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FLUSHING, N.Y. — Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz showed up in a surprise visit at two New York City senior care centers suspected of treating Medicaid like an open bar tab, and the staff responses landed somewhere between "the computer did it" and "please come back after lunch when the room looks fuller."
Fox News Digital tagged along as federal officials delivered the kind of warning letters that tend to make billing departments check the exits.
Oz and senior federal health officials handed the notices to Kent Senior Care and Evergreen Adult Day Care in Flushing, Queens, causing several severe cases of loose stools, and not the kind you sit in unless you're very weird.
Oz and senior federal health officials handed the notices to Kent Senior Care and Evergreen Adult Day Care in Flushing, Queens, causing several severe cases of loose stools, and not the kind you sit in unless you're very weird.
The visits formed part of a wider sweep that put the FBI, the Department of Health and Human Services Office of Inspector General, the NYPD and other agencies on the same Tuesday itinerary. More than 80 stops and warning letters went out across the city that day.
Taxpayers who fund the programs received no such courtesy tour.
"The whole experience was suspicious," Oz told Fox News Digital afterward.
Authorities described a broader effort that included arrests, search warrants and moves to halt certain operators from billing Medicaid, although these steps at the two Queens, NY sites were not observed directly by Fox News Digital.
"The whole experience was suspicious," Oz told Fox News Digital afterward.
Authorities described a broader effort that included arrests, search warrants and moves to halt certain operators from billing Medicaid, although these steps at the two Queens, NY sites were not observed directly by Fox News Digital.
Oz questions senior center director: 'We don't believe you'
The first stop, around 8:30 a.m. at Kent Senior Care, when residents were likely in the throes of being cleaned up, began with Oz walking in and personally delivering the federal letter. The posted maximum occupancy was 70. The room did not appear to be testing that number.
"The bills are much higher than they should be," Oz told the director. "The billing is for more people. It doesn't look very crowded here."
The director claimed that more seniors would arrive later. Oz noted the paperwork suggested something closer to this being the perpetual capacity.
"The bills we're getting are as though it's completely full all the time," Oz said. So something stank, much like these places at 8:30 in the morning.
The director insisted the center billed only for actual attendance and required sign-in sheets. Oz was unmoved.
"You're getting this letter from the U.S. Government because we don't believe you," he told the director.
Billing records indicated five-day-a-week participation. The director said many seniors came only two or three days. When the conversation turned to specialized wheelchair transportation charges, Oz looked around the room.
"I don't see any wheelchairs here," Oz told the director.
Fox News Digital saw seniors using walking aids but no wheelchairs during the visit. Another official noted the billing for specialized transport. The director said some participants had mobility issues after strokes, that wheelchairs were available, and that staff might have reused old codes.
"Probably he just copy and pasted," the director said, lying like an abandoned sofa by Coney Islamd Creek.
Oz then walked over to the mahjong tables set up for the Medicaid-funded program.
"Should the American taxpayers be paying so folks can play mahjong?" Oz asked the director.
The director said the game helped with finger exercise, socialization and memory. Oz answered that the benefit was not free.
"It's free for them, not free for the taxpayers," Oz responded. "Is that what our federal tax dollars for Medicaid is supposed to go to? Or is it life-saving heart surgery? Or, you know, new therapies for cancer?"
Oz also watched seniors walk in without signing anything, despite the stated requirement. He later described the timing.
"Should the American taxpayers be paying so folks can play mahjong?" Oz asked the director.
The director said the game helped with finger exercise, socialization and memory. Oz answered that the benefit was not free.
"It's free for them, not free for the taxpayers," Oz responded. "Is that what our federal tax dollars for Medicaid is supposed to go to? Or is it life-saving heart surgery? Or, you know, new therapies for cancer?"
Oz also watched seniors walk in without signing anything, despite the stated requirement. He later described the timing.
"People were just walking in there without signing anything," Oz said. "And then after I showed up and he saw what we were doing with my team, he started collecting these documents to be signed." You know, closing the barn door after the chickens made a run for it.
Social adult day care programs can supply activities, supervision, meals and support. Medicaid payment hinges on eligibility and documentation of what was actually provided. The gap between that rule and the observed room proved difficult to close on the spot.
At Evergreen Adult Day Care the pattern repeated.
A floor manager said roughly 200 seniors attended on Mondays, Wednesdays and Fridays and about 150 on the other days. Oz walked the space and offered a different count.
"So I look at maybe 25 people in the whole space now," Oz said, perhaps forgetting to multiply by 10.
The manager claimed that some were in classes and others had left for shopping, the pharmacy or appointments.
"The numbers don't seem to add up," Oz responded.
On wheelchairs the manager first said none were in use, then acknowledged a small number.
"But you said there weren't any, didn't you?" Oz pressed. He compared notes with the other federal officials present.
"I'm struck by how few people are here as well," Oz said. "This makes me wonder how they sustain these billing levels."
The attendance books supplied the next discrepancy. Fox News Digital saw sign-in sheets with names already entered for Oct. 22 and Oct. 23, dates that had not yet arrived. Whether the pages were finished records or advance schedules remained unclear. Let's hope he took photos of the fraudulent-sounding evidence,
Oz alleges organized crime ties to NYC Medicaid fraud. He said federal authorities believed organized criminal networks were paying seniors to appear at facilities so operators could bill for services never delivered. He described individuals he linked to the "Chinese mafia" offering some seniors between $1,000 and $1,200 to participate.
"So I look at maybe 25 people in the whole space now," Oz said, perhaps forgetting to multiply by 10.
The manager claimed that some were in classes and others had left for shopping, the pharmacy or appointments.
"The numbers don't seem to add up," Oz responded.
On wheelchairs the manager first said none were in use, then acknowledged a small number.
"But you said there weren't any, didn't you?" Oz pressed. He compared notes with the other federal officials present.
"I'm struck by how few people are here as well," Oz said. "This makes me wonder how they sustain these billing levels."
The attendance books supplied the next discrepancy. Fox News Digital saw sign-in sheets with names already entered for Oct. 22 and Oct. 23, dates that had not yet arrived. Whether the pages were finished records or advance schedules remained unclear. Let's hope he took photos of the fraudulent-sounding evidence,
Oz alleges organized crime ties to NYC Medicaid fraud. He said federal authorities believed organized criminal networks were paying seniors to appear at facilities so operators could bill for services never delivered. He described individuals he linked to the "Chinese mafia" offering some seniors between $1,000 and $1,200 to participate.
He did not name a specific group or present supporting evidence in the interview. He said billing spikes across the sector had pushed annual spending toward $1 billion.
Sounds a lot like a Minnesota Learing Center, doesn't it?
"We know from the billing here that there's no way this business is running in the way that they claim to be running without something being wrong," Oz told the media outlet.
"Is it an innocent mistake? A hundred times in a row, I don't think so."
He added that proceeds from the schemes were financing other crimes, including money laundering and human trafficking.
"It's really a clubhouse for crime," Oz said.
He said the fraud grew during the COVID-19 period and faulted the previous administration for letting the spending and the suspicious patterns continue.
"We know from the billing here that there's no way this business is running in the way that they claim to be running without something being wrong," Oz told the media outlet.
"Is it an innocent mistake? A hundred times in a row, I don't think so."
He added that proceeds from the schemes were financing other crimes, including money laundering and human trafficking.
"It's really a clubhouse for crime," Oz said.
He said the fraud grew during the COVID-19 period and faulted the previous administration for letting the spending and the suspicious patterns continue.
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Democratic New York Gov. comrade Kathy Hochul called the Tuesday actions part of a "massive effort to combat fraud and abuse" and noted that state health officials joined the federal and local effort. While Oz delivered the letters in Queens, searches continued at other sites across the city. Details on the remaining targets, the people involved and any evidence recovered were not available while the investigations continued.
Imagine if the Democrats were in power in the federal government. They would look the other way while holding out their hands for a little greasing.
Imagine if the Democrats were in power in the federal government. They would look the other way while holding out their hands for a little greasing.
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