Yesterday, the feds accused the city of committing Medicaid fraud, by improperly approving 24-hour home care for thousands of poor, elderly and disabled patients, often without the approval of doctors. They were tipped off to the alleged fraud by whistleblower Dr. Gabriel Feldman, a 49-year-old Upper West Sider, who was contracted by the city to make patient treatment recommendations. And depending on the outcome of the case, Feldman stands to make millions from the settlement.
The feds are suing the city for civil penalties and damages of more than $60 million. Under the whistleblower law, Feldman stands to get a 15-25 percent cut of the cash. Feldman's lawyer Alan Konigsberg told the News he was neither a disgruntled employee with a "personal vendetta" (since many of his suggestions were ignored by the Human Resources Administration, who administer the program), nor was he motivated by the cash. According to feds, the city favored home care because the state and federal governments split the cost; institutionalizing a patient requires the city to help share the cost.
But HRA officials counter that the agency was following a state push to keep the elderly out of nursing homes, and the city didn't even get money from those placements. Despite whatever mismanagement occurred, it gets especially complicated in that respect—as anyone with a sick, elderly relative knows, being able to live at home is often one of their last tethers to their former lives, and the only thing that keeps them wanting to live.
