Medicaid Fraud Exposed in the Bronx, New York

Medicaid Fraud Lawyers

Potential Medicaid Scam in New York

A case is currently underway in New York regarding a potential Medicaid scam that required New Yorkers to divulge their personal Medicaid information under the pretense of securing affordable housing. The People of the State of New York v. Leslie Montgomery, Healthy Living, Inc.  was initiated by Attorney General Letitia James following a report from the attorney general’s Medicaid Fraud Control Unit following indications that Leslie Montgomery was advertising affordable housing assistance in order to secure personal information.

Do you have knowledge of a billing scam that is defrauding Medicaid or Medicare? Our experienced whistleblower attorneys can help you receive a large monetary award for exposing fraud. Call Senior Justice Law Firm at 888-375-9998 or live chat with us now for a completely confidential, free case consultation. 

Understanding the Medicaid Fraud Involving Phony Back Brace Bills

The ruse required interested parties to divulge their personal Medicaid information in order to “qualify” for the affordable housing program (called Healthy Living Community Center) that Montgomery posted online. However, prosecutors allege that there was no such program, and instead, Montgomery was using the Medicaid information to submit claims to Medicaid for back braces.

According to reports, almost every applicant had back braces claimed using their Medicaid information. The braces themselves were billed at anywhere between $750 to $1550 each, and no individuals received a custom molded brace. Most received nothing, but those who were sent a back brace were given an “off-the-shelf” brace valued at approximately $20 that was purchased on Amazon.

New York Medicaid Funded Fraud

Medicaid fraud and medicare fraud at nursing homesProsecutors allege that Medicaid and Medicaid-funded managed care organizations like MetroPlus paid out more than four million dollars to Healthy Living—and by proxy, to Montgomery. Leslie Montgomery was arraigned early on October 9, 2020 and is currently awaiting further developments in her case. The charges brought against her were Grand Larceny in the First Degree, a Class B felony, and Identity Theft in the First Degree, a Class D felony. She may see as many as 25 years in prison if she is convicted on these charges.

Montgomery was brought before the New York City Criminal Court in Bronx County, where the Honorable Jeffrey Zimmerman released her on a number of conditions: that she must surrender her passport, waive her right to leave the country, and remain within New York state. She is still free to travel within the state’s borders.

The investigation into Montgomery’s fraudulent scheme was conducted by investigators Shavaun Clawson and James Briscoe, who were working under Deputy Chief Investigator Kenneth Morgan of the New York State Office of the Attorney General. An additional audit of Healthy Living’s finances was required and undertaken by auditors and investigators Ying Tuo,  Jonathan Romano, and Thomasina Smith. Nicholas Matthews and Victoria Sepe assisted with the compiling of the case as legal assistants and Si Lok Chao contributed in the data sciences.

Special Assistant Attorneys General Hayley Campbell and Anjna Kapoor are prosecuting in the case of The People of the State of New York v. Leslie Montgomery, Healthy Living, Inc., and Christopher M. Shaw is providing assistance to Senior Counsel David Arias. Montgomery is currently awaiting a decision, and the case is expected to continue on for much of the remainder of the year. Which charges, if any, she is convicted of will determine what sentence she receives, as well as whether such charges are felonies.

“Using affordable housing as a pretense for Medicaid theft is reprehensible,” said Attorney General James. “My office will do everything in our power to stop New Yorkers in need of housing assistance from being left in the lurch and having their information be unwittingly used for theft from New York taxpayers.”

Medicaid Fraud is a Serious Crime – How You Can Help

Senior Justice Law Firm is dedicated solely to lawsuits concerning nursing homes, assisted living facilities, and other long-term care facilities. We have a specific focus on representing Whistleblowers under the False Claims Act. Individuals with information about nursing homes that are defrauding Medicare or Medicaid can receive an award if they bring a successful lawsuit under the False Claims Act.

If you have information on a medical provider that is committing or has committed Medicare or Medicaid Fraud, reach out to us today by calling our toll free line at 888-375-9998.

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