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Nick Shirley walked into senior centers in New York City’s Flushing neighborhood with a camera crew and a laptop full of publicly available government billing data. In 53 minutes of footage, he documented what appears to be one of the largest Medicare fraud operations currently running in America. One center alone was billing for nearly 8,000 patients. The employee Shirley confronted on camera couldn’t deny it. He just asked Shirley to leave.
Here’s how the scam works, and it’s almost insultingly simple once you see it. Adult day care centers enroll elderly patients — in this case predominantly Korean and Chinese seniors — and bill Medicare and Medicaid at rates up to $1,600 per patient per visit. The centers are supposed to provide legitimate medical and social services. What Shirley’s investigation found instead were facilities that couldn’t plausibly have served the number of patients appearing in their billing records — and employees who flatly denied having thousands of members while the government’s own public data showed exactly that.
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