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September 29, 2023

Former medical office manager arrested for scheme to defraud the New York State Health Insurance Plan

New York State Comptroller Thomas P. DiNapoli reported the Officer Manager [OM] for numerous doctors’ offices in Manhattan defraud the New York State Insurance Plan [NYSHIP] out of over $12,000 by submitting fraudulent claims for reimbursement. OM was arrested following a joint investigation conducted by Comptroller DiNapoli, Ulster County District Attorney Clegg, and the FBI Hudson Valley White Collar Crime Task Force.

The Comptroller said that OM "allegedly took advantage of her position to fund her lifestyle at the expense of the taxpayers". Di Napoli noted his partnerships with Ulster County District Attorney Clegg and the Federal Bureau of Investigation in the investigation of this fraud and said "the defendant will be held accountable.”*

The Comptroller indicated that the joint investigation "revealed that from 2018 through September of 2019, the OM submitted false claims to NYSHIP under her husband’s NYSHIP identification number claiming that medical services were provided by two out-of-network providers for whom she worked, but the services actually never occurred." Through this scheme, OM received $12,957.50 from NYSHIP to which she was not entitled and "used the funds that she received from NYSHIP to pay her personal expenses including credit card debt."

The investigation was initiated as the result of a complaint submitted by United Healthcare's Special Investigations Unit and which assisted in the investigation.

OM was arraigned in Town of Ulster Court before Judge Kesick and was charged with Grand Larceny in the third degree, Healthcare Fraud in the third degree, Offering a False Instrument for Filing in the first degree, and Falsifying Business Records in the first degree. 

* N.B. The charges filed in this case against OM are merely accusations and the OM is presumed innocent unless and until proven guilty in a court of law.

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Since taking office in 2007, DiNapoli has committed to fighting public corruption and encourages the public to help fight fraud and abuse. Allegations of fraud involving taxpayer money may be submitted to the State Comptroller via the Internet by clicking on investigations@osc.ny.gov, by calling the toll-free Fraud Hotline at 1-888-672-4555, or by mailing a complaint to the Office of the State Comptroller, Division of Investigations, 8th Floor, 110 State St., Albany, NY 12236.

 


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