CBS data shows explosion in billing: From 2018-2024 billed seniors nearly quintupled (+390%). Local Medicaid-eligible senior population grew only 20%.
Facilities bill for more than 90% of area Medicaid seniors. Dense cluster of 64 centers in tiny area — densest in country.
DOJ busted one big operation: Inwoo Kim (Tony Kim) and Daniel Lee (Daniel Yang) ran Royal Adult Daycare and Happy Life. Allegedly paid cash and supermarket gift cards to seniors to enroll and fill fake/unneeded prescriptions at their pharmacy.
Scammed ~$120 million total. Medicaid paid $62M for day care services often not provided. Medicare paid $58M for drugs. Ran from 2016-2026.
Kickbacks used to lure vulnerable seniors. Billed for medically unnecessary or never-provided services.
“The defendants allegedly turned a pharmacy and social adult day care centers meant to help senior citizens into a $120 million dollar Medicare and Medicaid fraud scheme.” (DOJ press release)
Concentrated fraud in tight communities exploiting easy Medicaid rules and kickbacks is a recurring pattern in some immigrant-heavy areas.
Billions in taxpayer waste while real seniors may get poor or fake services. Weak oversight lets this scale fast.
CBS News investigation: https://www.cbsnews.com/news/adult-daycare-centers-dr-oz-potential-fraud/
DOJ charging details on Kim and Lee: https://www.justice.gov/opa/pr/two-queens-men-charged-120m-adult-day-care-and-pharmacy-fraud-medicare-and-medicaid
amny.com on the bust: https://www.amny.com/police-fire/medicare-medicaid-fraud-queens-day-care/