Highest NY Medicaid Billing in Middle Class Queens Nabe by Chris Glorioso - NBC New York

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Small Middle Class Enclave Generates Many Medicaid Bills

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Medicaid is a health care program reserved, primarily, for the poor.

Benefits are based on federal poverty guidelines. To be eligible in New York state, a single person must earn less than $17,000 a year.

With that in mind, you might expect the most impoverished neighborhoods would be the ones that generate the most Medicaid bills.

That's not true.

It turns out the state’s highest Medicaid billing total can be found within a relatively affluent community: Rego Park, Queen

The analysis found Rego Park -- a neighborhood with a median income above $50,000 -- generated more than $1.5 billion in Medicaid reimbursements in 2010. Because the health care program is aimed at helping poor people, the findings had regulators scratching their heads.With the help of the New York Office of the Medicaid Inspector General, NBC New York examined Medicaid data from all of the state’s nearly 15,000 zip codes.

“Why is Rego Park the highest? It’s something we have to look at,” said Deputy Medicaid Inspector General Michael Little.

Rego Park occupies a triangular plot of central Queens, roughly bordered by Woodhaven, Yellowstone and Queens Boulevards. The enclave is dotted by dozens of pharmacies, dentists, and medical device makers, but the neighborhood has no major hospital.

With 7 percent of the state’s $20 billion Medicaid budget passing through the 1.9-square-mile neighborhood, some observers believe Rego Park is the kind of community that deserves more regulatory scrutiny.

“These are places where the Medicaid Inspector General’s Office need to look at more closely to make sure that there is real honest alignment between the services that are provided and the needs of the patient,” said Paul Howard, a senior health policy analyst at the conservative think-tank Manhattan Institute.

Investigators who police New York’s Medicaid program use software designed by Salient Management Company, an upstate developer of data management tools. The data-mining computer program helps find suspicious patterns and unusual trends in health care billing. The office of the Medicaid Inspector General has about 50 investigators to battle fraud all over the state.

“Fifty investigators for billions and billions of dollars in claims. That means they have to be able to sift through data very quickly to get to the most likely targets for recovery,” said John Amisano, Salient senior health care adviser.

After learning the state’s single highest Medicaid billing total is within Rego Park, Michael Little’s office began to use the software to look deeper into the numbers.

“Why are they the biggest? Is it normal? Is it expected,” Little said.

By running data queries, Little discovered one of the state’s largest Medicaid managed care contractors uses a Rego Park address to process bills -- a clear reason for the high billing volume.

That doesn’t mean investigators won’t continue to have their eyes on the Queens neighborhood.

In his data query, Little also discovered pharmacy reimbursements make up the second largest share of Medicaid bills in Rego Park. That is significant because Rego Park pharmacists have been snared for fraud in the past. Most recently, federal prosecutors busted Rego Park’s ASA Pharmacy for taking part in a $2.5 million kickback scheme.

There are 13 Rego Park medical service providers who have been banned from participating in Medicaid.

“Our job is to prevent fraud, waste and abuse in the Medicaid program and New York State Legislature, when they established our office, did not want us to wait around for it to bite us,” Little said.

Readers who have information about Medicaid fraud in New York, New Jersey, or Connecticut, can report tips by clicking on the links.

Robbers Kill Woman in Struggle for Purse by Alice McQuillan - NBC New York

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A woman walking with her husband on a quiet Queens street Sunday night was shot and killed by robbers in a struggle for her purse.

The couple was outside in Hollis around 8:30 p.m. Sunday when three men wearing hoodies confronted them.

They demanded the 23-year-old woman’s purse and a struggle erupted. The robbers fired and the woman was shot twice in her torso in front of a home on 204th Street.

The unidentified woman was rushed to Jamaica Hospital where she was pronounced dead.

Her killers escaped.

Detectives ask anyone with information to call 1 800 577-TIPS.

The Kids Need Good, Experienced Teachers by Gabe Pressman - | NBC New York

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A battle is going on across the country for the soul of public education.

I went to public schools in the Bronx. They provided a pretty good education. The public school system has experienced ups and downs since then--but basic principles have remained intact: that every child deserves a good, free education, that teachers with experience are cherished, that parents should be invited into the educational process to work with teachers and administrators for the good of their children, that politicians and other outsiders have no business meddling with our educational system.

Today’s assault on public education is led by politicians across the country. Here in New York, Mayor Bloomberg and his advisers have far-reaching control over public schools. The mayor’s motives may be good but he is not an educator. And his main goals now appear to be to save money by eliminating veteran teachers [they get higher salaries than their juniors] and breaking the power of the teachers union.

Listening to members of the Bloomberg team talk, one might get the idea that the union members are horrible people who value their salaries more than the children they teach. As a reporter who has covered the public schools for many decades, I find that notion absurd. I also confess to a bias based on my life experience. I had three aunts who were teachers and I remember how dedicated they were to the kids and how they pursued courses to improve their ability to teach. And how they never lost their sensitivity to children nor their love of the teaching profession.

City Hall’s actions are somewhat sneaky: helping charter schools in their competition with public schools, without letting citizens know about it. The Independent Budget Office has just disclosed that, in the last year, charter schools received $649 more per student than regular public schools. The Daily News reports that charter schools are getting a windfall increase of 9 percent in New York City even as public schools are cut by more than 4 percent. Clearly the point seems to be: help the charter schools by starving the public schools.

The people of New York have not voted for such a policy. Do the taxpayers count for nothing?

Leonie Haimson, a parent leader, is angry at the way matters are unfolding. “Parents count for nothing in the way our leaders are handling the educational issues,” she told me. “We’ve been completely left out of major educational policy decisions.” Recently, she attended a Congressional hearing on education and, she says, “four parents testified and not one was for public schools.”

Haimson and other parents are organizing a group called Parents Across America, “to represent mothers and fathers in many school districts across this country. I don’t think it benefits our kids to create a system where there are so few incentives to make teaching a life’s work.

It’s interesting that this debate is not going on in Scarsdale or on Long Island. They’re looking to get rid of senior teachers in our most congested urban areas. The twin objectives are solely to destroy unions and save money.”

What is so sad, as this debate continues, is that our political leaders seem to place so little value on the wisdom of experienced teachers. Good teachers are essential to educating our most valuable resource, our children. The politicians seem to think that saving money is more important than saving children.

Coopers Hawk Causes a Flap on Capitol Hill at Library of Congress - NBC Nightly News

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A story unfolded of a female Copper's Hawk trapped high inside the Library of Congress since Wednesday. NBC Nightly news reported the hawk was captured after it was baited by two Starlings bought in by a Virginia Bird Conservancy

Expired Medications Sold Illegally at Queens Flea Market | NBC New York

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The FDA says it’s illegal, but it’s being sold to anyone right out in the open, and the people doing it don't seem to care that selling illegal and expired medications put lives at risk.

NBCNewYork.com went undercover at the aqueduct flea market in Ozone Park, Queens, where these kind of medications are sold for a steal.

On a bitingly cold Saturday afternoon, the flea market at the Aqueduct Race Track is packed with people buying everything from makeup, old candy, and clothing.

But taking a closer look at the goods being hawked you’ll find a more nefarious lineup of goods -- expired, over-the-counter medications like Robitussin, Claritin, and even children's medications, like Dimetapp.

The expiration dates range anywhere from a few months past the guaranteed safety date to years expired.

Pediatrician Greg Yapalater says the main concern with meds like these is not so much that they are expired, but rather the uncertainty of where they come from – whether they’ve been stored properly or if they’ve been tampered with.

“Buying junk for a dollar is still junk. Buying poison for a dollar is still poison. Why go that route? There are other ways. Go with the generics in the pharmacy. They're always going to be cheaper”, says Yapalater.

To watch video report...click here

News 4 confronted the vendors and asked why they were selling illegal goods and where they got the medications.

In response the reporter and cameraman were called named and screamed at to leave. No one could tell us the origin of the products.

The Flea Market’s managers told News4 the vendor in charge of stand selling the illegal drugs is a man named Pat Flynn.

Flynn denied he was in charge and would not answer questions.

By the time News 4 alerted the Market’s authorities the goods were quickly swept into a box and taken away.

Aqueduct Flea Market says they will revoke Pat Flynn’s permit. The market maintains that it checks twice a day for illegal products being sold. Still customers say they see the stuff being sold every market day – out in the open for anyone to see. State officials assure us that the proper authorities will be by the flea to stop vendors like Flynn from continuing to sell expired meds.

Bad Luck Biden: V.P.'s Escort Involved in Another Crash - NBC New York

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Don't ask Vice President Joe Biden about New York traffic.

For the second time in less than a year, a part of the vice president's motorcade was involved in a fender bender. Two NYPD motorcycle units helping escort the veep were involved in a minor accident in Queens, police said Thursday.

The officers suffered minor injuries and are being treated at Elmhurst Hospital. 

The VP continued on his way.

Last November, two advance vehicles -- paving the way for Biden to appear on The Daily Show -- were driving on 49th Street and 10th Avenue when they slammed into a livery cab. Four people -- two NYPD officers and two civilians -- were injured.

The cars apparently had lights and sirens on at the time, officials said.

Loving 5-year Reunion of Man, Gorilla by Mike Celizic- TODAY

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Two years ago, a lion’s loving reunion in the African wild with the two men who had raised him in London was a YouTube sensation. Now there’s a new animal star in town, and his name is Kwibi the gorilla.

You may have seen the video by now. A tall and aristocratic-looking Englishman rides a boat down a river in the African jungle hoping to find the gorilla he left there five years earlier.

In a deep voice, the man calls out, “C’mon! C’mon!” Finally, he sees his old friend on the riverbank. The man clambers out of the boat and up the bank. He sits in the undergrowth and Kwibi the gorilla greets him gently with caresses, sniffs, nose-rubs and hugs. The two gurgle at one another as the man chews on a leaf and then gives it to the gorilla.

Much as the “hugging” lion called Christian did, Kwibi the gorilla introduces his friend to his wives and children. When the man finally leaves, Kwibi follows his boat down the river and sleeps across from the man’s camp. In the morning, Kwibi is still there.

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Friday morning, Damian Aspinall, the man in the video, came to New York to tell TODAY’s Matt Lauer the back story behind the wildly popular video.

A gorilla’s gurgle
The first thing Lauer asked was whether Aspinall was scared at all. After all, gorillas are wary of humans, enormously powerful, and potentially dangerous.

And even though Aspinall had raised Kwibi from infancy at his zoo in the south of England, for the past five years the 10-year-old male had been living in the wild in a jungle preserve in Gabon. There was no guarantee Kwibi would remember Aspinall or, if he did, welcome him into his territory.

“I wasn’t 100 percent sure. You never know. He is a wild animal now,” Aspinall said. “But deep inside you believe that things will be OK.”

When he heard Kwibe the gorilla’s distinctive love gurgle, Damian Aspinall knew their reunion would be a happy one.

Aspinall knew that for sure when he heard a certain sound that Kwibi made.

“The moment I heard the gurgle — gorillas have a gurgle, and it’s a very deep love gurgle — I knew that I’d be OK,” Aspinall recalled. “Right at that moment, everything stopped. The sounds of the forest stopped and the sounds of the river stopped, and I was just captivated in that moment. He looked in my eyes with such intensity and such love.”

But the danger wasn’t over. There was still the chance that Kwibi’s wives would not be as welcoming to this total stranger.

“I was far more worried that one of the wives would be protective of Kwibi,” Aspinall admitted.

Unconventional upbringing
Lauer couldn’t help but wonder what a gorilla smells like after five years without a shower and shampoo and guessed that it must be ripe.

“I love the smell of a gorilla,” Aspinall said. “It never bothers me.”

It’s a smell he grew up with on his father’s estate in Kent in the south of England.

TODAY The animals that roamed young Damian Aspinall’s estate gave him the love he didn’t receive from his parents.

By all accounts, Damian Aspinall did not have the perfect set of doting parents. His father, John Aspinall, divorced his mother when Damian was 6 and told the boy never to have anything to do with her. John Aspinall determined early on that Damian, the eldest of his three children, was thick-headed and not worth his attention. After shipping the lad off to boarding school, the father had little to do with Damian until he grew up and made his first million pounds, with no help from the family fortune.

Damian got the emotional support he didn’t get from his parents from the animals that lived on the estate. The property is now a zoo, but when Aspinall was a child, wild and sometimes dangerous creatures roamed the house and the grounds freely.

“When I was a little boy, all the animals lived in the house with us,” he told Lauer. “I’d open my bedroom door, and tigers and gorillas and wolves would all jump on the bed.”

When he was an infant, Aspinall’s father put him in the hands of a female gorilla. The gorilla inspected him and showed off the new member of the family. As an adult, Aspinall has done the same with his own three daughters.

A multimillionaire who could be the real-life version of the “world’s most interesting man” of the Dos Equis beer ads, Aspinall runs the conservation organization his father started, the Aspinall Foundation, to breed gorillas and return them to the wild. He runs two wild animal parks in Kent, Howletts and Port Lympne, where 120 gorillas have been born and 77 of the great apes now live. In all, the foundation has returned 51 gorillas to protected areas of the African jungle.

But Kwibi was special, as anyone who has watched the reunion video can attest.

Aspinall has hopes that he’ll see Kwibi again.

“I go to Gabon three or four times a year, so I’m always hopeful I can see him. But it’s no different than if you go to see a friend of yours in another country, and you meet and you have a reunion, and then you go on your separate lives again,” he said.

A responsibilty to the Earth
Lauer asked if it’s not dangerous for Kwibi to be so friendly to humans, not all of whom are as nice to gorillas as Aspinall is. Aspinall said that’s not a problem.

“He’s familiar with me but not familiar with other human beings, which is the way it should be,” the conservationist explained.

The reunion took place two years ago and was shown on a British television show. Aspinall hopes that it inspires people to become involved in conservation efforts.

“I hope that when people see this they’ll realize that animals deserve their chance, and it just shows how gentle gorillas can be,” Aspinall said. “I think we have a responsibility to this earth, and I think we as a species can do so much more for this planet. I believe that and we’re trying to do a little bit of that.”

For more information about the Aspinall Foundation, click here. And to learn more about the foundation’s online animal adoption program, click here.

Obama to Pick New Yorker Kagan for SCOTUS

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NBC News has learned that President Obama intends to nominate Elena Kagan to the US Supreme Court, to succeed Justice John Paul Stevens.

She is currently a senior Justice Department official -- the first woman to be solicitor general, the nation's top courtroom advocate.

She was also the first woman dean of Harvard Law School. And she taught at the University of Chicago, where she met a young Barak Obama.

And if confirmed, she'd be the court's fourth woman justice -- and the third to currently sit on the court.

Officials say the president will make the announcement tomorrow morning at the White House.