A U.S. District Attorney for the Southern District of New York and Special Agent in Charge of the New York Regional Office of the U.S. Department of Health and Human Services announced that it settled a fraud lawsuit that alleges that Morris Park Nursing Home engaged in two fraudulent and illegal schemes from January 1, 2017, through December 31, 2019. The skilled nursing facility in the Bronx paid cash and gifts to a supervisor at a nearby medical facility for dozens of patient referrals. The nursing facility and staff also switched Medicare coverage without residents’ consent so that the facility got larger Medicare payments – they moved patients from Medicare Advantage to traditional Medicare.
The complaint also names Morris Park’s former administrator Tzodik Weinberg (known as “Justin Weinberg”) and Maier Arm for their roles in the fraudulent actions. While the owner of Morris Park at the time of the fraudulent conduct will pay $2.85 million, Weinberg will pay $495,000, and Maier will pay $115,000.
The scheme
According to a press release issued by the Southern District of New York, the modest size of the fines was due to voluntary self-disclosure of details surrounding the improper insurance coverage switches. According to the investigation, Morris Park staff would approach residents (often in their rooms) to make the change in coverage while not fully explaining how the coverage and co-pays would change. The difference could lead to the loss of supplemental coverage offered under the Medicare Advantage Plan. Often, the staff switched the plans without signatures or approval from patients or their families. As part of the scheme, Morris Park paid Arm and Weinberg $1,000 for each plan they changed.
