United States Reaches $37 Million Settlement Of Fraud Lawsuit Against Cigna For Submitting False And Invalid Diagnosis Codes To Artificially Inflate Its Medicare Advantage Payments
Damian Williams, the United States Attorney for the Southern District of New York, announced today’s conviction in federal court of PAUL FISHBEIN of multiple counts of fraud and aggravated identity theft. FISHBEIN stole hundreds of thousands of dollars from rental assistance programs administered by New York City’s Human Resources Administration (“HRA”) and New York City’s Housing Preservation & Development (“HPD,” and with HRA, the “Agencies”) by renting out properties throughout the City that he falsely claimed to own and by collecting made-up broker fees. FISHBEIN was also convicted of Medicaid fraud. The jury convicted FISHBEIN today following a nearly two-week trial before U.S. District Judge Paul A. Crotty.
U.S. Attorney Damian Williams said: “New York City assists millions of low-income and vulnerable New Yorkers through different types of programs, including rental assistance programs and Medicaid. These programs were designed to help New Yorkers in need. But, as a jury has now found, for years, Fishbein abused those programs to enrich himself. To do that, he told lie after lie after lie. He stole money, including federal funds, from the City’s rental assistance programs by lying about being the landlord of homes he didn’t actually own. He stole the identity of a real estate broker to get the City to pay him made-up broker fees. And he stole Medicaid benefits by lying to the City about how much money he made. Today, a unanimous jury has held Fishbein accountable for his yearslong fraudulent schemes.”
According to the Indictment, documents previously filed in the case, and the evidence introduced at trial:
From in or about 2013 through May 4, 2021, FISHBEIN rented out properties in New York City to low-income New Yorkers through the Agencies’ rental assistance programs, collecting rent payments from the Agencies as the purported owner of the properties. In fact, FISHBEIN was never the owner of those properties and lied to the Agencies to collect the rent payments. In addition, FISHBEIN lied to HRA that he used the services of a real estate broker to rent out certain properties in order to collect broker fee payments from HRA, also through its rental assistance program. FISHBEIN used an actual real estate broker’s license and name without her authority to collect these made-up broker fees from the City. In-need New Yorkers were placed in these properties, which FISHBEIN, because he was not actually the owner of the properties, failed to maintain. In one instance, the ceiling completely collapsed while a tenant and her family were living in a property FISHBEIN claimed to own. Through these two schemes, FISHBEIN fraudulently obtained hundreds of thousands of dollars from HRA and HPD, including more than $90,000 in federal funds.
FISHBEIN was also convicted of healthcare fraud because, from 2014 through May 4, 2021, he lied to New York City’s Medicaid program about how much money he made in order to collect Medicaid benefits. Medicaid is meant for low-income New Yorkers. FISHBEIN, each year, told the City that he made only $150 a week, or $7,200 a year, when in reality, he was raking in hundreds of thousands of dollars each year from his rental assistance and broker fee schemes described above. By lying about his income and assets, the defendant received at least approximately $49,524.80 in Medicaid benefits to which he was not entitled.
* * *
FISHBEIN, 49, of Queens, New York, was convicted of one count of wire fraud, one count of mail fraud, one count of theft of government funds, one count of aggravated identity theft, and one count of healthcare fraud. The wire fraud and mail fraud charges each carry a maximum sentence of 20 years in prison; the theft of government funds and healthcare fraud charges each carry a maximum sentence of 10 years in prison; and the aggravated identity theft charge carries a mandatory two-year sentence, which must run consecutive to any other prison term imposed.
The maximum potential sentences in this case are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendant would be determined by the judge. FISHBEIN is scheduled to be sentenced by Judge Crotty on July 31, 2023.
Mr. Williams praised the outstanding investigative work of the New York City Department of Investigation.
This case is being handled by the Office’s General Crimes Unit. Assistant U.S. Attorneys Sarah L. Kushner, Christy Slavik, and Jared Lenow are in charge of the prosecution and were assisted at trial by Paralegal Specialist Joseph Magliocco.