A.G. Schneiderman Announces Arrests Of Three Individuals For Allegedly Defrauding Medicaid-Funded Home Health Programs
Three Individuals Allegedly Stole From Medicaid By Submitting False Timesheets For Services Not Provided
Schneiderman. Those Who Steal From Medicaid Will Be Prosecuted To The Fullest Extent
Attorney General Eric T. Schneiderman recetnly announced the conclusion of two separate investigations and the arrest of Tina Gabel, 58, and Sean Gabel, 23, of Poughkeepsie, and Enny Portillo, 58, of Highland Mills, for submitting over $50,000 of false home health care claims to Medicaid.
“Medicaid programs are put in place to help those who need them most,” saidAttorney General Schneiderman. “We will continue to aggressively pursue all individuals who steal from Medicaid to enrich themselves.”
These cases arose out of two home care programs funded by Medicaid, the Consumer Directed Personal Assistance Program (CDPAP) and the Community Habilitation program. CDPAP allows a physically disabled individual or their representative to assume full responsibility for their home care and recruit, hire, train, supervise and fire the personal assistants providing the care. Personal aides in the Community Habilitation program provide those with developmental disabilities with personal, social and vocational support needed to live in their community.
Tina Gabel and Sean Gabel, who is Tina Gabel’s son, were arraigned today in Dutchess County Court before the Honorable Edward McLoughlin on an indictment charging them with Grand Larceny in the Second Degree, Offering a False Instrument for Filing in the First Degree and Falsifying Business Records in the First Degree.
It is alleged that Tina Gabel and Sean Gabel submitted false timesheets to AccentCare of New York, Inc., (AccentCare), a fiscal intermediary for CDPAP, which claimed that Sean Gabel provided consumer directed personal assistant services to two of their relatives in Dutchess County, New York between October 2011 and February 2015 when Sean Gabel was not in Dutchess County. As the relatives’ representative, Tina Gabel was responsible to administer CDPAP for both relatives and was responsible to submit and verify the accuracy of their assistants’ timesheets. Based upon the false timesheets, Medicaid paid AccentCare over $50,000 for hours that Sean Gabel did not work.
Tina Gabel is also charged with conspiring with another aide to submit false timesheets to Taconic Innovations, Inc., a not-for-profit organization, claiming the personal aide had provided community habilitation services to one of Gabel’s relatives. Tina Gabel managed the community habilitation services for her relative and was responsible for verifying the assistants’ timesheets submitted to Taconic. Based upon the false timesheets, Medicaid allegedly paid Taconic Innovations, Inc. over $50,000 for hours that the personal aide did not work.
Enny Portillo, 58, of Highland Mills, New York, was arrested and arraigned on November 1, 2016, in the Town of Woodbury Justice Court before the Honorable David Hasin on a felony complaint charging her with Grand Larceny in the Second Degree, Offering a False Instrument for Filing in the First Degree and Falsifying Business Records in the First Degree.
According to papers filed in Court, Enny Portillo verified false timesheets submitted to Priority Home Care Services, Inc., (Priority), a fiscal intermediary for CDPAP, claiming that her daughter provided CDPAP services to Enny Portillo’s a Medicaid recipient while the recipient was out of the country in Columbia. Enny Portillo was the recipient’s representative and oversaw the care. As such, she was responsible for the administration of the care, including certifying personal assistant’s timesheets submitted to Priority. Based upon the submission of false timesheets, Medicaid allegedly paid Priority over $50,000 for hours that Enny Portillo’s daughter did not work.
All three defendants were released upon their own recognizance. Grand Larceny in the Second Degree is a class C felony and carries a maximum sentence up to fifteen years in state prison. Offering a False Instrument for Filing in the First Degree and Falsifying Business Records in the First Degree are class E felonies and carry a maximum sentence of up to four years of state prison.
The Attorney General would like to thank the New York State Office of the Medicaid Inspector General for referring these matters.
The investigations were conducted by MFCU Investigators Valerie Patrick and Jeffrey Pitts and Senior Audit Investigators Sandra Iskowitz and Melissa Stoebling with the assistance of Supervising Investigator Peter Markiewicz, Deputy Chief Investigator Kenneth Morgan, Principal Auditor Investigator Lora Pomponio, Principal Supervising Auditor Investigator Ann Winslow and Regional Chief Auditor John Regan.
The criminal cases are being prosecuted by Special Assistant Attorney General Todd Pettigrew with the assistance of Regional Director Anne Jardine. Thomas O’Hanlon is MFCU’s Downstate Chief of Criminal Investigations. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney.
The charges are merely accusations and the defendants are presumed innocent unless and until they are proven guilty in a court of law.