New York State Office of the Attorney General, Press Release, August 20, 2021
NEW YORK – New York Attorney General Letitia James today announced the indictment of Leslie Montgomery, 50, of the Bronx for defrauding New York state out of millions of dollars in false Medicaid claims. Montgomery — who did business as Healthy Living Community Center (Healthy Living) and owned LCM Livery P/U, Inc. (LCM Livery) — allegedly scammed individuals and taxpayers through an elaborate scheme, whereby Montgomery advertised a fake housing assistance program to lure low-income New Yorkers into providing their personal information, including their Medicaid numbers. Montgomery then used that personal information to submit false claims for custom-molded back braces to MetroPlus Health Plan, Inc. (MetroPlus), a Medicaid-funded managed care organization, for braces that were not needed and never ordered by patients. Montgomery is accused of stealing more than $4 million from the illegal scheme.
“Cheating taxpayers by preying on vulnerable New Yorkers is disgraceful and unacceptable,” said Attorney General James. “This alleged scheme took advantage of those most in need, baiting individuals with fake promises of affordable housing, only to use their personal information to steal more than $4 million from taxpayers. This fraud will not go unchecked. We will go after anyone who steals from New Yorkers.”
In the indictment, the Office of the Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) alleges that Montgomery regularly used social media to advertise a sham housing assistance program as a ruse to lure low-income New Yorkers to Healthy Living. Healthy Living then required New Yorkers to divulge personally identifiable information — including their Medicaid numbers — in order to qualify for the purported program. But instead of helping New Yorkers find housing, Montgomery used their personal information to submit false claims to MetroPlus for highly customized back braces that she never provided to the Medicaid recipients. From time to time, Montgomery provided a $20 “off-the-shelf” back brace that was mailed directly from Amazon to the recipient. However, most of the time, she provided no brace at all, yet still billed MetroPlus between approximately $750 and $1,550 per back brace. Altogether, Montgomery is accused of pocketing more than $4 million from the scheme.
The indictment — filed in Bronx County State Supreme Court — charges Montgomery with one count of Grand Larceny in the First Degree, a class B felony; one count of Health Care Fraud in the First Degree, a class B felony; one count of Money Laundering in the First Degree, a class B felony; and five counts of Identity Theft in the First Degree, a class D felony. In addition to the charges against Montgomery, LCM Livery is also charged with one count of Money Laundering in the First Degree. If convicted on the top charge, Montgomery could face up to 25 years in state prison.
In conjunction with the criminal case, the OAG has also filed a civil complaint against Montgomery, LCM Livery, and other companies owned and controlled by Montgomery. The complaint — which asserts violations of New York’s False Claims Act, Section 145-b of New York’s Social Services Law, and other causes of action — seeks to recover millions of dollars in Medicaid money obtained by these defendants as a result of their fraudulent conduct.
The charges against the defendants are accusations, and the defendants are presumed innocent unless, and until, proven guilty in a court of law.
The OAG wishes to thank the New York state Department of Health, the Office of the Medicaid Inspector General, and MetroPlus for their assistance and cooperation in this investigation.
MFCU’s investigation was led by Investigator Shavaun Clawson, with the assistance of Supervising Investigator James Briscoe, under the supervision of Deputy Chief Investigator Kenneth Morgan. The underlying financial audit was completed by Senior Auditor Investigator Ying Tuo, with the assistance of NYC Regional Deputy Chief Auditor Jonathan Romano and NYC Regional Chief Auditor Thomasina Smith. Legal Assistants Victoria Sepe and Danielle Vercelli also assisted in the investigation.
The criminal case is being prosecuted by Special Assistant Attorneys General Hayley Campbell and Anjna Kapoor, with assistance from Senior Counsel David Arias and NYC Regional Director Christopher M. Shaw. Thomas O’Hanlon is MFCU’s Chief of Criminal Investigations-Downstate. The civil action is being litigated by Senior Counsel Konrad Payne, with the assistance of Civil Enforcement Chief Alee N. Scott. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney, and is a part of the Division for Criminal Justice. The Division for Criminal Justice is led by Chief Deputy Attorney General José Maldonado and is overseen by First Deputy Attorney General Jennifer Levy.
Reporting Medicaid Provider Fraud: MFCU defends the public by addressing Medicaid provider fraud and protecting nursing home residents from abuse and neglect. If an individual believes they have information about Medicaid provider fraud or about an incident of abuse or neglect of a nursing home resident, they can file a confidential complaint online on the OAG website or by calling the MFCU hotline at (800) 771-7755. If the situation is an emergency, please call 911.
MFCU’s total funding for federal fiscal year (FY) 2021 is $53,413,761. Of that total, 75 percent — or $40,060,324 — is awarded under a grant from the U.S. Department of Health and Human Services. The remaining 25 percent of the approved grant — totaling $13,353,437 for FY 2021 — is funded by New York state. Through its recoveries in law enforcement actions, MFCU regularly returns more to the state than it receives in state funding. Article