New York Attorney General Letitia James today secured over $5 million from Community Options, Inc. and Community Options NY, Inc. (Community Options) for failing to properly provide services for people with developmental disabilities and knowingly submitting false claims to Medicaid for services. Community Options is a nonprofit that provides “day habilitation” services to adults with developmental disabilities in New York City, ensuring they have enriching and educational community-based activities. A joint investigation between the Office of the Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU), and the United States Attorney’s Office for the Southern District of New York (USAO-SDNY) revealed that Community Options failed to follow regulations and requirements designed to ensure the people it serves are receiving safe and adequate care. Under settlements with OAG and USAO-SDNY, Community Options will repay Medicaid over $5 million in reimbursements it received for day habilitation services that it failed to provide and document in compliance with state regulations.
“New Yorkers with developmental disabilities rely on quality, community-based activities to lead fulfilling and independent lives,” said Attorney General James. “Community Options ignored the rules meant to ensure it was delivering the services it promised, depriving vulnerable New Yorkers of opportunities to participate in valuable programs that meet their needs. I thank the U.S. Attorney’s Office for their assistance in this investigation that will ensure New Yorkers with developmental disabilities get the care and services they deserve.”
Community Options’ services include the Day Habilitation Without Walls Program, where recipients can take part in activities, cultural events, and volunteer opportunities in their community. Medicaid and the New York Office for People with Developmental Disabilities (OPWDD) set requirements for day habilitation service providers to follow in order to receive Medicaid reimbursement. These requirements ensure organizations are providing an adequate number of services for enough time, are providing the correct types of services, and are documenting the services they provide…