On Tuesday, October 20th, Mehmet Oz, the director of the Centers for Medicare and Medicaid Services (CMS) in the United States, visited two senior day care centers in Flushing, New York, to personally deliver warning letters.
During his visit, the federal official questioned the services claimed for reimbursement by the senior centers, specialized wheelchair transportation costs, attendance records, and more.
According to Fox News Digital, Oz and federal health officials visited two senior activity centers located in Flushing, Queens, namely Kent Senior Care and Evergreen Adult Day Care.
This visit was part of a large-scale crackdown on Medicaid fraud conducted in New York City on Tuesday. CMS officials reportedly visited over 80 senior activity centers that day and issued warning letters informing operators that their cost claims were deemed excessive and had caught the attention of federal authorities.
So far, no arrests or prosecutions have been made in relation to this investigation. Both Kent Senior Care (referred to as Kent) and Evergreen did not respond to requests for comments from the press.
In the morning around 8:30 am, Oz first arrived at Kent Senior Care and questioned the discrepancy between the number of services claimed for Medicare and the actual number of elderly present at the center.
He informed the center’s supervisor that the billed amount was much higher than the number of elderly people observed on-site. A notice on the wall indicated that the maximum capacity of the center was 70 people.
The supervisor responded that more elderly individuals would arrive later and emphasized that the center billed costs based on the actual number of elderly attendees and required participants to sign in.
Oz further inquired why the billing records indicated that some elderly people attended activities at the center every five days a week.
“You received this warning letter from the U.S. government because we do not trust you,” Oz told the supervisor.
At Evergreen, the manager informed Oz that around 200 elderly people visited on Mondays, Wednesdays, and Fridays, while about 150 came on Tuesdays and Thursdays. But after Oz’s inspection, he remarked, “I now see only about 25 people in the entire place.”
The manager explained that some elderly individuals were in class, while others were out shopping, at the pharmacy, or seeing a doctor.
“These numbers don’t seem to add up,” Oz responded.
The cost of specialized wheelchair transportation services was also a key focus for the officials.
At Kent Senior Care, a accompanying medical official questioned the inclusion of specialized wheelchair transport fees in the center’s billing records when no elderly individuals were seen using wheelchairs on-site.
“I haven’t seen any wheelchairs here,” Oz said. A Fox News reporter also noted that during the visit, some elderly individuals used walkers but no one used wheelchairs.
The supervisor at Kent responded that some elderly individuals had mobility difficulties, including those recovering from strokes, and the center did have wheelchairs available. He added that it might be a case where staff continued using previous billing materials without updating the billing codes according to the actual wheelchair usage.
At Evergreen, the manager initially claimed that no elderly individuals used wheelchairs, but later admitted that a few did.
Oz also questioned the reliability of the attendance records at both institutions.
At Kent Senior Care, the supervisor explained that elderly visitors had to sign in at the center. However, on-site, elderly people were seen entering directly without signing any documents. It was only after the audit team arrived that the supervisor began collecting documents for elderly visitors to sign.
While examining the sign-in book at Evergreen, Oz noticed instances of “pre-signed” forms where elderly individuals signed documents dated October 22nd and 23rd, even though the visit was on the 20th.
However, Fox News could not confirm whether these records were complete attendance logs or pre-arranged schedules.
During the visit to Kent Senior Care, Oz questioned the use of Medicaid funds for activities such as indoor mahjong tables.
“Should American taxpayers pay for people to play mahjong?” he asked the center supervisor.
The supervisor defended this by saying that playing mahjong helps elderly individuals exercise their fingers, maintain social connections, and train memory, especially beneficial for those with cognitive difficulties.
Oz retorted, “It may be free for them (the elderly), but it’s not free for taxpayers.” He further questioned the prioritization of federal funds usage compared to life-saving heart surgeries or innovative cancer treatments.
This visit was part of the federal efforts to combat Medicaid fraud. Participating agencies included the FBI, the Office of Inspector General of the Department of Health and Human Services, the New York City Police Department, and other organizations.
Oz stated that the reported amounts for senior day care centers had significantly increased, with annual expenditures nearing $1 billion.
“We look at the bills, and without any funny business, they can’t possibly operate as they say,” Oz told Fox News Digital.
“Is this just an innocent mistake? When it happens a hundred times, it’s no longer a mistake,” he added.
New York Governor Kathy Hochul confirmed on Tuesday that state health officials were collaborating with federal and state law enforcement agencies to investigate fraud at adult day care centers. She described it as part of a widespread effort to combat Medicaid fraud and abuse.
While Oz was delivering warning letters to the two centers, other law enforcement officers were conducting searches in other locations in New York City.
Reports indicate that federal personnel entered two Chinese adult day care centers in Brooklyn – Jiale Elderly Day Activity Center and Warm Home Adult Activity Center – and removed some documents as evidence.