New York State Comptroller Thomas P. DiNapoli, announced the arrest yesterday of Gina Bradshaw, an officer manager for numerous doctors’ offices in Manhattan, for her alleged role in a long-term scheme to defraud the New York State Insurance Plan (NYSHIP) out of over $12,000 by submitting fraudulent claims for reimbursement. The arrest was the result of a joint investigation between Comptroller DiNapoli, Ulster County District Attorney Clegg, and the FBI Hudson Valley White Collar Crime Task Force.
“Gina Bradshaw allegedly took advantage of her position to fund her lifestyle at the expense of the taxpayers,” DiNapoli said. “Thanks to my long-standing partnerships with Ulster County District Attorney Clegg and the Federal Bureau of Investigation this health care fraud was discovered and the defendant will be held accountable.”
Gina Bradshaw, 50, of Maybrook, NY, worked as an office manager for multiple doctors in Manhattan. Her husband was a New York State employee, and the family was enrolled in NYSHIP. As a medical office manager, Bradshaw was aware that under NYSHIP, state employees and their beneficiaries can receive medical services from out-of-network providers. In those instances, the employee or family member receives any allowable reimbursement by check sent directly to the employee from NYSHIP. The employee must then pay the provider out of pocket either with their own funds or by endorsing the check to the provider.
The joint investigation revealed that from 2018 through September of 2019, Bradshaw submitted false claims to NYSHIP under her husband’s NYSHIP identification number claiming that medical services were provided by two out-of-network providers for whom she worked, but the services actually never occurred. On the claim forms submitted to NYSHIP, Bradshaw certified the providers’ names and information, as well as signing her own name claiming the services were performed. The providers had no knowledge of Bradshaw’s scheme at the time she submitted the claims. Through this scheme, she received $12,957.50 from NYSHIP that she was not entitled to.
Bradshaw used the funds that she received from NYSHIP to pay her personal expenses including credit card debt.
This investigation was initiated by a complaint from United Healthcare Special Investigations Unit, who assisted with the investigation.
Bradshaw was arraigned in Town of Ulster Court before Judge S. Kesick and charged with Grand Larceny in the third degree, Healthcare Fraud in the third degree, Offering a False Instrument for Filing in the first degree, and Falsifying Business Records in the first degree. She is due back in court on October 11, 2023.
The charges filed in this case are merely accusations and the defendant is presumed innocent unless and until proven guilty in a court of law.
Since taking office in 2007, DiNapoli has committed to fighting public corruption and encourages the public to help fight fraud and abuse. New Yorkers can report allegations of fraud involving taxpayer money by calling the toll-free Fraud Hotline at 1-888-672-4555, by filing a complaint online at https://www.osc.state.ny.us/investigations, or by mailing a complaint to: Office of the State Comptroller, Division of Investigations, 8th Floor, 110 State St., Albany, NY 12236.