MEDICARE/MEDICAID FRAUD AND THE TRESS SOLUTION…. AMNESTY AND THE FINANCIAL BENEFITS OF BEING LESS THAN HONEST
It is one thing to assist a person in paying overdue taxes accumulated because of medical problems, errors, stupid mistakes. It is one thing to assist people with money for lawsuits, unanticipated medical bills and other life events. Medicaid fraud is not a life event. It is a concerted effort to game a system and then circumvent the intention of providing amnesty.
It is also quite another to assist a person in paying back fraud when the entire fraud is not actually repaid and there is total and complete amnesty involved. The true victims of this fraud, particularly where Medicare and Medicaid are concerned are the people who have been denied assistance because there were simply not enough funds available or they did not meet the criteria.
Setting aside the fact that we don’t believe that 99% of the people in the ultra-Orthodox community meet the criteria (particularly if they have such generous benefactors). A drive through Kiryas Joel, Lakewood and numerous other towns will provide razor sharp clarity that many claim poverty and then drive around in $90K cars or wear $10K streimels to their simchot.
Perhaps Mr. Tress and his generosity towards his community should have carried over to the thousands in need of Medicare/Medicaid who were ineligible because his community had drained resources. Perhaps he should take a walk through places like downtown Newark and hand out some of his generosity there.
As to the charity he set up to spread his generosity, we note that there was far more about other companies owned by Mr. Tress than there was about the charity he set up allegedly to help the fraudsters.
We finally note that that the ultra-Orthodox community is extremely savvy – exceedingly so. We find it hard to believe that, as he quoted, that they could have been obvlivious to the fact that what they were doing was wrong. We believe that they gamed the system. Mr. Tress, your charity and mitzvot might be better spread turning less than honest people into honest ones and helping those genuinely in need of assistance.
Medicaid fraud Amnesty Program By the Numbers
Many families in Lakewood who cut deals in last year’s Medicaid fraud amnesty program paid little out of their own pockets, the Asbury Park Press has learned.
Instead, families that could not come up with enough money to repay their debt to the government borrowed from a pool of funds donated by a few dozen people, according to Moshe Tress, who also goes by the first name Mark and who helped organize the fundraising effort. The money was distributed on an honor system that borrowers would repay it if and when they were able, and without interest or a fee, Tress said.
Tress said such charity is second nature for Orthodox Jews, who make up the majority of Lakewood’s population. But a state senator says using donations to repay benefits allowed Medicaid cheats to escape without punishment.
“My fear there is the perception, and the reality will be that these people ended up profiting from their dishonesty and their illegal behavior,” said Sen. Declan O’Scanlon, R-Monmouth. “And that the punishment is nowhere near as severe as the punishment ought to be for such action.”
O’Scanlon said he will propose legislation because of the Press’ reporting on the amnesty program. He wants more rules and restrictions for any future amnesty offers, including that restitution must be paid in full. The state recouped $2.2 million through the amnesty program and $2.6 million was not repaid because of the deal making.
“This isn’t a victim-less crime,” O’Scanlon said. “There’s a finite amount of money available for truly needy people. When someone steals money they are stealing it from truly needy people.”
But Tress said some individuals applied for amnesty not knowing if they did something wrong. The Office of the State Comptroller, which offered amnesty, did not vet whether an applicant received Medicaid benefits they were not qualified for. Tress said many residents entered the program with a “better safe than sorry” mentality.
“We don’t pay for fraud,” Tress said. “The program was designed with so much unknown, people said better safe than sorry.”
Tress is a noted philanthropist in Lakewood and his company, Cedar Holdings LLC, owns real estate and healthcare facilities across the tri-state area.
He said donated funds went to help families with a legitimate financial need.
“The community at large raises millions of dollars a year to help people,” Tress said, speaking specifically of Lakewood’s majority Orthodox Jewish population. “That’s what we do. People care about other people. We step up to the plate in any situation that is a tragic situation, or a situation that needs camaraderie. This is one of those cases.”
Lakewood board member repays half owed in amnesty deal, builds $500K house
State: $2.6M never repaid because of amnesty deals
Last year 159 Ocean County residents entered the comptroller’s special amnesty program in the wake of sweeping raids that netted 26 arrests in Lakewood. Thirteen Orthodox Jewish couples were arrested in the raids and charged with fraud. Those charges are pending, and in most of the cases plea deals are being negotiated.
Until the Press contacted the comptroller’s office Wednesday, the office was not aware that a community fundraising effort allowed some amnesty participants to repay money owed, according to C. Andrew Cliver, attorney in charge of the comptroller’s investigations division and a spokesman for the office.
“The deal was, you owe the state this amount of money, you need to make the state whole for the amount of money in the agreement,” Cliver said. “How they came to collect the money was not something we were aware of and (we) have no comment as to the appropriateness of that.”
After it was announced, the amnesty program was criticized quickly in the national media and by local advocates as favoritism for Lakewood’s Orthodox Jewish community. Comptroller Philip J. Degnan, who was nominated for a Superior Court judgeship in September, has stood by the program as a success, saying in a report that it recouped four times as much money in just a few months than criminal prosecutions had returned to the state in seven years.
But the problems circling around the program haven’t waned even a year later.
The Press revealed last month that though Degnan said repayments must be made in full, his office offered discounts of up to 50 percent for participants. A total of $2.6 million was not recovered because of the deal making.
And one person granted amnesty was Moshe S. Newhouse, an elected member of the Lakewood Board of Education who entered into a contract to buy a $500,000 house just days before he applied for amnesty. It is unclear if Newhouse borrowed money to repay the $24,000 in Medicaid benefits he owed the state, an amount reduced from the $48,000 in benefits Newhouse received for three years between 2013 and 2015.
O’Scanlon, the senator, is considering legislation to prevent individuals who partake in amnesty programs from serving in public office for a period of time and to require full repayment of benefits received from all participants.
“I understand there are times when it’s beneficial to the public for there to be some flexibility to these investigations and having people self-report their mistakes,” he said. “But there have to be consequences as well … Permitting people to keep some of the money they stole cannot happen again.”
He said Newhouse should resign his post.
Melinda Murray, a Lakewood public schools bus aide, calls for Moshe S. Newhouse to resign during a board meeting on Oct. 24, 2018. Stacey Barchenger, @sbarchenger
“That should happen right now,” O’Scanlon said. State Sen. Robert Singer, a Republican whose district includes Lakewood, has not responded to calls from the Press seeking comment on the amnesty program.
Who knew of amnesty deals? Memo says several
Hundreds of Lakewood Medicaid fraud cases can’t be prosecuted, lawsuit says
The comptroller’s office is also now facing a lawsuit over the program, filed Tuesday by a former employee. Andrew Poulos Jr. said in his civil lawsuit that he was fired in retaliation for disputing claims made by one of his supervisors that Poulos went rogue and acted without approval when he negotiated lower repayment amounts.
Degnan has said an employee acted alone to offer discounts, but Poulos’ lawsuit and a November 2017 memorandum obtained by the Press say supervisors in the comptroller’s office were aware of the deal making.
O’Scanlon said he has also had discussions with the comptroller, who is charged with rooting out fraud and waste in state government, encouraging further investigation to determine who inside the office knew reduced repayments were being offered.
“That’s something that we all need to know,” he said. “We pay all their salaries. There were deals cut here that I believe were inappropriate. Taxpayers have a right to know who cut them.”
It’s unclear how much restitution money was raised through community donations and how many of the 159 amnesty applicants relied on those dollars. The comptroller has said 159 people were granted amnesty through 81 settlement agreements, meaning each settlement agreement included an average repayment of about $27,700.
“Most of the repayments that were made were actually collected from charities,” attorney Yosef Jacobovitch told the Press. Jacobovitch represented many people who sought amnesty, but said his role did not include any discussions of how the money was repaid. Jacobovitch said many people who sought amnesty had dire financial needs and were unable to repay vast sums on their own.
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