TRENTON — The owners of a Newark adult day care center investigated for Medicaid fraud will pay a $1.6 million fine and give up their business, according to a settlement announced today by the Office of the State Comptroller. The owners of Garden Adult Medical Day Care also agreed to a five-year suspension from participating in the Medicaid program,...
Mark Anderson, the Medicaid Inspector General.TRENTON — The owners of a Newark adult day care center investigated for Medicaid fraud will pay a $1.6 million fine and give up their business, according to a settlement announced today by the Office of the State Comptroller.
The owners of Garden Adult Medical Day Care also agreed to a five-year suspension from participating in the Medicaid program, the state and federally financed health insurance program for the poor, the comptroller said.
In June, the state Medicaid Inspector General alleged Garden Adult Medical Day Care billed the state for services it never provided, including testing patients' blood pressure and blood sugar levels and dispensing medication.
The inspector's office alleged the for-profit facility wrongly pocketed $1.87 million, but demanded the owners pay $5.6 million - three times that amount - for "intentionally submitting Medicaid claims for 50 recipients when it knew it did not render the services, or submitted the claims in reckless disregard of whether the services were rendered.''
The settlement with the owners, Marat Zeydelis, Zoya Halal and Larisa Melnik, reduces the penalty to $1.6 million.
"We are pleased to have secured the return of $1.6 million to a program funded by New Jersey’s taxpayers," said state Comptroller Matthew Boxer, whose office oversees the Medicaid inspector general. "Equally as important, we have removed from the Medicaid program a business that was failing to provide crucial health services for which it was being paid."
Medical day care centers are staffed by nurses, doctors and other trained professionals, and enable elderly and medically frail people to live on their own and delay entering a nursing home. But the industry is vulnerable to abuse, state investigators have said. An investigation into 13 other centers continues.
This is not the first time the owners of the facility have been cited by the state. On seven separate occasions between October 2003 and June 2009, the state Department of Health and Senior Services cited them for failing to maintain nursing standards, develop care and discharge plans, and monitor the medical and nutritional needs of their clients.