00:04One New Jersey-based Medicaid conglomerate has billed taxpayers over $950 million in what appears
00:10to be shady billing records, according to an investigation from the New York Post.
00:14This company called Honor Health Network, based in Bergen County, New Jersey,
00:18owns Medicaid providers all across the country, primarily in the home healthcare sector and the
00:24adult daycare sector. One thing about these daycares that we can't really seem to figure
00:28out is what exactly are they supposed to be for? Now, according to Medicaid, adult social adult
00:32daycares are supposed to be for chronically ill homebound adults who have severe disabilities,
00:38mobility issues, basically people who should be in nursing homes, but they're not. The idea behind
00:44it is actually one that most people agree with. It's the idea that if you have a severe chronically
00:49ill infirm older person in your family, in order to keep them out of a nursing home, you would hire
00:55someone to take care of them in their own home, usually a family member. Taxpayers pay
01:00for this. Then for a social outlet, you have the adult daycare aspect. So for elderly, chronically
01:06ill seniors who are unable to leave the home would then go to a daycare for a little bit
01:10of social interaction. This is how the system is meant to work. But what has been proven in
01:15the last 10 years is that it is rife with fraud. HHS fraud investigators told us that one thing
01:20they look for when they're examining Medicaid records is companies that bill for a very
01:26high amount of money, coupled with a low amount of billing codes, usually just one or two billing
01:32codes. A billing code is basically what a Medicaid provider is charging taxpayers for, whether
01:37it be transportation services, cleaning someone's home, administering medication, helping someone
01:42get to bed. We visited two of these companies in New Jersey, Broadway Respite Home Care, which
01:48had billed taxpayers $157 million using just one billing code, and across the street, Broadway
01:54Adult Daycare, which had billed taxpayers some $40 million using a single billing code. These
02:00two companies are owned by a healthcare conglomerate called Honor Health Network based in Bergen County,
02:05New Jersey. Among the Medicaid businesses owned by this conglomerate, we identified nearly a
02:09dozen that seem to have shady billing practices. Some of them based in Brooklyn were billing upwards
02:15of $400 million over the six-year period for one or two billing codes. We stepped into Broadway
02:22Respirate Home Care Services, where we were told by a woman who identified herself as the manager
02:27that she didn't know how many patients they currently were serving. According to the data,
02:32it says that you have 89,000 beneficiaries that you have worked with. Does that sound right to you?
02:37You don't know? No. Okay. Sorry.
02:38She didn't have any comment about the billing numbers that we presented to her, and she basically
02:44told us to reach out to a man in the corporate office at Honor Health Network. That individual
02:50did not respond to multiple requests for comment. Everywhere we went, we encountered managers who
02:56seemed to have no information about the billing practices. At Broadway Adult Social Daycare,
03:02Yuri, the manager, told us that he didn't know anything about the numbers we were showing him. He didn't
03:06know anything about billing and insisted that was all handled by corporate. We are part of, like I
03:11said, like a corporation. All this spending this go through our financial department, which is not
03:17even in this building. He told us that he didn't know about the nearly 30,000 patients, individual
03:22patients who were listed on HHS data as having attended there over the six-year period. Now, to put it
03:29into context, our research shows that there's only about 20,000 Medicaid-eligible seniors in all of
03:35Bergen County. Last summer, the post did a deep dive on what's called New York's Medicaid fraud
03:40capital, Flushing, Queens, where there are over 80 social adult daycares within a one-mile radius,
03:46billing taxpayers some $100 million a year. Last month, federal investigators announced a string of
03:52arrests and charges for daycare providers in Brooklyn and Queens, in which they alleged that those
03:57providers were providing kickbacks to patients. This is a system in which daycares compete for patients to
04:03come, and they offer them money in return for their Medicaid number. They then bill Medicaid for
04:08services that that patient is supposedly getting, and they give the patient a cut. Now, none of these
04:12businesses we investigated in New Jersey have been accused of any wrongdoing, but we've noticed a
04:17similar pattern of billing cycles that were rampant across New York State and New Jersey. Now, a lot of
04:22these businesses that we saw were billing something like 5, 10, even 700 times higher than the median
04:30amount that they were billing for in the area. The Broadway respite home care service is 68 times
04:36higher than any other home care service in that area. Honor Healthcare Network did not respond to
04:41multiple requests for comment, and they have not been accused of doing any wrongdoing.
