Doctor who defrauded Medicaid ordered to repay money
October 11, 2016
As published by Rochester First on October 6, 2016.
Attorney General Eric Schneiderman announced on Thursday the resolution of criminal charges and civil liability arising from billing practices at Clifford Hurley, D.O. LLC, a medical practice in Gates.
Clifford Hurley, a doctor of osteopathy, pled guilty on August 17 to misdemeanor falsification of business records for recording office visits that he did not provide.
Hurley’s business corporation pleaded guilty on August 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.
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.