Home Care Operator Admits False Medicaid Billings
Posted on Thursday, 15 of May , 2008 at 6:33 pm
NASSAU COUNTY—The former operator of a Manhattan-based home care agency and his former billing manager have pleaded guilty to stealing over $314,000 from the state through false Medicaid billing schemes.
The pleas are the first ones obtained by the joint Medicaid Fraud Task Force Attorney General Andrew Cuomo and Nassau District Attorney Kathleen Rice launched in 2007.
Charles Zizi, 46, of South End Ave. in New York City, operator of Always There Homecare, pleaded guilty to stealing more than $314,000 from Medicaid by submitting false claims for services that were either never provided or provided in areas where he was not licensed to operate.
Zizi’s former billing manager, Ricardo Francois, 38, of Corporate Drive in Westbury, pleaded guilty to assisting Zizi in overbilling Medicaid and fraudulently obtaining a credit union loan. Both pleaded guilty before Nassau County Judge David Sullivan. Zizi admitted to stealing more than $314,000 from the state by submitting claims for services that were not provided or provided in areas where he was not licensed to operate, inflating his nurses’ hours of service and billing Medicaid for the maximum authorized services price rather than actual services rendered. In addition, Zizi admitted to using the stolen money to pay various personal expenses, including payments for a credit card that he had obtained through identity theft. Zizi also admitted he fraudulently obtained a home equity line of credit from the Nassau Credit Union with Francois.
Zizi pleaded guilty to two counts of second-degree grand larceny, one count of third-degree grand larceny, one count of first-degree identity theft and one count of fourth-degree money laundering, all felonies.
Francois pleaded guilty to two counts of second-degree grand larceny. He assisted Zizi in the Medicaid overbilling scheme by submitting the falsified claims. He also admitted to filing fraudulent documents in order to obtain the credit union loan.
Zizi must fully reimburse the state for the fraudulent billings with interest, and he is expected to be sentenced July 18 in Nassau County Court.
Francois must pay $50,000 in restitution to the Medicaid system and is scheduled for sentencing June 13.
This was the first case to be brought by the New York State-Nassau County joint Medicaid fraud task force, created by Attorney General Cuomo’s Office and District Attorney Rice’s Office to cooperatively investigate and prosecute Medicaid provider fraud.
Attorney General Cuomo’s long-term and statewide investigation into fraud in the home health care industry, known as “Operation Home Alone,” has thus far resulted in charges against more than 80 defendants, including patients, aides, nurses, instructors, and the administrators of licensed and certified home health agencies. Defendants convicted during the investigation have been ordered to repay nearly $14 million in restitution.
Cuomo urges New Yorkers who suspect cases of Medicaid fraud to call the Attorney General’s Medicaid fraud hotline at 1-866-NYS-FIGHT. 5-15-08
Category: Courts, Crime, Disabled, Elder Care, Government, Health, Insurance, Taxes
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