Two Plead Guilty to $68 Million Adult Day Care Fraud in Brooklyn
“The defendants were large-scale recruiters who bribed patients with laundered cash and billed Medicaid over $68 million for services that were not provided.”
As far as I can tell, the two people are not from Somalia. This is a deep-rooted problem, regardless of nationality.
The DOJ announced that two people pleaded guilty to a $68 million Medicaid fraud scheme involving adult day care.
“The defendants were large-scale recruiters who bribed patients with laundered cash and billed Medicaid over $68 million for services that were not provided,” said Assistant Attorney General A. Tysen Duva of the Justice Department’s Criminal Division. “Today’s guilty pleas demonstrate the Department’s longstanding commitment to rooting out fraud in government health care programs by aggressively prosecuting those who steal from taxpayer-funded programs.”
Six other people face charges for the same scheme.
Manal Wasef and Elaine Antao, both 46, admitted to defrauding “Medicaid by paying health care kickbacks for services that were not provided at two Brooklyn social adult day cares and a home health care company.”
They took advantage of “the Consumer Directed Personal Assistance Program (CDPAP), which allows those with minimal health care experience to care for their elderly or disabled relatives and friends.”
According to court documents, Manal Wasef, 46, and Elaine Antao, 46, both of Brooklyn, were marketers and recruiters for two social adult day cares: Happy Family Social Adult Day Care Center Inc. and Family Social Adult Day Care Center Inc., as well as Responsible Care Staffing Inc., a home health care fiscal intermediary.
Between approximately October 2017 and July 2024, in exchange for illegal kickbacks and bribes, Wasef and Antao referred Medicaid recipients to the social adult day cares and the home health company. The defendants also paid illegal kickbacks and bribes to Medicaid recipients for social adult day care services and home health care services that were billed to Medicaid but were not provided or that were induced by kickbacks and bribes. Wasef and Antao used multiple business entities to launder the fraud proceeds and generate the cash used to pay kickbacks and bribes.
In connection with their guilty pleas, Wasef and Antao agreed to collectively forfeit approximately $1 million. Wasef and Antao are the sixth and seventh individuals, respectively, to plead guilty in this case.
Wasef and Antao pleaded guilty to conspiracy to commit health care fraud. Antao is scheduled to be sentenced on May 20 and Wasef is scheduled to be sentenced on May 27. They each face a maximum penalty of 10 years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
“These defendants orchestrated an egregious scheme involving illegal kickbacks to steer Medicaid claims and to receive payment for services not rendered,” said Special Agent in Charge Naomi Gruchacz of the Department of Health and Human Services, Office of Inspector General (HHS-OIG). “Extensive fraudulent operations like this jeopardize the availability of federal health care program funds intended to support millions of beneficiaries. HHS-OIG is committed to working with our law enforcement partners to bring to justice those who prioritize greed over patient care.”
Owners Zakia Khan and Ahsan Ijaz, as well as Oasmneah Hamdi, Ansir Abassi, and Amran Hashmi, also face charges, according to The New York Post.
The New York Post reported that a CDPAP-funded home care worker in New York City can earn $21.09 per hour, which equals around $44,000 a year if they work 40 hours a week.
Well, under Gov. Andrew Cuomo, the state government made it easier to become a CDPAP home care worker “by allowing family members or friends of Medicaid recipients to become CDPAP aides.”
It sounds great, but experts warned the legislature that it opened a door to fraud:
But experts warn that the vague rules for eligibility are prime for exploitation — and that the program’s flaws run deep.
“Consumer-directed personal assistance is an important and life-changing benefit when used appropriately, but it’s also highly vulnerable to overuse and fraud — and in New York’s program, all the warning lights are flashing bright red,” Hammond said.
Not only that, but the qualifications aren’t clear:
For instance, those seeking Medicaid coverage who live in a nursing home are required to have their past five years of financial records reviewed.
The list includes “bathing or showering, dressing, getting in and out of bed or a chair, walking, using the toilet, and eating,” according to the US Centers for Medicare & Medicaid Services.
In comparison, those applying for home-based care don’t have any look-back period, which means they can potentially transfer cash, or sell off assets, to relatives so they can then qualify for Medicaid.
Currently, an applicant has to undergo an assessment of eligibility, which includes, in part, having an ongoing medical condition, a need for medical assistance and a need for long-term care.
Plus, businesses and nonprofits can serve as middlemen.
These people collect the “money from Medicaid that is then doled out to CDPAP aides in the form of paychecks.”
Yeah, as we’ve seen, that’s caused problems:
These intermediaries take a cut of funding, but aren’t responsible for training or supervising aides.
The legislative changes prompted fiscal intermediaries to start trying to enroll as many people as possible — including those with less severe and costly illnesses, according to the 1199 Service Employees International health care union, which represents home health aides.
The number of fiscal intermediaries surged from just seven to 700 in the wake of the changes, the union added.
Just awful.
[Featured image via The New York Post from Google Maps]
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Comments
Good catch. Keep looking. The rise in home care businesses should be a place to look because such businesses are in need which seems to result in home care operations coming out of the woodwork with tv ads.
I notive that the names of the perpetrators suggest that, while not Somali, they too come from low-trust, shame based cultures, rather than a Western high-trust, guilt based one, which is what our financial field programs are based on.
I hate autocorrupt. “Notice” not “notive”, and “aid” not “field”.
Guilt and shame are no longer is a part of Western culture. This is due to women many of which if not most are allergic to accountability. Also due to the fact religion is less of a factor in the West This is a problem..
Something else. I suspect the majority of this fraud, if not all of it, is in democrat jurisdictions. This is not a national problem. it’s a democrat problem.
It’s like they all took the same fraud franchise course. And 10 more will take the pl
place of this one. All with the support and protection of their friendly neighborhood democrat representative.
Not Somali, but, mostly, your typical immigrants from sh!thole countries.
Owners Zakia Khan and Ahsan Ijaz,
If the Somalis could figure it out, you have to expect that others did, too.
I’m glad that people are being held accountable but we need to shut off the money at the source.
We need to eliminate the federal income tax. It was sold to the American people as something that would only target the evil rich but eventually – and unsurprisingly – gave rise to fraud that is exponentially greater than the wealth of a Rockefeller or a Carnegie.
I’m tired of having half of my labor confiscated from me at the point of a gun only to have it stolen by people that have no business even being present in the United States.
Enough!
How about an all inclusive 19% flat tax instead? One standard deduction = to annual federal min wage for full time work assuming one worked full time (2000 hours). Roll SSA and Medicare into that 19%. No other deduction,. zero exemptions, zero ‘tax credits’. All individual filing no joint or head of household. Include cap gains but the taxable amount to be reduced by the cumulative rate of inflation for the holding period. Eliminate estate tax include inheritance as income with a lifetime cumulative exclusion of $2.5 million per person.
….cap gains only paid upon sale of assets… none of this ‘wealth tax’ nonsense
Well duh… no sale means no taxable event. Of course there do seem to be a number of other folks who don’t seem to grasp that concept.
They seem to want to apply the property tax regime of real estate to other assets which may sound logical to commies that don’t understand economics but the real world works on incentives. On that note I got a solution for rising property taxes; take the 3 year moving average of valuation the tax assessor claims the property is worth and that becomes a ‘floor’. The property owner gives 90 days notice to the assessor that he accepts their bid price (3 year moving ave) and the tax assessor office and the entities who directly receive tax revenue gotta bring cash to closing on day 91. Do that and suddenly the rapid rise in property taxes in some locations will be mitigated.
Or at least a flat tax, say 20%, that has no loopholes, carve outs etc.
One of the famous UK liberty economists before the American Revolution wrote that if taxes under self-government systems ever exceeded the 10% tax common under the feudal system, self-government should be deemed a failure.
Held accountable? 68 million in fraud. These fraudsters pay back, collectively, maybe a million, do some time, less than 10 years I bet. Probably 5 or less. Then get to retire in wealth with whatever they managed to secret out of the country. Not a bad deal
What a shit hole country we’ve become
Good Luck President Trump
I’d rather see these people go free, and jail the bureaucrats who make this kind of theft so easy it would tempt a nun.
One wonders whether any Medicaid money goes to intended law abiding recipients?
Probably the same percentage that goes from the United Way to actual charities.
Found a video of her at a family festival.
https://youtu.be/-0CSI1b1IOA?si=CGkYUEXMSjO-UVc_
Looks like Pakistan has entered the chat
How things change…..where I’m from an adult daycare is usually a building on a corner with a Budweiser sign lit up in the window.
did the co-criminals who took the money also face charges?
dont forget ,,after the headlines,,,,, some of these dems/criminals are treated better then you can imagine……
weekend passes
computers etc etc
the jan6 patriots were given the treatment that the real criminals should face
this is the overlooked part of a lefty run “justice system”
Bilk me out of my retirement at the cost of a pound of flesh…tread lightly unless you desire to see blood.
No one has day care for adulteresses anymore… 🙂
Anybody have time to bounce those names against political contribution databases?
After $1M no one thought to start asking questions ?