicaid and other federal healthcare programs for a period of 15 years. 

Acting U.S. Attorney Audrey Strass said:  “ACI and Steven Yohay engaged in unscrupulous and illegal practices – including hiring drivers to scour the streets for potential patients – to fill the beds at their facilities and maximize the payments they received from Medicaid.  This Office will continue to act aggressively to ensure that substance abuse treatment providers and those who run them are held accountable when they cheat the system to fraudulently obtain federal health care funds.” 

HHS-OIG Special Agent in Charge Scott J. Lampert said:  “ACI and Stephen Yohay operated a fraud scheme that targeted some of the most vulnerable people in our society and diverted valuable Medicaid funds that millions of New Yorkers depend on for vital services.  This settlement should send a message that this behavior will not be tolerated, and we will hold those that attempt to steal from federal health care programs accountable for their actions.” 

The Complaint filed in Manhattan federal court alleges three forms of illegal conduct:

First, from January 2014 to December 2019, ACI and YOHAY improperly induced Medicaid beneficiaries to be admitted into ACI’s inpatient treatment program by employing drivers, who were compensated based in part on the volume of patients they recruited for admission into the treatment program, to solicit and transport potential new patients to ACI’s facility.  The drivers routinely targeted homeless individuals and sometimes offered them food, cash, money to purchase drugs, and/or alcohol to persuade them to enroll in the program.  The drivers were expected to pick up a certain number of potential patients in order to be eligible for a pay raise.  Most of the new enrollments into ACI’s inpatient program resulted from the ACI drivers’ solicitation efforts.

Second, in October 2012, ACI created a sham part-time Spanish “translator” position so that it could employ an individual whose real job was primarily to provide a stream of patient referrals.  The individual was simultaneously employed at an organization that refers individuals to substance abuse clinics.  ACI placed the individual on its payroll to receive referrals to its treatment programs.  The individual translated only a few times, even though she remained on the payroll until March 2017 and was paid more than $75,000.

Third, from July 2012 through July 2013, ACI admitted Medicaid patients into its inpatient treatment program who were not evaluated by a qualified health care professional to determine the appropriate level of care, as required by applicable state law.  ACI staff fraudulently created medical forms containing a photocopied physician’s signature to make it appear that a physician had conducted the evaluation.  The falsified forms were used to support claims for reimbursement, for the indicated level of care, from Medicaid.

In the settlement agreement, ACI and YOHAY admit, acknowledge, and accept responsibility for the following conduct:

Role of Drivers:

  • From January 2014 to December 2019, ACI employed drivers who were involved in identifying, recruiting, and providing transportation services for new patients who were admitted into ACI’s inpatient treatment program.  During the relevant period, ACI employed approximately five to 10 drivers at any given time.
  • ACI drivers rode in unmarked vehicles and picked up individuals, who were often homeless, from a wide range of locations, including parks, train stations, shelters, hospitals, under bridges, and from other substance abuse treatment centers. 
  • ACI financially incentivized its drivers to bring in new patients.  ACI paid the driver who brought in the most new patients during the relevant period an annual salary of more than $200,000, as well as a bonus consisting of thousands of dollars.
  • ACI’s management, including YOHAY, were made aware of allegations that certain ACI drivers gave some potential new patients money, drugs, and/or alcohol to induce them to enroll in ACI’s inpatient program.  However, ACI and YOHAY failed to investigate these allegations adequately or take appropriate corrective actions in response.

Use of Paid Employee to Make Patient Referrals:

  • In October 2012, ACI created a part-time “translator” position and hired an individual to fill the position who was simultaneously employed at an organization that refers individuals to substance abuse clinics, like ACI, for treatment as an alternative to incarceration. 
  • Throughout the course of her employment with ACI, the individual provided ACI managers with lists of individuals who were being referred by the organization to ACI for substance abuse services. 
  • Although the individual was hired to be a “translator,” she rarely was asked by ACI to provide any translation services.  The individual translated for ACI only a few times in 2012, and thereafter, she did not perform any translation services for ACI but continued to be paid by ACI until 2017.
     

Medical Assessments Not Completed by Physicians:

  • From July 2012 through July 2013, ACI admitted certain patients into its inpatient program who were not properly evaluated by a qualified health professional as required. 
  • During the relevant period, ACI admissions staff, who were not qualified health professionals, conducted the patient assessment and completed the admissions criteria forms.  These forms, which were part of a patient’s file used to support claims for reimbursement from Medicaid, contained a photocopy of a physician’s signature.

In connection with the filing of the lawsuit and settlement, the Government joined a private whistleblower lawsuit that had previously been filed under seal pursuant to the False Claims Act.

Ms. Strauss thanked HHS-OIG, the Medicaid Fraud Control Unit of the New York State Attorney General’s Office, and the New York State Office of Addiction Services and Supports for their assistance with the case. 

Governor Cuomo Announces New York Has Administered 38,000 Doses of COVID-19 Vaccine - Highest Total in the Nation

 

346,000 Doses of Moderna Vaccine and 120,000 Additional Doses of Pfizer Vaccine Arriving this Week

New York Launches Vaccine Equity Task Force Chaired by Secretary of State Rosado, Attorney General James, National Urban League President & CEO Marc Morial, and Healthfirst President & CEO Pat Wang

New York Developing Community Vaccination Kits - Self-Contained Units Which Include All Items Necessary for Setting Up a Vaccination Site, Will Be Used Particularly in Health Care Deserts 

Federal Program to Vaccinate Nursing Home Residents and Staff Began Today

 Governor Andrew M. Cuomo today announced more than 38,000 vaccine doses have been administered in New York State as of Monday morning - the highest reported total in the nation thus far. 

Bolstering this effort, the first 346,200 doses of the Moderna vaccine are expected to begin arriving in New York today, with an additional 120,000 doses of the Pfizer vaccine expected later this week.

The Governor also announced the launch of New York's Vaccine Equity Task Force chaired by Secretary of State Rossana Rosado, Attorney General Letitia James, National Urban League President & CEO Marc Morial, and Healthfirst President & CEO Pat Wang. The Task Force will work to ensure vulnerable and underserved communities are not left behind by breaking down the barriers to vaccination and ensuring there is equitable distribution of the vaccine across the state

Governor Cuomo also announced that New York is developing Community Vaccination Kits to provide communities, particularly those located within health care deserts, with the supplies and resources needed for standing up vaccination sites.

The Governor also announced that a federal program to vaccinate nursing home residents and staff began today in New York State and is expected to vaccinate residents and staff at 618 facilities across the state, with first doses administered starting today and over the next two weeks. 

"We're now talking about who's getting vaccinated, and let me be clear: there is no politics in the vaccination process," Governor Cuomo said. "We went through this with COVID testing, with big shots, celebrities, and affluent people getting to the front of the line. This preferential treatment in COVID testing undermines our entire sense of democracy, equality and a government that works for all people. And in this time of COVID where we've seen gross injustices, politics has nothing to do with it. There's no governor, no county executive, and no mayor who controls the process, and anyone who says that is not telling the truth or violating the law. This is entirely done by medical professionals and our hospitals have already vaccinated more people than any state in the nation." 

Mayor De Blasio Holds his Moderated Media Availability


EDITOR'S NOTE:

Day 35 of trying to ask the mayor a question, and 35 days of not being called on by the moderator as other reporters get called on, and called on, and called on.

Mayor Bill de Blasio: Good morning, everybody. Well, today is something we don't look forward to, it's the first day of winter officially on the calendar and that makes it the shortest day of the year in terms of how much light we're going to have. So, it's the shortest day of the longest year we have ever been through 2020, but today is also a reminder 2020 is almost over, thank God, and we know that every day from this point on, it’ll get a little lighter in every sense. So that's the good news, we're getting ready for next year, we're getting ready for much better things ahead. But let me just comment upfront for a moment on something that isn't good news, and that's what's come out of Washington DC. I can't even call what the Congress has agreed to as stimulus. It's not a stimulus. It's a short-term survival plan. I'll give you that. There's some aid there that I certainly value for everyday New Yorkers, everyday Americans. It's something, but it's months late. It's billions short. It has no direct aid to localities. There's so much missing you can't call it a stimulus. A stimulus would actually stimulate the economy, help us move forward, help us recover. This doesn't do it. This barely helps us to tread water and from the point of view of New York City, and I know New York State's in the same boat, if we don't get substantial help, we cannot provide the services our people need. We can't keep the good people who serve our people employed. We cannot recover. So, if this is what Washington thinks is a stimulus, they sure don't understand what the people of New York need and people all over the country need. I have a lot of faith that President Joe Biden will make it right, and we're going to need something much bigger, much stronger going forward, but let's not kid ourselves. Something that doesn't help us get back on our feet just can't be called a stimulus.  

 

Now that was bad news, but let's turn to good news now. Let's turn to the things that we can do because we do take care of our own people here in New York City, and we are now, thank God, dealing with a good reality, we're in a new era because the vaccine is here and everywhere I go in New York City I talk to people about the fact that the vaccine is here and it's really lifting spirits and has given people hope. So now it's time to focus on how we turn the page on the coronavirus, how we make 2021 a much better year, and that begins with what we need to do for our children. For so many of us, this is our heart, how we help our children, how we protect them, how we help them move forward, and our kids have been through so much. Let’s remember, every adult out there listening, you've been through so much in this horrible year, 2020, but our kids are going through so much in every sense, and it's harder for them to make sense of. They're going through trauma, they're going through a lot of pain and they need our help. And we have to make sure that help reaches every child, and we particularly need to focus on kids in the communities hardest hit by COVID. We always talk about those 27 neighborhoods in New York City that bore the brunt of the COVID crisis. African-American neighborhoods, Latino neighborhoods, Asian neighborhoods that really got hit so hard and all those disparities that came out. We talk about that to focus our energies, focus our attention on making sure we do what the people in those neighborhoods need and that they get the priority going forward. 

We've got to right the wrong by making them the priority.  

 

So, that's what we will be doing as we go into 2021 as we go into the next school year, we talked over the last couple of weeks about our 2021 Student Achievement Plan, how we're going to close the COVID achievement gap, and we're going to do that for every child. We're going to particularly focus on those neighborhoods that have been hurting the most and the kids who need it the most. You know, I will tell you something pretty unusual that happened last few days, something I said a few days ago when we're talking about how we address fairness and equity in our schools, and we talked about how we create more diversity in our schools, how we address a segregated past and move forward, how we create fairness and justice. We talked about that on Friday, and Fox News apparently was very interested in that and they quoted one of the sentences that I said. I said that we needed to recognize if we were going to address all this structural inequality, structural racism, we would actually have to do things differently. And so here's the quote from Fox News summarizing, they said NYC Mayor sees the redistribution of wealth as an important factor toward ending structural racism education. I'm going to say it one more time in case Fox News is watching again, NYC Mayor sees the redistribution of wealth as an important factor towards ending structural racism in education. Exactly right. I don't get to say it very often, but Fox News got it exactly right. Amen. We are going to fight structural racism through redistribution. So Fox News, congratulations, fair and balanced coverage right there. In fact, if we think we're going to deal with structural racism and segregation without redistributing wealth, we're kidding ourselves.  

 

We got to be real about nothing changes unless you put the resources behind it and that's what we're doing. We're going to make sure our kids have the support they need now, and especially in the new school year, when everyone comes back into the school buildings and that doesn't just mean the academic support, it means the emotional support as well. It means making sure the social factor is taken account of as well, social and emotional learning. That's something that a Chancellor's focused on. That's something the First Lady is focused on, but it takes on even more importance as we go into this new school year, September 2021, it'll be different than anything we've ever experienced in our lives. So we have to make sure that we are really looking out for our kids, that we're checking in on them to see what they need and if they need help, we're giving it to them. And this has been an idea that has long been a core notion of Thrive NYC. One of the foundational concepts of Thrive NYC is get their early, help people, particularly young people, early, provide the support, and if you find out there's a problem, you can do something about it. That's what Thrive has been all about. So here to tell you about this really important new initiative for all our public schools and the way it's going to reach all our school kids, the leading champion for providing mental health support to all the people of New York City, the person who brought us Thrive NYC, our First Lady Chirlane McCray. 

 

First Lady Chirlane McCray: Thank you, Bill, and good morning, everyone. I don't know if anyone can be happier than I am today to say we are bringing social, emotional, and academic behavioral screenings to New York City public schools. Yes, finally.   

 

This is a huge moment. Our teams at the Department of Health, Department of Education, Health + Hospitals, and Thrive NYC have worked towards this day for a long time. And if you're a parent who sends your child to a pediatrician every year for a physical, you know, the preventive measures that are taken and peace of mind that comes with a regular checkup, but our nation has never put that same emphasis on engaging the whole child when it comes to education or prevention, when it comes to mental health. That means educators and families don't have as well of an assessment about what our children are doing and what they need. So think of these screenings as an expanded health checkup for students to learn how they are feeling, how they are getting along with friends and at home, even in the best of times, this is a best practice. Now, after COVID-19, it is critical than ever.  

 

So, let me tell you about P.S. 89 in Queens, the borough that was earlier this year was the epicenter of the crisis. Dozens of P.S. 89 students back then reported COVID-19 had sickened or taken the lives of their loved ones. These children had lost grandparents, parents, their parents had lost jobs and they were isolated at home. Every New York City student will carry the experience of this past year in a different way. Some will be processing grief and have trouble focusing. Some will rejoice at being back in the classroom while others will feel uncomfortable. These screenings will help school staff create individual plans to move forward and help educators make sure that no child falls through the cracks. There are no grades, there are no labels or classifications associated with how these questions are asked, there is only learning how adults can offer the best support. We will begin with schools and the neighborhoods hit hardest by this crisis, but we want every student to benefit and we urge a federal stimulus that will help expand this support. Today's announcement, along with our social emotional learning and restorative justice curriculum and community schools reflects a generational shift in education to supporting the whole child socially, emotionally, and academically. New York City is leading the way because we know it's easier and less expensive to grow a healthy child than it is to mend a broken adult. There is no better investment than our young people and when our young people succeed our city succeeds. Thank you. 

 

Mayor: Thank you so much and, Chirlane, I can hear the passion and the joy in your voice. This is a vision that you've had and a lot of other good people have had for a long, long time, and now it will come to fruition starting in September, and we're going to be able to do so much good for so many children. This has been a labor of love for a lot of people. I want to thank our Deputy Chancellor for School, Climate, and Wellness, LaShawn Robinson, who's put her heart and soul into this work and has been one of the architects of so much of what we've done with social emotional learning. Also, someone who's really gotten under the hood and figured out how we could make this work in our schools, day after day, he's a former principal and he's been our Senior Advisor for Education, Brandon Cardet-Hernandez, thank you for the amazing work you've done. I know you truly, truly believe in this approach. Thank you for helping it come to life and I'd like to give you a chance to say a few words about why this is so important, Brandon. 

 

Senior Education Policy Advisor Brandon Cardet-Hernandez: Thank you so much Mayor de Blasio, First Lady McCray and Chancellor Carranza. You know, today is a historic day and one that is truly exciting for all of us educators and parents who understand the inextricable link between social and emotional wellbeing, mental health and academic success. See, New York City educators, we've always understood that our charge is not just to teach content and skills, but to make sure students have the academic, social, and emotional skills and tools that will allow them to thrive in college and in their careers. And to realize that incredible goal, we have to know our students, truly know them, as individuals and as individuals and as scholars, so that we can teach them their strengths and provide the supports in the areas where they need it. And it needs to be said, educators across the city had been doing just that for decades. And as a former New York City public school principal in the South Bronx and in New York City public school teacher, I know firsthand what it's like to have a student who needs additional supports and then grasping for a way to connect them to the care they deserve. I know firsthand the intense work that educators take on, analyzing and reflecting on how our students are doing and then making sure we aren't missing any signs that that might help us do our job better. And, today, we're launching something that'll make that charge, our charge of educating New York City students, the whole student, easier to realize.   

  

In addition to expanding our partnership with H + H, we're launching 27 new community schools and neighborhoods hardest hit by the pandemic and hiring 150 new social workers to support those communities. And equally as exciting, in September, we're going to launch a simple screening tool, a social, emotional, and academic behavioral screener that that allows us to check in on the whole child, and, for some students, connect them to additional supports they need. It's an honor to be here today and to be able to bring these incredible resources to New York City students, families, and educators. Thank you so much.  

  

Mayor: Thank you, Brandon. Thanks for all the great work you did on this initiative. And now, as I turned to the Chancellor, I want to say, when you have a Chancellor who really values this important work, it happens. And from the beginning, Chancellor Carranza has believed that social, emotional learning and a focus on mental health was necessary to reach our kids. That was true before the pandemic, and we did plenty of work on it before, but we've had so many really, really heartfelt conversations about what kids need now and how much greater it is and how we're going to have to do something truly universal to reach every child and support them. So, again, labor of love is the right phrase here. Chancellor, please let us hear from you about why this is so important.  

  

Schools Chancellor Richard Carranza: Thank you, Mr. Mayor. And I want to thank our First Lady McCray, thank you for your passion. Brandon, as always, you bring it right down to the classroom and I want to thank you for that as well. I want to begin today by thanking all of the educators that are out in the field, that have been on the front lines of supporting our students' mental health and emotional wellbeing while also looking after your own families and yourselves as you've done. That they have gone above and beyond by taking the tools of trauma-informed education and social, emotional learning, and integrating them in new creative ways into remote learning and our re-imagined in-person learning. As we've charted our path forward out of COVID-19, we are here to take our students who needed the most first. That means driving support to schools in the 27 communities hardest hit by this pandemic with more critically important supports. This is not new – we're building on the foundations we've built through our Resilient Kids, Safe Schools and Bridge to Schools initiatives that were well underway prior to this global pandemic. Critically, we know community schools work and we in New York City are nationwide leaders in building community schools. We know what happens when schools are built on a foundation of community partnership and they have the resources necessary to address the unique needs of their communities. In community schools, we see higher graduation rates. In community schools, we see improved student achievement and we see decreases in chronic absenteeism and disciplinary incidents. I don't know about you, but that sounds exactly like the kinds of supports our students will need in a post COVID-19 educational environment.   

  

By providing each of these hard-hit communities with additional community schools, we are partnering with our terrific community-based organizations who have done truly incredible work on behalf of our young people during this crisis in community schools and beyond, and investing in the long-term social, emotional academic success of students in these communities, we will do right by our students in our communities. As our First Lady mentioned, by using social emotional screens, we are providing a simple, effective tool for educators in schools to assess the general wellbeing of our students. With a parent's consent, these assessments will be used to target interventions and craft personalized care for individual students, helping them heal and flourish academically. In addition, it may be that once we do these screens the student is just fine and they're okay. That's fine too, but it's always important to know so that we know when to act.  

  

Paired with social, emotional screening, we are going to 150 additional social workers and expand our partnership with Health + Hospitals to provide the direct mental health care to students. This is an addition to the historic investments that have already been made in New York City. Not only does this ensure our students have access to another caring adult during the school day, but these experts will help educators identify and provide targeted intervention when necessary and appropriate. Our goal is to bring these supports city-wide, but to do what we need to do we need federal support. In the meantime, we will continue to double down on our core belief for our students to succeed academically. We must first need to make sure they're okay. Socially and emotionally.    

  

Mayor: Thank you very, very much Chancellor. And, everyone, one more note on education. We announced on Friday that the specialized high school exams were going to be happening in January. Want to remind all parents, all students that registration for those exams begins today. So, you can start registering literally today. The test administration will begin on January 27th. I want to encourage all young people and their parents who think this is the right choice for them to take that exam. This is a chance for everyone. We want to see as much diversity and inclusion in our specialized high schools as possible. So, everyone who's interested sign up today.   

  

Okay. Now, let's turn to the health care front. Obviously, every hour, every day, the fight against COVID continues. And we now have the greatest tool we possibly could have, the vaccine. So, New York City is focused on getting that vaccine to as many people as possible, as quickly as possible. Now, it's a brand-new vaccine. Our health care leaders, our health care workers are getting used to working with it. Obviously, it requires some very careful handling because of the ultra-cold storage, but New York City is moving rapidly to get the vaccine out and get people vaccinated. And, right now, based on the data we've received from the CDC, New York City is vaccinating people basically at twice the national average time. We're basically doing things twice as fast as the national average. In New York City, of the doses we have received, 42.2 percent – as of yesterday, 42.2 percent have been administered. Nationwide, it’s under 20 percent had been administered. We are going to keep speeding that up further and further. Our Vaccine Command Center is leading the way and they will provide regular updates on we're doing through their website, which is now live – nyc.gov/vaccinecommandcenter. So, thank you to everyone at the command center. I know they're working intensely to ensure we get the maximum impact from the vaccine. Right now, in New York City, we've had over 18,000 doses administered as of yesterday, that number again will grow rapidly. And good news – more good news – we have a second vaccine. The Moderna vaccine has been approved and will be shipping into New York City very soon. So, what we're seeing is safe and effective vaccines that are going to change the entire reality and help us turn the situation around. And now, not just one vaccine, but two, and we think more to come after that. So, there is some good news right there.   

  

Now, everyone with the holidays upon us it is another time to remember how careful we have to be. It's great we have the vaccine, and with every passing week, with every passing month, that's going to make more and more impact. But the holidays, unfortunately – we love them, we love our family gatherings, we love seeing our loved ones, but the holidays create a danger too. We saw this over Thanksgiving. We all love gathering, but, unfortunately, despite all the warnings people gathered and in some cases didn't take all the precautions. We saw a spike in the number of cases after Thanksgiving. We're really concerned about Christmas and this whole holiday season – New Years – and this is a time where we really could see an intensive spike and we can't handle another spike, so we need to, for all of us, be careful. Everyone, please, you've got to – you've got to wear those masks, practice social distancing, keep those gathering small, do not travel. It's so important. And that would be true if it were not a new fact that there's a new strain of the virus that's been identified England. Even if it weren't for that, all of these warnings would be true. The new strain makes me even more worried about what might happen and how we have to guard against it. I just need everyone to understand, if we hang on for the next few months, if we do the right thing and we fight back, we can turn the corner on the coronavirus. We can avoid having to put into effect a lot more onerous restrictions – no one wants them. And, look, we're going to need help from the federal government, we're going to need help from the airline industry. It's really, in my view, it's time for a travel ban from Europe, given what we're seeing with this new strain, or, at minimum, a requirement that anyone getting on a plane has proof that they have a negative test if they're coming out of Europe. We need to be aggressive.  

This is a decisive moment. If we get it right now, if we're careful during the holidays and we give time for the vaccine to be distributed, we really turn the corner. So, everyone, we need your full, full participation.    

Now, let me go over today's indicators. Number one, daily number of people admitted to New York City hospitals for suspected COVID-19 – today's report, 184 patients. So, that's below our 200 patient threshold, but not by much, so concerned continually about the situation in our hospitals. Our rate – hospitalization rate, 3.1 – excuse me, it’s 3.1 per 100,000 New Yorkers. That's too high, we want to get under two percent. That rate has continued to grow, and that's a problem. New cases on a seven-day average, combining the cases that we have – 2,802 is today's number. We want to be under 550. It's obvious, that's a very, very high number. We’ve got to bring it down. And then the update on the percentage of New York City residents testing positive, seven-day rolling average, 6.05 percent. We want to get back under five and go well below that. 6.05 percent today, we need to work harder, everyone.    

Acting Manhattan U.S. Attorney Announces $40.5 Million Settlement With Durable Medical Equipment Provider Apria Healthcare For Fraudulent Billing Practices

 

Apria Admits It Continued to Seek Reimbursement from Federal Programs When It Did Not Know If Patients Were Continuing to Use Their Non-Invasive Ventilator Rentals and After It Had Information Indicating That Patients Had Stopped Using Their Ventilators

 Audrey Strauss, the Acting United States Attorney for the Southern District of New York, Scott Lampert, the Special Agent in Charge for the New York Office of the Inspector General of the U.S. Department of Health and Human Services (“HHS-OIG”), Patrick J. Hegarty, Special Agent in Charge of the Northeast Field Office of the U.S. Department of Defense - Office of Inspector General’s Defense Criminal Investigative Service (“DCIS”), and Norbert E. Vint, Deputy Inspector General Performing the Duties of the Inspector General, Office of Personnel Management Office of the Inspector General (“OPM OIG”), announced today a $40.5 million settlement of a fraud lawsuit against Apria Healthcare Group, Inc. and its affiliate, Apria Healthcare LLC (together, “Apria”), a large durable medical equipment (“DME”) provider with approximately 300 branch offices located throughout the United States.  The lawsuit alleges, among other claims, that Apria submitted false claims to federal health programs, including Medicare and Medicaid, seeking reimbursement for the rental of costly non-invasive ventilators (“NIVs”) to program beneficiaries who were not using the NIVs such that the devices were not medically necessary or that involved the improper waiver of patient co-insurance payments.  

Under the settlement, which was approved on December 18 by U.S. District Judge Edgardo Ramos, Apria agreed to pay a total sum of $40.5 million, with $37,632,789.89 being paid to the United States and the remaining amount to be paid to various states.  As part of the settlement, Apria also made extensive factual admissions regarding its conduct.

 Acting U.S. Attorney Audrey Strauss said: “It is critical to the financial integrity of federal health programs like Medicare and Medicaid that reimbursements are made only for medically necessary items and services.  DME providers like Apria have an obligation to ensure that the equipment and devices they rent to patients are medically necessary.  When companies knowingly disregard that obligation to maximize their profits, this Office will hold them accountable for their fraudulent conduct.” 

HHS-OIG Special Agent in Charge Scott J. Lampert said:  “Apria’s conduct compromised the integrity of the Medicare and Medicaid programs, and needlessly increased the financial burden on taxpayers.  Along with our law enforcement partners, HHS-OIG will continue to ensure that those individuals and entities that bill federal health care programs improperly are held accountable for their actions.”

DCIS Special Agent in Charge Patrick J. Hegarty said:  “The Defense Criminal Investigative Service (DCIS) is committed to protecting the integrity of TRICARE, the healthcare system for military members and their families.  Charging TRICARE for DME that was not necessary betrays the public’s trust.  This settlement demonstrates our partnership with HHS-OIG, OPM-OIG and the U.S. Attorney’s Office to investigate fraudulent schemes that impact TRICARE and put its beneficiaries at risk.”

OPM OIG Deputy Inspector General Norbert E. Vint said:  “The OPM OIG is committed to fighting all forms of health care fraud.  As demonstrated by this settlement, providers that exploit federal health care programs by submitting false claims will be held accountable.”

As alleged in the complaint filed by the United States, Apria decided in 2014 to prioritize the expansion of its NIV rental business because health care programs like Medicare paid as much as $1,400 per month to cover NIVs, a type of complex respiratory equipment that can dynamically adjust the pressure level of air delivery.  That expansion, however, came at the cost of Apria’s compliance with the basic medical necessity requirement of federal health programs.  Specifically, while Apria knew that it was responsible for monitoring patients’ utilization of their NIVs and to stop billing when NIVs were no longer being used, it did not have enough staff, or “respiratory therapists,” to conduct such monitoring.  As a result, Apria routinely billed Medicare and other programs when it did not know whether NIVs were still being used by patients and, therefore, remained medically necessary.  Further, even when Apria had information indicating that patients were no longer using their NIVs, it often continued to bill the federal health programs. 

As further alleged, Apria engaged in two other types of improper practices to obtain more NIV orders and higher profits.  First, Apria improperly billed federal health programs for certain NIV rentals that were being used in a setting called PAC mode to provide bi-level pressure support therapy, which was available from a less expensive device called VPAP RAD and did not qualify for reimbursement at the NIV rate.  Second, Apria improperly waived co-pays for a number of Medicare and TRICARE beneficiaries to induce them to rent NIVs.  For example, Apria employees offered to waive co-pays to convince patients to rent NIVs from Apria instead of competitors.  Further, Apria also waived co-pays without making the required individualized assessment of financial need.  As a result of those three widespread improper practices, Apria submitted thousands of false claims to federal health programs for NIV rentals and fraudulently received millions of dollars in reimbursements.

As part of the settlement, Apria admitted, acknowledged, and accepted responsibility for, among others, the following conduct:

NIV Continued Use Conduct

  • Apria relied on the respiratory therapists (“RTs”) in its branches to monitor patients’ usage of their NIV devices.  Further, Apria’s NIV promotional materials indicated that Apria’s RTs would regularly visit NIV patients to assess whether they used their NIV devices in accordance with their physicians’ instructions.
  • The RTs at Apria’s branches, however, often did not conduct regular visits to NIV patients to confirm that patients were using their NIVs as directed by their physicians. A January 2017 internal analysis, for example, found that in December 2016, Apria’s RTs failed to complete more than half of the visits to NIV patients mandated by Apria’s NIV clinical procedures at all three of Apria’s operational zones. 
  • Apria continued to seek payments from federal health programs for NIV rentals each month even though its RTs frequently failed to conduct in-home visits to verify that patients were still using their NIVs.  
  • In addition, when it had information from the RT visits indicating that patients had stopped using their NIVs, Apria often did not take steps to stop seeking payments from federal health programs or to determine if the NIV rentals were still medically necessary.

PAC Mode Conduct

  • In 2015, Apria encouraged its sales staff to actively urge physicians to order the Astral NIVs in PAC mode.  When they urged physicians to order the Astral NIVs in PAC mode, Apria’s salespeople frequently did not tell the physicians that PAC mode therapy was also available through the VPAP RAD at a lower monthly cost.
  • On a number of occasions, this resulted in Apria renting the more expensive Astral NIVs to patients with the PAC mode therapy orders, including patients covered by federal health programs, even though the less expensive VPAP RADs may have met those patients’ medical needs.

Co-Pay Waiver Conduct

  • Managers at a number of Apria’s branches directed salespeople at those branches to routinely discuss the availability of co-pay waivers with NIV patients, including before the patients raised concerns about their ability to make these payments.  In a number of cases, those managers also authorized salespeople to offer co-pay waivers to persuade patients to rent NIVs from Apria instead of other DME suppliers.
  • During the Covered Period, Apria gave full co-pay waivers to hundreds of NIV patients without making an assessment as to whether those patients could have afforded some portion of their co-pay responsibilities.
  • As a result of the admitted conduct, Apria received reimbursements from the federal health programs for some NIV rental claims that did not comply with all of those programs’ billing rules and guidance.

In connection with this settlement, Apria also entered into a Corporate Integrity Agreement with HHS-OIG, which requires Apria to implement board oversight, a claims review process by an Independent Review Organization, and other compliance steps designed to foster adherence to federal health care program requirements and thereby protect the programs.

This settlement arises from a whistleblower case filed by three former Apria employees under the qui tam provisions of the False Claims Act, which allow private persons – known as “relators” – to file civil cases on behalf of the United States and share in the recovery. 

Acting U.S. Attorney Strauss thanked the Washington State Medicaid Fraud Control Unit for its extensive collaboration in the investigation and resolution of this case, and also praised the outstanding investigative work of the HHS-OIG, DCIS, and OPM-OIG.

AG James Secures $6 Million Over False Medicaid Billing Scheme at an Inpatient Drug Treatment Center

 

Former Owner and CEO of Drug Treatment Facility Personally Liable for $3 Million for Defrauding the State, and Also Agrees to a Ban from the Medicaid Program

 New York Attorney General Letitia James today announced an agreement with A.R.E.B.A.-CASRIEL, Inc. d/b/a/ Addiction Care Interventions Chemical Dependency Treatment (ACI) and its majority owner, Steven Yohay, regarding multiple schemes that defrauded the state Medicaid program, as part of a joint state-federal investigation. Filed this past Friday in the United States District Court for the Southern District of New York, ACI and Yohay admitted that they failed to respond to reports of wrongdoing — which the investigation substantiated — that ACI engaged in multiple illegal schemes, including that its employees bribed people experiencing homelessness into getting inpatient treatment there.

“Exploiting individuals who are experiencing homelessness is disgraceful,” said Attorney General James. “My office will use its power to seek out Medicaid providers looking to defraud the Medicaid system and New York state taxpayers. I will not stand idly by while those funds get misused by bad actors who wish to wrongfully collect funds that will be so desperately needed elsewhere.”

ACI admitted to many instances of deceitful and fraudulent behavior, such as: paying an individual for a “no-show” job at ACI, while that person worked as a full-time employee at another organization with the same function as ACI; encouraging “outreach” drivers who regularly bribed potential Medicaid patients into seeking inpatient treatment at ACI, many of whom were experiencing homelessness at the time; and allowing Medicaid patients to enroll in its inpatient treatment program despite not being evaluated by a qualified health care professional, a violation of New York enrollment practices. Instead of the evaluations, ACI used fraudulent signatures from medical providers that were photocopied onto medical forms in order to falsely substantiate an evaluation by a medical provider where none had occurred. 

Among these allegations, the most serious incidents took place between January 2014 and December 2019, when ACI’s “outreach” drivers coerced out-of-state residents to enroll in ACI’s inpatient treatment program by offering them money, drugs, and/or alcohol. ACI and Yohay admitted that most of these out-of-state enrollees were from New Jersey, where many were already enrolled in New Jersey’s Medicaid program.

ACI has agreed to reimburse the New York state Medicaid program in the amount of $3 million dollars, and Yohay personally agreed to reimburse the New York state Medicaid program another $3 million dollars. Additionally, all current owners of ACI, including Yohay’s brother, agreed to divest themselves of their ownership interests in ACI. Yohay has also agreed to be banned from participation as a provider in any government-funded health care program for fifteen years. The new owners of ACI have agreed to be bound by the terms of this agreement, which includes changes to the ACI program to ensure it steers clear of future illegal conduct. The case against ACI and Yohay was initiated by a former employee and whistleblower, who will receive a portion of the agreement. The whistleblower lawsuit was filed under the qui tam provisions of the federal and New York State False Claims Act, which allows average citizens to file civil actions on behalf of the government and to share in the proceeds of any recovered funds.

New York’s claims in the qui tam case were handled by the Medicaid Fraud Control Unit (MFCU) in the Office of the Attorney General (OAG), which worked closely with the U.S. Attorney's Office for the Southern District of New York.

This is the latest in a long line of work by Attorney General James to protect New Yorkers from those who seek to defraud the state Medicaid program. In October 2020, Attorney General James charged a Bronx clinic-owner for stealing $4 million from taxpayers in a scheme where the owner submitted false claims for back braces. In the same month, Attorney General James cracked down on non-licensed individuals who were providing physical therapy services to unknowing New Yorkers and submitting claims to Medicaid.

The Attorney General would like to thank the New York State Office of Addiction Services and Supports, and the United States Department of Health and Human Services’ Office of the Inspector General, for their valuable assistance and cooperation in this investigation. 

MFCU’s investigation was led by Detectives Alexander Lipkin and Larry Williams with the assistance of Detective Supervisor Dominick DiGennero, under the supervision of Deputy Chief Kenneth Morgan. The underlying financial audit was completed by Senior Auditor Investigator Svetlana Volchyok with the assistance of NYC Regional Deputy Chief Auditor Jonathan Romano and NYC Regional Chief Auditor Thomasina Smith. Also assisting in the investigation were Confidential Legal Assistant Victoria Sepe, with the assistance of Supervising Legal Assistant Wendy E. Dorival and Lead Data Scientist Si Lok Chao.

This matter is being prosecuted by Special Assistant Attorneys General David G. Abrams and Amy B. Delfyett, with assistance from Civil Enforcement Chief Alee N. Scott and NYC Regional Director Christopher M. Shaw. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. The Division of Criminal Justice is led by Chief Deputy Attorney General for Criminal Justice José Maldonado and overseen by First Deputy Attorney General Jennifer Levy.

Reporting Medicaid Provider Fraud: The Medicaid Fraud Control Unit of the Office of the New York State Attorney General enforces laws that protect the public by addressing Medicaid provider fraud and that protect nursing home residents from abuse and neglect. If an individual believes they have information about Medicaid provider fraud or about an incident of abuse or neglect of a nursing home resident, they can file a confidential complaint online on the OAG website at https://ag.ny.gov/nursinghomes, or by calling the MFCU hotline at 212-417-5397. If the situation is an emergency, please call 911.

MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $60,071,905 for Federal fiscal year (FY) 2019-20, of which $45,053,932 is federally funded. The remaining 25 percent of the approved grant, totaling $15,017,973 for FY 2019-20, is funded by New York state. Through MFCU’s recoveries in law enforcement actions, MFCU regularly returns more to the state than it receives in state funding.

Comptroller Stringer Audit Uncovers Hazardous Conditions in City Homeless Shelters for Families with Infants

 

Audit of New York City Department of Homeless Services (DHS) shelters found unsafe sleep conditions and other hazards jeopardizing infants’ health and safety

Cluttered and unsafe cribs, exposed electrical outlets, mold and mildew, vermin infestation, and accessible hazardous substances found in units where infants reside

Comptroller recommends 10 actions to protect infants’ health and safety

 New York City Comptroller Scott M. Stringer released an audit of infant safety within the New York City Department of Homeless Services (DHS) shelter system, revealing widespread hazardous conditions in sampled shelters where infants reside – including exposed electrical outlets, mold and mildew, vermin infestations, broken or missing window guards, and unsafe cribs. The Comptroller’s auditors found deficiencies raising health and safety concerns in all 13 shelters they visited and 92 percent of the 91 units they inspected, including 32 units with 4 or more safety concerns in 11 shelters. The audit also found that non-compliant shelter operators faced no apparent consequences; five of the 13 shelters in the audit sample were allowed to continue doing business with the City after receiving poor performance evaluations from DHS.

Comptroller Stringer recommended ten measures to protect the safety and wellbeing of infants in City shelters, including action by DHS to ensure that providers inspect all units where infants reside weekly, promptly correct all deficiencies found, and properly instruct all families with infants on safe sleep practices promptly after they enter a shelter.

“As a parent, I find the conditions we uncovered shameful, distressing and unacceptable. Our young children are the most vulnerable among us; they rely completely on us, as adults, to protect and care for them. Our investigation into infant safety in homeless shelters found that the City has utterly failed in its responsibility,” said New York City Comptroller Scott Stringer. “It is a stain on this City that babies in our care are sleeping alongside vermin, breathing in mold and mildew, and playing near live electrical outlets. Even one child exposed to these conditions is too many, but our audit found safety violations in 92 percent of the units we inspected. Families experiencing homelessness enter the shelter system seeking safety and stability in their time of need, and we must not allow a child’s first days and months to be spent in an environment that poses a direct threat to their health and wellbeing. I urge the City to immediately correct this unacceptable state of affairs and adopt the recommendations outlined in this report to protect the young lives in shelter care. We don’t have a second to waste.”

During Fiscal Year 2019, DHS managed two City-operated and 155 provider-operated shelters that served families with children. In that period, DHS provided shelter to approximately 25,661 families with approximately 46,454 children including 4,824 infants. The audit found that the providers of the 13 sampled shelters failed to ensure the safety and wellbeing of infants in the sampled shelters. The audit identified crib-related deficiencies, missing safe sleep posters, exposed electrical outlets, mold and mildew, vermin infestation, and accessible hazardous substances in the units where infants lived. Auditors found that 11 of the sampled shelters had no records to show that 638 (44 percent) of the 1,445 of the required weekly inspections had been performed for 86 noncompliant units. In addition, shelter management often failed to update the Client Assistance and Rehousing Enterprise System (CARES) timely to record the arrival of newborn infants in the shelters and ensure that appropriate safeguards, such as approved cribs, safe sleep videos and posters, and weekly inspections, were promptly put in place, and that DHS’ records of the families and infants present in its shelters were accurate.

According to DHS, approximately 50 infants in New York City die from preventable, sleep-related injuries each year. DHS participates in a Safe Sleep Initiative that the City’s Administration for Children’s Services (ACS) and Department of Health and Mental Hygiene (DOHMH) initiated in or around 2015. As part of that initiative, in 2018, DHS issued its “Safe Sleep Policy on Infants in Shelters for Families with Children,” to provide shelters with guidelines for safe sleep practices for infants. The Safe Sleep Policy includes provisions such as the use of stationary or portable cribs for the safety and wellbeing of infants whose families reside at a shelter. DHS also requires shelters to show families a safe sleep video within 48 hours of their arrival. Shelters are required to have each family sign a Safe Sleep Education Acknowledgment and Crib Acceptance/Refusal Form. If a family decides to use its own crib, shelters must obtain approval from DHS. DHS also requires shelters to conduct weekly unit inspections for families with infants. Shelters must document such inspections by entering a unit inspection note in CARES maintained by DHS and maintaining hard copies of the completed inspection forms within each client’s physical file.

Comptroller Stringer’s audit found the following deficiencies in DHS shelters for families with children:

  • Inspection of 91 randomly selected units with infants at 13 shelters found 264 deficiencies, including –
    • Unsafe sleep conditions, such as nonuse and the improper use, placement, and condition of cribs, and the absence of required safe sleep posters; and
    • Inadequate unit conditions, including exposed electrical outlets and sharp edges, mold and mildew, vermin infestation, missing and broken window guards, accessible hazardous substances, and dirty and cluttered units.
  • At least one deficiency was found in 92 percent of units inspected.
  • All 13 shelters visited had deficiencies, including 32 units with 4 or more safety concerns in 11 shelters.
  • Shelter management often did not update CARES in a timely manner to reflect arrival of newborn infants residing in their shelters.
  • Shelters did not inform families of safe sleep protocols.
  • Shelters did not consistently perform or document the required unit inspections.

Despite poor performance evaluation scores for five of the 13 shelters in our sample, all 5 shelters were nevertheless offered opportunities to continue doing business with the City. If the conditions found at the sampled shelters are consistent with conditions at the remaining shelters contracted by DHS, the City faces an increased risk that providers managing shelters throughout the City are offering inadequate housing to homeless families.

In response to these alarming findings, Comptroller Stringer recommended 10 actions to DHS ensure the safety of infants in their care. The recommendations included:

  • DHS should ensure that the shelter providers promptly inspect and correct the conditions that raise safety and health concerns in the 13 sampled shelters identified.
  • DHS should update, and enforce, its written policies and procedures to include a specific timeframe in which shelters must update their records in CARES, any successor system, and other records to account for the presence of all infants. The written policies and procedures should cover, at a minimum, updates to the family composition records, and a standard, readily searchable, contemporaneous record of the date every infant, including every newborn, begins residing in the shelter.
  • Shelters should ensure that they play the prescribed safe sleep instructional video for all families with infants and then obtain properly completed Safe Sleep Education/Acknowledgment and Crib Acceptance/Refusal Forms on time from all families with infants and that they use only the updated form DHS prescribes.
  • Shelters should ensure that they perform the required weekly unit inspections, that they document the results in a timely manner, and that they take prompt corrective action to address the deficiencies they find.
  • DHS should establish and enforce consequences for noncompliance with infant safety policies.

To read Comptroller Stringer’s report on DHS’ care of infants residing in the shelter system, click here.