Full Breakdown
Crackdown on Medicaid Fraud in New York’s Adult Day-Care System
By Drooid · · How we work
Core Event: Coordinated Raids and Indictments
Federal, state and city law-enforcement agencies swept through dozens of adult-day-care centers across New York City, executing search warrants and seizing evidence boxes. The Staten Island District Attorney’s Office called the operation “Operation Golden Grift.” It resulted in a 457-count indictment against Yangsim Oum, 79, owner of SI Day Care Center, Inc., and her daughter Juyone Choe, 49, program director. Prosecutors allege the pair billed Medicaid for more than $530,000 in services that were never provided between April 17 and August 25. The indictment includes $13,000 for services claimed for at least 32 seniors who were dead or abroad. Both face up to 15 years in prison on the top charge of second-degree health-care fraud and multiple counts of falsifying business records.
Background & Context
New York’s Social Adult Day Care (SADC) benefit, a non-medical Medicaid program, offers daytime supervision, meals and personal care to roughly 45,000 seniors through more than 400 centers. The program costs the state over $500 million annually and is funded jointly by the state and the federal Centers for Medicare & Medicaid Services (CMS). Auditors have flagged rising expenditures and questionable payments, prompting a months-long investigation of more than 100 providers suspected of illegal activity, including money laundering, kickbacks and improper billing.
Data & Statistics
- $530,000 alleged fraudulent billing by Oum and Choe (457-count indictment).
- $13,000 billed for services to seniors who were dead or overseas.
- Over 100 adult-day-care providers targeted in the broader crackdown.
- Approximately $2.4 billion paid to SADC services from Jan 2019 through Oct 2024.
- A 2022 state audit identified $285 million in questionable payments, including $28.6 million to centers terminated for fraud.
Official Statements & Responses
The Department of Health and the Office of the Medicaid Inspector General have been directed to require health plans to review SADC claims before payment and to consider suspending payments where fraud is suspected. Governor Kathy Hochul ordered a review of the SADC benefit, with recommendations due by Dec. 31, which could include phasing out the program or shifting participants to alternative services.
State Health Commissioner Dr. James McDonald said the department will advise whether reforms can improve accountability or whether participants would be better served by other options. CMS Administrator Dr. Mehmet Oz described the operation as the largest enforcement action of its kind and met with Governor Hochul in Washington to coordinate the response.
Attorney General Letitia James reported that her Medicaid Fraud Control Unit secured 59 indictments, 13 convictions and more than $98 million in recoveries in fiscal year 2026, underscoring the breadth of the state’s anti-fraud efforts.
Conflicting Reports & Gaps
Sources differ on the exact number of arrests directly tied to the adult-day-care raids. Some reports note “at least two arrests” at the Staten Island facility, while others reference “more than a dozen” centers searched without specifying additional arrests. The total count of providers investigated remains approximate (“more than 100”), and the list of targeted locations has not been publicly released.
What’s Next
- The Department of Health must submit reform recommendations by Dec. 31, which may include phasing out the SADC benefit or restructuring it.
- A moratorium on new SADC providers, imposed in July, remains in effect until Jan. 2027 and could be extended.
- Ongoing coordination with CMS and federal agencies aims to tighten claim-review processes and pursue payment suspensions where fraud is identified.