A New York City social adult day care (SADC) director admitted to helping carry out a $127 million Medicare and Medicaid fraud scheme that went on for more than a decade. Now, as New York cracks down on fraud involving similar facilities, the state is considering whether to get rid of the program altogether.
Daniel Lee of Flushing, Queens, pleaded guilty on Nov. 9 to conspiracy to commit money laundering and conspiracy to commit health care fraud, according to the U.S. Department of Justice.
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Lee was a program director at Happy Life Inc. and Royal Adult Day Care Center, two SADC centers in Flushing. The centers offered Medicaid recipients cash to enroll, then billed Medicaid for care they never received. Lee and his co-conspirators also helped run a related pharmacy scheme involving prescriptions that patients didn’t need.
“Paying kickbacks and billing for services that were never provided is not patient care. It is theft from programs that vulnerable people depend on,” Scott J. Lampert, deputy inspector general for investigations with the U.S. Department of Health and Human Services, said in a statement.
A decade of fraudulent claims
SADC centers are designed to help older adults and people with disabilities continue living at home while receiving extra support during the day. They typically offer meals, activities and help with everyday tasks…