New York Attorney General Andrew M. Cuomo recently announced an indictment that alleges Deborah Kantor, owner of H.I.S. Holdings, Inc., bribed a Niagara County Department of Social Services employee in order to gain assistance for approving Medicaid coverage for certain patients.
Kantor and H.I.S., a debt collection agency that serves many major hospitals in Western New York, including Niagara Falls Memorial Medical Center, were charged with bribery in the second degree and rewarding official misconduct in the second degree.
According to the release, Kantor paid Michael Albrecht, a DSS employee with access to the Welfare Management System (WSM) computer, to obtain Medicaid identification numbers for patients, which are required when billing Medicaid.
The release alleges Kantor provided names to Albrecht, which he would then research using the WSM computer. From there, Albrecht was able to obtain Medicaid client identification numbers for active accounts. Kantor would use those numbers to bill Medicaid. In some cases Albrecht was able to re-activate inactive Medicaid accounts without receiving the appropriate paperwork from Kantor and H.I.S., according to the release.
Kantor allegedly paid Albrecht $50 for every number he was able to provide. The Department of Justice claims that added up to approximately $17,700 between 2000 and 2007. On top of that, Kantor allegedly gave Albrecht a cell phone with service, and other gratuities for approving subpar Medicaid applications.
According to the release, the state wants H.I.S. and Kantor to repay the $730,000 the state paid H.I.S. as a result of the scheme and is seeking an additional $2.2 million in damages, per the state’s False Claims Act and Social Services Law.
The indictment also names Amy Gardner, an employee at H.I.S., and alleges she aided Kantor in the submission of a false Medicaid application. Kantor and Gardner knowingly submitted the application with the wrong address in order to obtain Medicaid reimbursement, the indictment alleges.
Kantor, H.I.S., and Gardner, have been charged with offering a false instrument for filing in the first degree and attempted grand larceny in the third degree.
Albrecht has not been charged in the case.
Ben Amirault is an Editorial Assistant for the revenue cycle division of HCPro. He manages the Compliance Monitor e-newsletter and has developed a number of online learning modules. He can be reached at bamirault@hcpro.com.