In recent years, there have been irregularities at some adult day care centers in Flushing and Brooklyn, where elderly people are recruited through cash, kickbacks, gift cards, and other means, falsely report services, and misuse government medical assistance.
According to reports, some adult day care centers are luring eligible seniors with cash incentives to join in order to receive Medicaid benefits. Insiders have revealed that some centers inform seniors who have white cards and home care services that as long as they come to the center two or three days a week, they just need to “sign their names,” and they can receive approximately $600 in cash per month.
Mrs. Li, who has cancer and relies on her white card to pay for expensive targeted medications, shared that an adult day care center once approached her, offering $700 in cash per month if she visited the center a few days a week and just signed casually. However, she refused to participate out of fear that a government investigation in the future could jeopardize her white card eligibility and potentially endanger her cancer treatment.
“White card is too important to me. The targeted medication I need every month is very expensive. If medical benefits are affected because of these matters, it’s not worth it,” Mrs. Li expressed.
Meanwhile, 88-year-old Mr. Li mentioned that despite holding a white card, his insurance company deemed him still “able-bodied and self-sufficient in daily life,” and thus, his application for home care services was not approved. In the past when oversight was lax, he could still participate in activities and meals at an adult day care center in Flushing and receive six to seven hundred dollars in cash per month. However, starting this year with increased scrutiny from federal and insurance companies, the center notified him that he could no longer participate unless he obtained home care qualification.
“Now it’s getting stricter, they told me not to come anymore,” Mr. Li commented.
Home care professionals also informed that after a recent federal investigation, many seniors who were concurrently attending adult day care centers have started withdrawing and opting to increase their home care hours. At the same time, in recent months, various healthcare insurance companies have begun reviewing seniors who receive both adult day care and home care services to verify genuine care needs and detect false service claims or Medicaid fraud.
The federal government has been closely monitoring adult day care centers in Flushing for several months. In February of this year, the U.S. Department of Justice formally charged two Asian men for allegedly collaborating between a Flushing adult day care center and a pharmacy to design a fraudulent scheme, involving embezzling up to $120 million in federal healthcare benefits, facing multiple criminal felony charges.
In March, the Director of the federal Centers for Medicare and Medicaid Services (CMS), Oz, personally visited Flushing for inspection.
Oz pointed out that some “social” adult day care centers use elderly care as a guise but actually deceive or even bribe seniors to pretend to receive services at the center every day, enabling them to submit claims to Medicaid. He mentioned that some seniors might even be prescribed unnecessary medications, undergo unnecessary X-ray examinations and treatments, before being referred to cooperating pharmacies, durable medical equipment suppliers, and home care companies, creating a profit chain utilizing government medical assistance.
Oz emphasized that not all adult day care centers are involved in illegal activities, but some operators, by continuously expanding their service volume and lacking effective supervision, “reach into taxpayers’ wallets.” The federal government is aware of the situation and is prepared to take action.