State: New York AG Announces Arrests in Medicaid Fraud

New York State Attorney General Andrew M. Cuomo has announced the indictment of six individuals and seven corporations charged in a Medicaid fraud scheme totaling $47,000,000. The AG's press release says in the past ten years, Alexander Levy, assisted by several cohorts, allegedly secretly controlled a string of health care entities to both illegally obtain payment for Medicaid recipients' treatment and also to launder the profits from the scheme. According to the press release, Levy had already been excluded from participation in Medicaid in 1997 for submitting false claims.


Levy had set up a series of corporations designed to conceal his control and ownership interest of various companies and medical clinics, the AG's release stated, and did not put his name on any documents filed with the New York State Department of Health. These companies billed Medicaid for millions of dollars of services. The Medicaid money was directed to the Levy-controlled health care entities through a series of bank accounts and transfers, and funneled to shell companies that he created and owned. Attorney General Cuomo has filed a civil forfeiture complaint against Levy, his cohorts, and a total of 16 corporations.

"This individual is accused of cheating New York taxpayers out of tens of millions of dollars through an elaborate money laundering scheme," Attorney General Cuomo said. "But as we have done before, we 'followed the money,' which led us to today's serious charges. Ensuring that Medicaid payouts are made only to those who rightfully deserve them has been a top priority of my administration." The charges against the defendants are accusations, and the defendants are presumed innocent until, and unless, proven guilty.

Federal: Nursing Home Executive Agrees to Permanent Exclusion

The Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) has announced in a press release that the president and chairman of the board of Pleasant Care Corporation, Emmanuel Bernabe, has agreed to permanent exclusion from Federal health care programs. The exclusion follows an OIG investigation of Pleasant Care, concerning allegations of substandard care in Pleasant Care nursing facilities between 2003 and 2007.

Pleasant Care once was the second largest nursing home chain in the State of California, with more than 29 different facilities in 14 counties. Currently, Pleasant Care does not manage any nursing facilities or provide patient services. Bernabe had contested OIG's allegations and denied any liability. No judgment or finding of liability has been made against Bernabe. The OIG alleges in the press release that under Bernabe's management, Pleasant Care placed nursing home residents at risk through the level of care failing to meet professionally recognized standards. This included inadequate hydration and nutrition, failing to administer appropriate wound care and inadequate staffing levels.

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