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Cuomo's 'operation: home alone' uncovers Medicaid fraud.

ALBANY, N.Y., August 22 -- Ten home health aides, two registered nurses, and a Medicaid recipient have been convicted by Attorney General Andrew Cuomo through his office's "Operation: Home Alone" probe, which investigates the multi-billion dollar home health care industry.

The announcement comes after a previous round of guilty pleas by four home health aides for the same types of offenses.

"The problems our investigation has uncovered suggest organized, calculated operations that have bilked the system for tens of millions of New York taxpayer dollars," said Cuomo. "As the home health care industry continues to grow, so too must we expand our aggressive pursuit of those who would defraud New York's Medicaid system, and taxpayers, for personal gain."

Three of the aides, Vano Saralidze, Ketevan Saralidze, and Hershl Schwartz, have pleaded guilty to felony grand larceny.

Former home health aides George Babuadze, Raisa Haypapeyan, Rima Petrosyan, Julieta Sephashvili, Elvira Bruce, and Sahakanush Yuzbashyan each pleaded guilty to petit larceny, an A Misdemeanor, and will pay restitution ranging from $3,000 to $5,000. Miriam Schwinder also pleaded guilty to the misdemeanor, received a conditional discharge, and will pay $40,000 over the next five years.

"Medicaid fraud impacts every New Yorker, driving up income and property taxes and threatening the very lives of those who count of the care Medicaid provides," continued Cuomo. "I urge anyone who may have information on suspected Medicaid fraud to contact our office's Medicaid Fraud Hotline."

The charges against the aides were based on their possession of falsified certification documents, and in the case of many of the aides, their lies about the hours they worked. Medicaid requires home health care aides--who primarily care for elderly patients, administer medication, and provide services such as catheter care, colostomy care, and wound care--to successfully complete a training program licensed by the Department of Health or the State Education Department. All aides must receive a minimum of 75 hours training, including 16 hours of supervised practical training conducted by a registered nurse.

None of the aides received that training, and as a result, Medicaid was billed for ineligible services and Medicaid patients were given care by untrained aides.

Two of the aides, Schwartz and Schwinder, were caring for family members, which is also not Medicaid-reimbursable.

According to the Attorney General's Office, many of the aides worked concurrently for multiple home care service agencies, often submitting time sheets that, when put together, totaled more than 24 hours worked in a single day. In at least one case, Medicaid was billed for 36 hours of care provided for patients by one aide in a single day.

Registered nurses Medina Manashirova and Anna Mills pleaded guilty to related misdemeanor charges. Both worked for multiple certified home health agencies, and would submit bills to the agencies for multiple patients during concurrent periods of time.

In some cases, said Cuomo, the recipients did not need care, but were complicit in the fraud. Home care recipient Raisa Tarakanova pleaded guilty to a misdemeanor and is to repay $3,000 for her role in a scam in which she split Medicaid payments with her home health aide who provided no services.
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Title Annotation:NEW YORK
Author:Best, Jessica
Publication:Insurance Advocate
Date:Sep 10, 2007
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