Clifford Hurley, a doctor of osteopathy, pled guilty on Aug. 17 to misdemeanor falsification of business records for recording office visits that he did not provide, and Hurley’s business corporation pleaded guilty on Aug. 31 to felony grand larceny in the third degree arising from services that were improperly billed during the time period of July 9, 2013 to May 6, 2014.
“Health care providers who defraud Medicaid hurt taxpayers and the vulnerable New Yorkers who rely on the critical services the Medicaid program provides,” Attorney General Schneiderman said. “We will fight to hold fraudulent medical professionals accountable and recover those ill-gotten gains.”
Along with the criminal pleas, the Attorney General entered a civil settlement agreement requiring Hurley to pay over $500,000, which resolved claims for overbilling services and/or procedures relating to clinical testing services, billing for counseling services provided by ineligible staff, and improper billing of prescription pick-ups and medication refills.
“Victims in crimes like this are honest, hard-working New Yorkers who are unnecessarily forced to pay more for health insurance and more in taxes to support Medicaid,” said Maria T. Vullo, Superintendent of Financial Services. “The Department of Financial Services is committed to aggressively fighting and stamping out health care fraud and we are pleased to work with the Office of the Attorney General in resolving this case.”
The Rochester Regional Office of the New York State Attorney General’s Medicaid Fraud Control Unit (MFCU) began investigating this case after receiving a referral from Excellus, LLC, a Medicaid Managed Care Organization that services Medicaid recipients in Monroe County. Managed Care Organizations are required to report suspected fraud.
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