State Suspends, Investigates Adult Care Plan for Possible Fraud

This article was written by C. Zawadi Morris.

State officials have suspended enrollment in VSN Choice, New York’s largest managed long-term care plan for elderly and disabled people, after Medicaid fraud investigators began examining the possible illegal business practices of senior care centers who enlist patients under the Visiting Nurse Service plans, The New York Times reported.   

On Thursday, investigators from the state attorney general’s office were in Brooklyn probing the relationship of VNS and adult day care centers where workers reportedly had persuaded seniors to the center with incentives like free takeout food, casino visits and cash before steering them to managed care companies designed for older people with long-term needs like home health care and nursing.   

The New York Times published an article online on Monday night detailing complaints about several centers.

VNS Choice, the largest plan, with 20,000 enrollees, reported paying $642,875 for social day care to R & G alone, and acknowledged receiving 100 referrals from the center, where a reporter had observed a stream of agile elderly people collecting free restaurant takeout food and walking away with it, or riding off on bicycles.   

“We are going to recoup every penny from any plan that is deemed ineligible,” said Jason Helgerson, the state’s Medicaid chief, late Thursday. “We will expand the scope of our investigation if we find that there were problems.”