The director of the Centers for Medicare and Medicaid Services (CMS), Mr. Oz, paid a visit to the Kent Senior Care in Flushing, New York on October 20th and delivered a warning letter. After the visit, the person in charge of the center denied allegations of overbilling Medicaid (Medicare white card) and offering cash rebates to seniors. They stated that they would cooperate in providing the necessary information. In response to Mr. Oz’s remarks about “using taxpayers’ money to play mahjong,” the person in charge and interviewed seniors emphasized that playing mahjong is a beloved social and mental activity among the Chinese community, and that the center strictly prohibits cash gambling.
The anonymous person in charge mentioned that Mr. Oz, along with officials, law enforcement officers, and media personnel, totaling nearly 20 individuals, stayed for about an hour the day before. The presence included FBI, Department of Homeland Security officials, Immigration and Customs Enforcement (ICE) officers, and local police.
During the visit, Mr. Oz mentioned that through AI analysis, the center may be engaged in overbilling. The person in charge refuted this claim, stating that the letter from the authorities was a reminder for self-audit, with no specific allegations of violations against the center and no explicit demands for submitting bills or other documents. The center is currently conducting its own review of billing records.
It was emphasized that the center reports service days based on insurance-approved durations and the actual attendance of seniors. Seniors must be present and sign in; if they are absent due to illness or other reasons, the center does not bill for that day.
The person in charge explained that each partnering insurance company conducts audits annually, cross-referencing attendance logs, service records, and documents. Individual care plans are developed for each senior, medication information is updated approximately every three months, and assessments of seniors’ conditions are recorded every six months. All relevant documents are meticulously stored for inspections by regulatory authorities at any time, and the center is willing to cooperate with any subsequent reviews, stating, “We will comply with governmental regulations.”
The person in charge confirmed that Mr. Oz inquired if the center was providing money to seniors during the visit. He promptly denied this and made it clear that such actions could carry severe legal consequences. He mentioned witnessing other institutions facing investigations due to similar issues.
Regarding the practice of offering cash incentives weekly or monthly to recruit members within the industry, the person in charge acknowledged its existence. Some seniors have inquired whether similar benefits were available, and he shared that some members might have been enticed by other centers offering such incentives. However, the center does not engage in illegal actions to retain members, understanding the serious repercussions.
In response to Mr. Oz’s comment about seniors using taxpayers’ money to play mahjong, the person in charge highlighted that mahjong is a familiar cultural entertainment among Chinese seniors, similar to Western seniors playing chess, requiring thought and interaction. The center uses chips to record wins and losses, without involving cash transactions or permitting monetary bets. He further noted that activities requiring mental engagement and interaction help seniors maintain cognitive health and prevent decline.
One senior chimed in, expressing that playing mahjong primarily serves to stimulate the mind, keep the hands active, and prevent dementia in the elderly.
Addressing Mr. Oz’s questioning of the relatively low number of attendees during the visit, the person in charge explained that the group arrived around 8:30 AM, and some seniors were still preparing to leave or in transit, with the majority typically arriving between 9:00 to 9:30 AM. He clarified that the attendance at the time of the visit did not reflect the full-day attendance.
Since its establishment in 2022, the center has registered over a hundred members, with around 40 to 50 individuals present daily. Most members are approved by insurance companies to attend one to two days weekly, with a few granted three days. Those attending all five days per week are rare, thus the total member count does not equate to the daily attendance.