Find Corporate Waste

Tag: New York

  • DOJ Sues to Stop Alleged Fraud in New York’s $10 Billion Medicaid Home-Care Program

    DOJ Sues to Stop Alleged Fraud in New York’s $10 Billion Medicaid Home-Care Program

    The Department of Justice⁠ filed suit in the Eastern District of New York against the New York State Department of Health, New York Medicaid Director Amir Bassiri, and Public Partnerships LLC over alleged fraud involving New York’s $10 billion Consumer Directed Personal Assistant Program, known as CDPAP.

    CDPAP is a Medicaid home-care program for patients with disabilities or significant medical needs.

    According to the DOJ, in 2024, New York consolidated hundreds of fiscal intermediaries into a single statewide administrator, ultimately awarding the contract to Public Partnerships LLC.

    The DOJ alleges that New York awarded PPL the CDPAP contract through a “sham bid process,” then failed to stop PPL from deviating from the financial limits and representations contained in its bid.

    The lawsuit⁠ also claims PPL and New York misled the public about whether the transition could be completed by April 1, 2025, despite allegedly knowing the timeline was unlikely to be met.

    The complaint alleges that CDPAP served more than 250,000 patients and 300,000 caregivers as of fall 2024. DOJ says the program bills approximately 350 million hours of care each year, meaning even small improper rate changes could generate tens of millions of dollars in unauthorized revenue.

    For Find Corporate Waste⁠, the case reflects the core oversight problem in federally funded health-care programs: public money can be lost not only through false claims, but also through weak contract enforcement, eligibility failures, and unchecked administrative control over taxpayer-funded payment streams.

  • Brooklyn Clinic Manager Convicted in $8M Medicare Fraud Scheme

    Brooklyn Clinic Manager Convicted in $8M Medicare Fraud Scheme

    A federal jury convicted Olga Popovych, a New York clinic manager, for her role in an $8 million Medicare fraud scheme, according to the DOJ.  

    Prosecutors said Popovych managed several physical therapy clinics that paid cash kickbacks to ambulette drivers who brought Medicare patients to the clinics. The DOJ said she was personally involved in paying the kickbacks and falsifying medical records to claim that physical therapists treated patients when they were not actually present.  

    Between 2018 and 2020, Medicare paid the clinics more than $8 million. Trial witnesses also testified that Popovych used coded text messages to discuss kickbacks and took steps to conceal the scheme after suspecting law enforcement was watching the clinics.  

    The jury convicted Popovych of conspiracy to commit health care fraud, conspiracy to make false statements relating to health care matters, four counts of health care fraud, and three counts of making false statements relating to health care matters.

    She faces up to 10 years for each health care fraud conviction and up to 5 years for each false-statement conviction. A federal judge will determine the sentence under the U.S. Sentencing Guidelines and other statutory factors.  

    The case was investigated by HHS-OIG and the FBI.

    Anyone with inside knowledge of kickback arrangements, false billing, fabricated medical records, or patient-recruitment schemes involving federal health care programs may have information relevant to public-fraud enforcement.

    Find Corporate Waste protects confidential sources and helps preserve the right to report fraud.

  • $56.5M Settlement Targets Medicare Diagnosis Codes Scheme

    $56.5M Settlement Targets Medicare Diagnosis Codes Scheme

    Community Care Health Network LLC, doing business as Matrix Medical Network, DPN USA, doing business as HealthFair, and Shahriah “James” Ekbatani agreed to pay $56.5 million to resolve False Claims Act allegations over unsupported Medicare Advantage diagnosis codes, the DOJ announced.

    Matrix will pay $36.5 million, HealthFair will pay $5 million, and Ekbatani will pay $15 million.

    The DOJ alleged the defendants caused Medicare Advantage Organizations to submit false or invalid diagnosis codes to CMS, increasing risk-adjusted taxpayer payments.

    Matrix allegedly used in-home assessments to report unsupported conditions. HealthFair allegedly used mobile assessment buses to report unsupported diagnoses under Ekbatani’s direction.

    The whistleblowers will receive major awards. Former Matrix employee Nancy Cahill will receive $7.3 million. Former HealthFair chief medical officer Dr. Robert Oristaglio Jr. will receive $3.6 million.

    Insiders with knowledge of unsupported diagnosis coding, chart-review pressure, mobile assessments, or Medicare Advantage billing failures may have information relevant to public-fraud enforcement.

    Find Corporate Waste helps protect insiders while exposing fraud, waste, and abuse in taxpayer-funded programs.

  • Brooklyn Clinic Owner Convicted in $52M Health Care Fraud and Kickback Scheme

    Brooklyn Clinic Owner Convicted in $52M Health Care Fraud and Kickback Scheme

    A federal jury in the Eastern District of New York convicted Tony Brown-Arkah, 78, owner of American Medical Centers, a Brooklyn clinic that purported to provide substance abuse treatment, for his role in a $52 million health care fraud, narcotics, and kickback scheme.

    According to the Department of Justice, Brown-Arkah’s clinic illegally prescribed Suboxone, a Schedule III narcotic used to treat opioid use disorder, while allowing drug diversion activity to operate around the clinic. Witnesses testified that patients were directed to sell prescriptions outside the facility, including to a van near the clinic.

    The DOJ said many patients received prescriptions signed by a nurse practitioner in Florida who did not see or speak with them. Patients were also subjected to medically unnecessary testing, while Medicare and Medicaid were billed for services that were not provided or not legitimate.

    Brown-Arkah was also convicted of paying patient kickbacks and receiving laboratory kickbacks tied to unnecessary testing referrals. Prosecutors said he used a shell company and sham contract to conceal the payments.

    The case reflects the DOJ’s continued focus on health care fraud involving addiction treatment, laboratory testing, controlled substances, and federal program billing.

    DOJ Press Release — Clinic Owner Convicted for $52M Health Care Fraud, Illegal Narcotics Distribution, and Kickback Scheme

    DOJ Health Care Fraud Unit

    Find Corporate Waste — False Claims Act

  • How States Game the System: Medicaid Fraud and the FMAP Loophole

    Medicaid was originally created as a partnership between the federal government and individual states. The concept was simple: every time a state spends a dollar, the federal government matches a portion of that investment.

    This is known as the Federal Medical Assistance Percentage (FMAP).

    Over time, some states discovered a way to manipulate the system by shifting the burden entirely to the federal government while padding their own budgets.

    How Medicaid Fraud Works

    1. The state taxes hospitals or nursing homes.
    2. The state pays this tax back to the provider as Medicaid reimbursements.
    3. The federal government matches a percentage of the returned funds through FMAP.
    4. The provider gets their money + the FMAP.
    5. The state contributes nothing, while the federal government is on the hook.

    Why It All Adds Up to a Big Problem

    This fraud is one of the major factors contributing to the systemic weakness of our entire healthcare system.

    When states are allowed to run these schemes, Medicaid becomes more expensive, draining money away from the people who actually need help.

    Instead of creating a safety net, the system becomes a slush fund for state coffers—and the federal government (read: taxpayers) gets stuck with the tab.

    At Find Corporate Waste, we dig deep into these kinds of backdoor deals because we believe in a system that’s honest, accountable, and actually works for the people it’s supposed to serve. Not one that lets bureaucrats and politically connected hospitals game the rules for a payday.

    But here’s the thing—we can’t do it alone.

    If you’ve seen this kind of scheme from the inside—maybe you work in healthcare, government, or finance—you might be sitting on information that could make a real difference. Thanks to the False Claims Act, whistleblowers who step forward not only help protect public funds—they may also be eligible for a financial reward if the government recovers money based on their tip.

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