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The following describes a government action that has been resolved by either a settlement or a decision by a court or administrative agency. If the matter is being appealed, it will be noted below.
On 5/23/2024, New York Attorney General Letitia James announced a $10.1 million settlement with health care companies RiverSpring Living Holding Corp. (RiverSpring) and ElderServe Health, Inc. d/b/a RiverSpring at Home (ElderServe) for failing to provide vulnerable New York seniors with personalized health care services while continuing to bill New York’s Medicaid program for those services. For years, RiverSpring and ElderServe collected millions of dollars in Medicaid payments while members of the RiverSpring Managed Long Term Care Plan in New York City and Westchester, Nassau, and Suffolk counties did not receive the care they were promised. The settlement is the result of a joint investigation between the Attorney General’s Medicaid Fraud Control Unit (MFCU), and the United States Attorney’s Office for the Southern District of New York (USAO-SDNY). Under the settlement, approximately $6 million will be returned to the New York State Medicaid Program.
RiverSpring is a New York not-for-profit corporation that provides administrative support to The Hebrew Home for the Aged at Riverdale and affiliated organizations. ElderServe is a New York not-for-profit corporation that administers a Managed Long Term Care Plan (the RiverSpring MLTCP) for Medicaid beneficiaries. Services provided under the RiverSpring MLTCP are specific to each member’s needs and can include home health aide services, nurse visits, social adult day care services, and other community-based services.
An investigation by MFCU found that from 2012 to 2017, the RiverSpring MLTCP collected Medicaid payments for services it never provided to its members. In many cases, RiverSpring either did not provide its members with qualifying services or did not adequately document that the services were provided. Despite this, RiverSpring received millions of dollars in Medicaid payments for these services.
As a result of the settlement, RiverSpring and ElderServe must pay $10,159,130 to federal and state Medicaid programs. $6,095,478 of the settlement funds will be returned to New York’s Medicaid program.
The case against RiverSpring was initiated by a former employee, who will receive a portion of the settlement because the former employee filed a whistleblower lawsuit under the qui tam provisions of the federal and New York False Claims Act. This Act allows people to file civil actions under seal on behalf of the government and share in any recovery.
At-a-glance
Business Details
- Location of This Business
- 5901 Palisade Ave, Bronx, NY 10471
- BBB File Opened:
- 10/21/2015
- Years in Business:
- 107
- Business Started:
- 1/1/1917
- Business Incorporated:
- 12/2/2009
- Type of Entity:
- Corporation
- Alternate Business Name
- ElderServe Health, Inc.
- RiverSpring Health Holding Corp.
- Business Management
- Mr. David V. Pomeranz, President/CEO
- Contact Information
Principal
- Mr. David V. Pomeranz, President/CEO
Customer Complaints
0 Customer Complaints
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