纽约成人日托遭州联邦联合大执法：逾百家机构涉医疗补助欺诈被查，法拉盛、布鲁克林在列
纽约——联邦与纽约州执法人员 10 月 20 日对纽约市多家社会成人日托中心（Social Adult Day Care，简称 SADC）执行法院授权的搜查令，一项针对医疗补助（Medicaid）欺诈、历时数月的调查就此公开。据多家媒体现场报道，国土安全调查局（HSI）、联邦调查局（FBI）等机构人员当天出现在皇后区法拉盛、布鲁克林、曼哈顿与史坦顿岛的多家中心；法拉盛一家中心门口贴出暂停营业、禁止进入的告示，探员从中心内搬出成箱文件与电脑。HSI 一名发言人向《纽约邮报》证实，该局正在执行一次「经法院授权的执法行动」，因调查仍在进行，不作进一步评论。
纽约州州长 Kathy Hochul 同日宣布，州卫生厅、州医疗补助督察长办公室（OMIG）与州总检察长下属的医疗补助欺诈控制组，已与联邦卫生与公众服务部督察长办公室、FBI 及十多个联邦、州与地方伙伴合作数月，调查对象为 100 多家涉嫌欺诈或其他非法活动的成人日托机构。「我们锁定的，是我们认为从事了从洗钱、回扣到不当计费等非法活动的提供者。」Hochul 说。她表示：「纽约对欺诈零容忍。当不法分子利用这些关键项目牟利时，有需要的纽约老年人才是受害者。」州长办公室的数字显示，2021 至 2025 年间，州医疗补助督察长办公室共调查了 387 个与成人日托运营有关的对象，并将约 100 起案件移交州总检察长考虑刑事起诉；2025 年一年，州卫生厅对 418 家成人日托机构做了合规审查。今年稍早，布鲁克林有两人就一桩 6,800 万美元的成人日托欺诈案认罪，皇后区另有一起涉成人日托与药房服务、据称达 1.2 亿美元的医保欺诈案被提起指控。州长办公室称，过去五年，全州医疗补助通过项目完整性行动共节省与追回逾 150 亿美元。
FBI 在声明中说，一次审计发现，纽约州医疗补助在 2019 年 1 月至 2024 年 10 月间为社会成人日托服务支付了约 24 亿美元；该局在发现该行业存在明显的浪费、滥用与欺诈迹象后加入跨部门工作组，目前正核查这笔钱中有多少被窃取。纽约州总检察长 Letitia James 表示，其医疗补助欺诈控制组仅在 2026 财政年度就已取得 59 份起诉书、13 项定罪，并通过数十起民事和解追回逾 9,800 万美元。执法行动次日，史坦顿岛地区检察官 Michael E. McMahon 宣布起诉当地史坦顿岛成人日托中心的业主 Yangsim Oum 与项目主任 Juyoung Choe（两人为母女），指控两人为从未接受服务的老人虚假申报、骗取逾 53 万美元，其中包括为至少 32 名已去世或身在国外的老人申报的约 1.3 万美元，两人被控 400 多项罪名；检方称，这只是当天全市被锁定的约百家机构中的两家。
社会成人日托是一项非医疗福利，经联邦医疗保险与医疗补助服务中心（CMS）批准、由联邦与州共同出资，通过纽约州的管理式长期护理计划提供日间看护、膳食、社交活动与个人护理服务。据州长办公室数字，全州现有 400 多家成人日托机构，服务约 4.5 万名医疗补助会员，年成本逾 5 亿美元。法拉盛与布鲁克林日落公园、八大道一带是纽约最大的华人聚居区之一，这类日托中心日常服务的长者中有大量华语老人。Hochul 已指示州卫生厅在今年 12 月 31 日前提交项目去向建议，选项包括加强监管、改革项目，或逐步取消该福利并将参加者转往其他老年服务；卫生厅同时被要求推动健康计划对成人日托申报实行预付审核、必要时暂停付款。今年 7 月宣布的新机构暂停准入令将至少执行到 2027 年 1 月。CMS 主任 Mehmet Oz 当天走访了皇后区的两家中心，称这是同类执法行动中规模最大的一次。
同一天，联邦层面的反欺诈工具也同步加码。美国司法部 10 月 20 日宣布设立「欺诈举报人激励计划」（Fraud Whistleblower Incentive Program，简称 WHIP），由该部国家欺诈执法司负责，财政部为此拨款 2,500 万美元。司法部称，这是首个在刑事指控提出阶段即发放「预付奖励」的举报人奖励计划：民众自愿提供真实、原创的可信线索，且线索导致刑事指控提出的，可获 1 万至 3 万美元奖励，具体由司法部裁量。计划重点覆盖的领域包括临终关怀欺诈、居家护理欺诈、日托欺诈与特殊服务欺诈，举报入口为 america.gov/fraud。司法部长 Todd Blanche 说，该计划「让每个人都有机会成为解决方案的一部分，帮助揭露欺诈，并因其努力迅速获得奖励」。（GSM 据纽约州长办公室、美国司法部新闻稿及公开报道）
Federal and State Agents Raid New York City Adult Day Care Centers in Medicaid Fraud Crackdown Targeting More Than 100 Providers
NEW YORK — Federal and state law enforcement officers executed court-authorized search warrants at multiple social adult day care centers across New York City on Tuesday, October 20, bringing a months-long Medicaid fraud investigation into public view. Agents from Homeland Security Investigations (HSI), the Federal Bureau of Investigation and other agencies were seen at centers in Flushing, Queens, in Brooklyn, in Manhattan and on Staten Island, according to local media reports; at one Flushing center, a notice on the door said the business had suspended operations and entry was prohibited, as agents carried boxes of files and computers out of the site. An HSI spokeswoman confirmed to the New York Post that the agency was carrying out a "court-authorized law enforcement action" and declined to comment further, citing the active investigation.
Governor Kathy Hochul announced the same day that the state Department of Health, the Office of the Medicaid Inspector General (OMIG) and the state attorney general's Medicaid Fraud Control Unit have been working for months with the U.S. Department of Health and Human Services Office of Inspector General, the FBI and more than a dozen other federal, state and local partners, targeting more than 100 social adult day care providers suspected of fraud or other illegal activity. "We're targeting providers — we believe — who engaged in illegal activity, ranging from money laundering to kickbacks to improper billing, and other fraudulent activities," Hochul said. "New York has zero tolerance for fraud, and when bad actors take advantage of these critical programs, older New Yorkers in need lose out," she added. According to the governor's office, OMIG investigated 387 subjects related to adult day care operations between 2021 and 2025 and referred approximately 100 cases to the attorney general for potential criminal prosecution; in 2025 alone, the health department reviewed 418 programs for compliance. Earlier this year, two individuals in Brooklyn pleaded guilty to a $68 million adult day care fraud scheme, and investigators announced separate charges in an alleged $120 million Medicare and Medicaid fraud scheme connected to adult day care and pharmacy services in Queens. Over the past five years, the governor's office said, New York's Medicaid program has realized more than $15 billion in savings and recoveries through program integrity efforts.
In a statement, the FBI said an audit found that New York's Medicaid program paid about $2.4 billion for social adult day care services from January 2019 through October 2024; the bureau said it joined an interagency working group after finding significant signs of waste, abuse and fraud in the sector, and that investigators are working to determine whether part of that money was stolen. Attorney General Letitia James said her Medicaid Fraud Control Unit has, in fiscal year 2026 alone, secured 59 indictments, 13 convictions and more than $98 million in recoveries from dozens of civil settlements. A day after the searches, Richmond County District Attorney Michael E. McMahon announced that Yangsim Oum, owner of the Staten Island Adult Day Care Center, and Juyoung Choe, its program director — a mother and daughter — had been arrested and indicted on more than 400 counts, accused of billing more than $530,000 for seniors who were never served, including about $13,000 billed for at least 32 seniors who were dead or out of the country on the dates of service; prosecutors said the two were just two of about 100 providers targeted across the city that day.
Social adult day care is a non-medical benefit approved and jointly funded by the federal Centers for Medicare & Medicaid Services (CMS) and delivered through New York's Managed Long Term Care program, providing daytime supervision, meals, social activities and personal care in community settings. More than 400 programs serve approximately 45,000 Medicaid members statewide at an estimated annual cost of more than $500 million, according to the governor's office. Flushing and Brooklyn's Sunset Park and Eighth Avenue corridor are among New York's largest Chinese communities, and many of the seniors who use such centers are Chinese-speaking. Hochul has directed the health department to deliver recommendations on the program's future by December 31, including options to reform it or phase out the benefit and transition participants to other services for older New Yorkers; health plans have been directed to apply prepayment review to adult day care claims and pursue payment suspensions where warranted. A moratorium on new providers, announced in July, remains in effect until at least January 2027. CMS Administrator Dr. Mehmet Oz, who visited two facilities in Queens on Tuesday, called the operation the largest enforcement action of its kind.
The same day, the federal government also rolled out a new fraud-fighting tool. The Justice Department on October 20 announced the Fraud Whistleblower Incentive Program (WHIP), run by its National Fraud Enforcement Division and backed by a $25 million commitment from the Treasury Department. The department described it as the first-ever whistleblower rewards program that pays an up-front award for tips leading to criminal charges: individuals who voluntarily provide truthful, original information that leads to criminal charges may receive between $10,000 and $30,000, with awards made at the department's sole discretion after charges are filed. Priority areas include hospice fraud, home health care fraud, day care fraud and special services fraud, and tips can be submitted at america.gov/fraud. "The Fraud Whistleblower Incentive Program (WHIP) offers everyone the opportunity to be part of the solution, help expose fraud, and be rewarded quickly for their efforts," Attorney General Todd Blanche said. (GSM, based on releases from the New York governor's office and the U.S. Department of Justice and other public reporting)
来源：GSM·美国（原文链接）
图片来源：法拉盛缅街站（资料图） · Pacific Coast Highway 摄，Wikimedia Commons，公共领域
- 2026-10-21 18:57纽约成人日托遭州联邦联合大执法：逾百家机构涉医疗补助欺诈被查，法拉盛、布鲁克林在列本篇
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