00:00What we saw develop Tuesday across New York City was a widespread set of raids for the social adult daycare
00:08centers.
00:09These have been particularly exposed over the last year or two to be potentially ridden with fraud and guilty of
00:17overbilling Medicaid
00:18and the managed care plans that facilitate this and ultimately get paid for by taxpayers through federal and state Medicaid
00:27dollars.
00:27So this operation yesterday appeared to be a very wide net.
00:31We understand it involved about 100 of these social adult daycares or similar providers around New York City.
00:38It was a multi-agency task force that was working on this with the state level, the feds, the FBI,
00:47New York State Medicaid inspector general,
00:50all the way down to local law enforcement, NYPD was involved as well.
00:53So the way these schemes have been exposed to work in the cases that we know of, especially in these
01:01social adult daycares,
01:03is typically the fraud involves overbilling.
01:06So there's a storefront where these centers will be located.
01:10Elderly New Yorkers will come in for services, whether that's social interaction or other services.
01:15They will often come in, however, there will be an attendance sheet that they are required to, by law, keep
01:24and maintain records of.
01:26So what we see in these cases is that there's not so much of just the daycare not existing,
01:31but that the records are often sometimes falsified to represent that more people are there when they're not.
01:38So what Dr. Oz and others have complained about, and we were seeing potentially in this operation,
01:45is cases where on paper these centers look like they're full or should theoretically be full of people.
01:52If you or I or Dr. Oz or any of these investigators would walk in there,
01:56they should expect to see a room full of people based on the paperwork that they submit to Medicaid through
02:03a managed care plan.
02:04However, when investigators show up, usually they're less attended.
02:09We could see them carrying out in these raids on Tuesday,
02:12lots of computers, files, other information that I think we could very safely assume investigators may review.
02:19Today, the Staten Island District Attorney announced that there were at least two arrests coordinated with the raids yesterday
02:25for a center located on Staten Island.
02:28And in this case, the two individuals involved here had this business set up for a number of years,
02:35this social adult daycare set up for a number of years.
02:38But when the Staten Island District Attorney's Office began looking into it,
02:41they found that between April and August of this year,
02:44they illegally and fraudulently allegedly billed Medicaid for over half a million dollars worth of false billing.
02:52They were charged with over 450 counts, including 374 counts of falsifying business records.
03:00So we're still awaiting details on some of these other raids and whether there are arrests associated with them.
03:08But we definitely know that this was a multi-jurisdictional and multi-pronged investigation.
03:15And this effort does not seem to be concluded at this point.
03:20It seems like we'll have some sort of follow-up on this investigation with a set of raids this expansive.
03:26There certainly are trends that these do pop up in immigrant neighborhoods.
03:29However, it's not limited to one specific immigrant group.
03:34We do see them a lot, particularly in Asian communities.
03:37But they certainly are all over the city.
03:39Also, the Staten Island District Attorney said today he was asked if these were all connected,
03:44if this was part of one singular coordinated effort.
03:48He seemed to shy away from that and suggest that these were all very similar modeled cases of fraud,
03:55though they might not actually be particularly connected.
03:59Though we could see through the course of this investigation that information may change.
