The Post investigates $950M in shady Medicaid billing tied to NJ senior care company

One New Jersey-based Medicaid conglomerate has billed taxpayers over $950 million in what appears to be shady billing records, according to an investigation from the New York Post. This company called Honor Health Network, based in Bergen County, New Jersey, owns Medicaid providers all across the country, primarily in the home health care sector. and the adult daycare sector. One thing about these daycares that we can't really seem to figure out is what exactly are they supposed to be for? Now, according to Medicaid, social adult daycares are supposed to be for chronically ill homebound adults who have severe disabilities, mobility issues, basically people who should be in nursing homes, but they're not. The idea behind it is actually one that most people agree with. It's the idea that if you have a chronically ill, infirm older person, In your family, in order to keep them out of a nursing home, you would hire someone to take care of them in their own home, usually a family member. Taxpayers pay for this. Then for a social outlet, you have the adult daycare aspect. So for elderly, chronically ill seniors who are unable to leave the home would then go to a daycare for a little bit of social interaction. This is how the system is meant to work. But what has been proven in the last 10 years is that it is rife with fraud. HHS fraud investigators told us that one thing they look for when they're examining Medicaid records is companies that bill for a very high amount of money coupled with a low amount of billing codes, usually just one or two billing codes. A billing code is basically what a Medicaid provider is charging taxpayers for, whether it be transportation services, cleaning someone's home, administering medication, helping someone get to bed. We visited two of these companies in New Jersey, Broadway Respite Home Care, which had billed taxpayers $157 million using just one billing code, and across the street, Broadway Adult Daycare, which had billed taxpayers some $40 million, using a single billing code. These two companies are owned by a healthcare conglomerate called Honor Health Network based in Bergen County, New Jersey. Among the Medicaid businesses owned by this conglomerate, we identified nearly a dozen that seemed to have shady billing practices. Some of them based in Brooklyn were billing upwards of $400 million over the six year period for one or two billing codes. We stepped into Broadway Respite Home Care Services where we were told by a woman who identified herself as the manager, That she didn't know how many patients they currently were serving. According to the data, it says that you have 89,000 beneficiaries that you have worked with. Does that sound right to you? You don't know? No. Okay. She didn't have any comment about the billing numbers that we presented to her. And she basically told us to reach out to a man in the corporate office at Honor Health Network. That individual did not respond to multiple requests for comment. Everywhere we went, we encountered managers who seemed to have no information about the billing practices. At Broadway Adult Social Daycare, Yuri, the manager, told us that he didn't know anything about the numbers we were showing him. He didn't know anything about billing and insisted that was all handled by corporate. We are part of, like I said, a corporation. All this spending goes through our financial department, which is not even in this building. He told us that he didn't know about the nearly 30,000 patients, individual patients who were listed on HHS data as having attended there over the six year period. Now to put it into context, Our research shows that there's only about 20,000 Medicaid eligible seniors in all of Bergen County. Last summer, The Post did a deep dive on what's called New York's Medicaid fraud capital, Flushing, Queens, where there are over 80 social adult daycares within a one-mile radius, billing taxpayers some $100 million a year. Last month, federal investigators announced a string of arrests and charges for daycare providers in Brooklyn and Queens, in which they alleged that those providers were providing kickbacks to patients. This is a system in which daycares compete for patients to come, and they offer them money in return for their Medicaid number. They then bill Medicaid for services that that patient is supposedly getting, and they give the patient a cut. Now, none of these businesses we investigated in New Jersey have been accused of any wrongdoing, We noticed a similar pattern of billing cycles that were rampant across New York State and New Jersey. Now, a lot of these businesses that we saw were billing something like 5, 10, even 700 times higher than the median amount that they were billing for in the area. The Broadway Respite Home Care Service is 68 times higher than any other home care service in that area. Honor Healthcare Network did not respond to multiple requests for comment, and they have not been accused of doing any wrongdoing.