RECENT HEALTH LAW NEWS


Warning: Minor Errors Can Mean Big Takebacks for AWV Claims
March 15, 2024 | Rivkin Rounds Staff | Behavioral Health | Fraud and Abuse | Litigation | Medicare and Medicaid
A March 11 article in Part B News, “Warning: Minor Errors Can Mean Big Takebacks for AWV Claims,” discussed how compliance shortcomings can cause problems for claims to Medicare for annual wellness visits (AWVs). Rivkin Radler’s Mary Aperance was quoted in the article. “Routine internal audits should be conducted to…
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NY Nursing Home Settles Fraud Suit
March 11, 2024 | Chris Kutner | Fraud and Abuse | Litigation | Medicare and Medicaid | Nursing Homes
On March 4, the New York Attorney General announced an $8.6 million settlement with Fulton Commons Care Center, a nursing home located in East Meadow, NY. The settlement resolves an action brought against Fulton in 2022 claiming financial fraud, physical abuse, mistreatment of residents, and covering up resident complaints. The…
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Physician Employment Arrangements: Assuring Compliance while Maximizing Opportunities
March 02, 2024 | Rivkin Rounds Staff | Employer/Employee | Fraud and Abuse | Legislation and Public Policy
On Thursday, March 7, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Tamika Hardy, Ada Janocinska and Syma Levine will present “Physician Employment Arrangements: Assuring Compliance while Maximizing Opportunities.”  The program will take place from 12:00 noon to 1:00 PM Eastern time via…
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Montefiore Medical Center Settles HIPAA Breach for $4.75 Million
February 27, 2024 | Mary Aperance | Cybersecurity | Electronic Health Records | HIPAA | Hospitals | Litigation
On February 6, the U.S. Department of Health and Human Services (HHS) announced a $4.75 million settlement with Montefiore Medical Center (MMC) for a breach of unsecured electronic protected health information (ePHI). The settlement stems from an internal investigation that found that an employee of the New York hospital system…
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Prohibitions on Provider Inducements
February 15, 2024 | Rivkin Rounds Staff | Fraud and Abuse | Hospitals | Legislation and Public Policy | Medicare and Medicaid
On Tuesday, February 27, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler partners Jeff Kaiser and Ben Malerba will present “Prohibitions on Provider Inducements.”  The program will take place from 12:00 noon to 1:00 PM Eastern time via Zoom. Some of the topics…
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NY Man Jailed for 12 years for $600 Million Healthcare Fraud
February 14, 2024 | Chris Kutner | Fraud and Abuse | Litigation | Private Insurers
A Long Island man who impersonated the general counsel of the NFL and an NBA player as part of his scheme for multiple frauds will now serve jail time. Sentenced in federal court in Central Islip, Matthew James used physicians throughout the country to bill health insurers fraudulently to the…
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CT Psychologists Convicted for Medicaid Fraud
February 06, 2024 | Mary Aperance | Behavioral Health | Fraud and Abuse | Litigation | Medicare and Medicaid
On December 19, Michael Lonski, a Greenwich psychologist, was sentenced to a 27-month prison term and three more years of supervised release for a scheme to defraud Medicaid. Lonski submitted over 80,000 claims from 2014 to 2019, and in calendar year 2017 he submitted claims for services on all but…
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NJ Hospital and Investors to Pay $30.6 Million to Settle FCA Claims
January 29, 2024 | Eric Fader | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid
The U.S. Department of Justice recently announced that Silver Lake Hospital, a long-term care hospital in Newark, New Jersey, and some of its investors agreed to pay $30.6 million to settle claims that they violated the False Claims Act (FCA) and the Federal Debt Collection Procedures Act (FDCPA). The hospital…
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OIG Advisory Opinion Blesses Gift Card Plan
January 17, 2024 | Eric Fader | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
A recent Advisory Opinion (No. 23-15) from the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) concluded that a healthcare consulting company’s plan to offer gift cards to physician practices in exchange for referring potential new customers to the company does not violate the federal Anti-Kickback…
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Top Ten Activities to Jump Start Your Compliance Program in the New Year
January 17, 2024 | Rivkin Rounds Staff | Legislation and Public Policy | Medicare and Medicaid
On Thursday, January 25, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler partner Bob Hussar will present “Top Ten Activities to Jump Start Your Compliance Program in the New Year.”  The program will take place from 12:00 noon to 1:00 PM Eastern time…
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Health Network Pays $345 Million for Compensating Physicians Above FMV
December 28, 2023 | Ada Janocinska | Employer/Employee | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid
Community Health Network, Inc., based in Indianapolis, Indiana, has paid $345 million to settle alleged violations of the False Claims Act (FCA). The lawsuit was initiated through a whistleblower complaint that was filed in 2014 by the network’s former Chief Financial Officer. The suit alleged that, between 2008 and 2009,…
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FinCEN Issues Update to Corporate Transparency Act
December 28, 2023 | Rivkin Rounds Staff | Legislation and Public Policy
On November 29, the U.S. Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN) issued an update to the Corporate Transparency Act (CTA), extending the deadline for reporting companies to disclose beneficial ownership information. Once the CTA goes into effect on January 1, 2024, reporting companies created in 2024 will now have…
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NY Bill to Reduce Temp Agency Staff in Nursing Homes on Governor’s Desk
December 21, 2023 | Jeffrey Ehrhardt | Legislation and Public Policy | Nursing Homes
A law that would incentivize reductions in the use of temporary staffing agencies in nursing homes awaits action by Governor Hochul, who must either sign or veto the law by December 23. [UPDATE: Gov. Hochul signed this bill into law (S.6897/A.7328) on December 22. The Governor’s press release can be found…
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Brooklyn Cardiologist Hit with Fraud Charges
December 20, 2023 | Joseph DiBella | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
On December 14, the U.S. Attorney’s Office for the Southern District of New York and other agencies announced the indictment of Niranjan Mittal, a Brooklyn cardiologist, on multiple fraud charges. Mittal allegedly fabricated patient records, paid physicians for patient referrals, and billed for medically unnecessary procedures. The U.S. Attorney’s Office also…
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New HHS Rule for Nursing Home Ownership and Manager Disclosure
December 08, 2023 | Lindsay Brocki and Sean Simensky | Legislation and Public Policy | Medicare and Medicaid | Nursing Homes
A new rule will require nursing homes enrolled in Medicare or Medicaid to make disclosures about certain facility ownership, management and other operational information. The U.S. Department of Health and Human Services (HHS) published the rule on November 17, with lawmakers emphasizing that greater transparency in the operation and ownership…
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2024 Medicare Physician Fee Schedule Extends Telehealth Flexibilities
December 01, 2023 | Eric Fader | COVID-19 | Legislation and Public Policy | Medicare and Medicaid | Telehealth
The 2024 Medicare Physician Fee Schedule final rule, released by the Centers for Medicare & Medicaid Services (CMS) earlier this month, extended certain telehealth-related flexibilities that were implemented during the early days of the COVID-19 pandemic. CMS issued a Fact Sheet summarizing the telehealth updates, as well as other important…
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Important Changes to NY’s Health Care Proxy Law
November 29, 2023 | Wendy Sheinberg | Legislation and Public Policy
As of November 2023, having a valid health care proxy became easier for New Yorkers. A health care proxy allows a competent adult to appoint an agent to make health care choices for them if they lose the ability to make those decisions for themselves. Two adults who are not…
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NY Physician, Wife and Staff Admit AKS Violations
November 28, 2023 | Eric Fader | Fraud and Abuse | Litigation | Medicare and Medicaid
The U.S. Attorney’s Office in Trenton, NJ announced on November 22 that primary care physician Yitzchok “Barry” Kurtzer of Monsey, NY, and his wife pleaded guilty to soliciting and receiving kickbacks and bribes in exchange for ordering genetic tests. Kurtzer had offices in the Scranton, PA area that his wife…
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OCR Releases Resource Documents on Telehealth Risks
November 14, 2023 | Eric Fader | Cybersecurity | HIPAA | Legislation and Public Policy | Telehealth
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently released two resource documents to help healthcare providers explain the privacy and security risks of telehealth to their patients. The first document, entitled “Educating Patients about Privacy and Security Risks to Protected Health Information when Using…
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The Corporate Transparency Act: Will it Impact You?
October 21, 2023 | Rivkin Rounds Staff | Legislation and Public Policy
The Corporate Transparency Act (CTA) will affect most small, privately held businesses starting January 1, 2024. Does the CTA apply to you? What is the CTA?The CTA, a law enacted by Congress, will require certain business entities to disclose beneficial ownership information to the U.S. Department of the Treasury’s Financial…
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NY and CT Prohibit Geofencing near Health Care Facilities
October 13, 2023 | Jeffrey Ehrhardt and Frank Izzo | Cybersecurity | Legislation and Public Policy
New York State and Connecticut have recently enacted laws that prohibit “geofencing” near health care facilities. The New York State law took effect on July 2, 2023, and Connecticut’s on October 1, 2023. These geofencing laws, enacted partly in response to the Supreme Court Dobbs decision (to prevent advertisers from targeting people…
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Recent OMIG Updates (NOTE NEW DATE)
October 12, 2023 | Rivkin Rounds Staff | Legislation and Public Policy | Medicare and Medicaid
On Friday, October 27, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler partner Bob Hussar will present an overview of recent regulatory developments at the New York State Office of the Medicaid Inspector General (OMIG).  The program will take place from 12:00 noon…
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NJ man arrested for selling counterfeit supplements on Amazon
October 12, 2023 | Rivkin Rounds Staff | FDA | Fraud and Abuse | Litigation
A September 29 article in NutraIngredients-USA, “New Jersey Man Arrested for Selling Counterfeit Supplements on Amazon,” discussed the arrest of Brad Snyder of Marlton, NJ, for allegedly counterfeiting Pure Encapsulations and Nature M.D. branded products and selling them online. Rivkin Radler’s Steve Shapiro was quoted in the article. Steve noted…
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NY Cardiologist Settles AKS Claims for $6.5 Million 
September 26, 2023 | Eric Fader | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
The U.S. Attorney’s Office for the Southern District of New York announced on September 18 that cardiologist Klaus Peter Rentrop and his practice, Gramercy Cardiac Diagnostic Services, P.C., agreed to pay $6.5 million to settle allegations that they violated the federal Anti-Kickback Statute and Stark Law. Rentrop admitted to paying…
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FTC Issues Guidance on HIPAA, FTC Act, and Health Breaches
September 24, 2023 | Eric Fader | Cybersecurity | Electronic Health Records | HIPAA | Legislation and Public Policy
The Federal Trade Commission (FTC) recently issued guidance entitled “Collecting, Using, or Sharing Consumer Health Information? Look to HIPAA, the FTC Act, and the Health Breach Notification Rule.” The guidance points out that while businesses that collect, use, or share consumer health information are (or should be) accustomed to complying…
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Telehealth Awareness Week
September 15, 2023 | Eric Fader | Telehealth
The American Telemedicine Association (ATA) has announced that its third annual Telehealth Awareness Week will take place September 17-23, 2023. The official website for the event states: “During the week, the ATA invites telehealth solution providers, hospital systems and medical practices, patient advocacy leaders, policymakers, and other stakeholders to highlight…
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You can ‘fire’ patients for just cause, but hew to a clear policy
September 15, 2023 | Rivkin Rounds Staff | Hospitals | Legislation and Public Policy
An August 24 article in Part B News, “You can ‘fire’ patients for just cause, but hew to a clear policy,” explained how healthcare providers can legally and ethically refuse service to a patient. Rivkin Radler partner Frank Izzo was quoted in the article. Although healthcare facilities usually get into…
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NYS DOH Provides Overview of Material Transaction Reporting 
September 08, 2023 | Jeffrey Ehrhardt and Benjamin Malerba | Legislation and Public Policy
The New York State Department of Health has published a webpage regarding Public Health Law (PHL) Article 45-A.  In our prior post, we discussed how PHL Article 45-A requires health care entities involved in material transaction(s) to provide written notice and information to DOH at least 30 days prior to…
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Kaiser and Janocinska Author ABA Book on the Federal AKS and Safe Harbors
September 07, 2023 | Rivkin Rounds Staff | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
The American Bar Association has published the second edition of “The Federal Anti-Kickback Statute and Safe Harbors: A History and Practice Guide.” Written by Geoffrey R. Kaiser and Ada Janocinska, the book is a comprehensive reference for one of the nation’s most commonly cited, investigated and enforced health care fraud…
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Due Diligence: A Critical Component of any Transaction
September 06, 2023 | Benjamin Malerba, Douglas Menikheim and Sean Simensky | Dentistry
In our previous article, we detailed the role and importance of the letter of intent (LOI) in establishing a framework for selling a dental practice. Now we will discuss the next step in the transaction – performing due diligence. Due diligence is the process through which each party evaluates the other…
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Telehealth After the Pandemic: Recent Federal and State Developments
September 05, 2023 | Rivkin Rounds Staff | COVID-19 | Legislation and Public Policy | Medicare and Medicaid | Private Insurers | Telehealth
On Thursday, September 14, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler partner Eric D. Fader will present an update on the regulatory landscape for the provision of telehealth services, including recent changes to federal and state laws and rules.  The program will…
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OIG Advisory Opinion Warns on IONM Company “Surgeon Deals”
August 22, 2023 | Eric Fader | Fraud and Abuse | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Private Insurers
On August 18, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) published an Advisory Opinion warning that a common arrangement under which surgeons profit from referrals of their patients for intraoperative neuromonitoring (IONM) services can violate the federal Anti-Kickback Statute (AKS). The Advisory Opinion, the…
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NJ DME Company Owner Pleads Guilty to Kickback Scheme
August 05, 2023 | Joseph DiBella | COVID-19 | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid
The U.S. Attorney’s Office for New Jersey recently announced that Alexander Schleider of Lakewood pleaded guilty to wire fraud and conspiracy to commit healthcare fraud in a durable medical equipment (DME) kickback scheme. Schleider owned and operated several DME companies that provided orthotic braces to beneficiaries of Medicare and other…
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Kaiser to Present on Drug and Device Enforcement Trends for PLI
August 03, 2023 | Rivkin Rounds Staff | FDA | Fraud and Abuse | Legislation and Public Policy | Medical Devices and Wearables | Pharmaceuticals
On September 14, Rivkin Radler’s Jeff Kaiser will participate on a panel at Practising Law Institute’s Life Sciences 2023: Navigating Legal Challenges in Drug and Device Industries program in New York City. Held at PLI’s New York Conference Center at 1177 Sixth Avenue, the program will cover the explosive growth…
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NY Pharmacy Owner and Manager Indicted for Medicaid Fraud
July 31, 2023 | Eric Fader | Fraud and Abuse | Litigation | Medicare and Medicaid | Pharmaceuticals
New York State Attorney General Letitia James recently announced that the owner and manager of Santiago Pharmacy in Flushing, Queens, were indicted for paying kickbacks to Medicaid recipients in exchange for filling their HIV prescriptions at the pharmacy. Juan Poveda, the owner, and Javier Burbano, the pharmacy manager, were charged…
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Letters of Intent – Negotiating the Framework of Your Transaction
July 27, 2023 | Benjamin Malerba, Douglas Menikheim and Sean Simensky | Dentistry
In our last installment, we discussed some of the initial steps involved in the process of selling a dental practice, including preparing your practice for sale and finding a potential suitor. Specifically, we described ways in which sellers can find potential buyers and work with advisors and brokers to evaluate…
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Compliance Issues and Trends in Healthcare Transaction Laws
July 06, 2023 | Rivkin Rounds Staff | Legislation and Public Policy
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Ben Malerba and Jeff Ehrhardt will discuss compliance issues and trends in healthcare transaction laws. The presentation will focus on: Ben is a partner and Jeff is an associate in Rivkin Radler’s Health Services Practice…
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NJ Psychiatric Practice Fined for HIPAA Privacy Rule Violation
June 30, 2023 | Eric Fader | HIPAA | Litigation
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently announced that Manasa Health Center in Kendall Park, New Jersey entered into a Resolution Agreement and Corrective Action Plan to resolve a HIPAA Privacy Rule violation. The psychiatric practice, owned by Dr. Nidagalle Gowda, inexplicably disclosed…
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Contemplating Selling Your Practice? Consider These First Steps
June 26, 2023 | Benjamin Malerba, Douglas Menikheim and Sean Simensky | Dentistry
In our last installment, we discussed that the dental services industry has undergone large-scale consolidation in recent years, primarily driven by Dental Services Organizations (DSOs) and private investors. We described what a DSO is and why it is a prevalent vehicle through which private investors are seeking to consolidate the…
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Bronx Nursing Home Settles AKS/FCA Case
June 23, 2023 | Joseph DiBella | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid | Nursing Homes
The U.S. Department of Justice recently announced that Morris Park Nursing Home, a skilled nursing facility in the Bronx, and two individuals agreed to pay a total of $3.46 million to resolve federal Anti-Kickback Statute and False Claims Act violations. The schemes included paying cash kickbacks to a supervisor at…
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Former NY Nurse Sentenced for Fake Vax Cards
June 20, 2023 | Eric Fader | COVID-19 | Fraud and Abuse | Litigation
On June 9, Steven Rodriguez, a former nurse from Long Beach, New York, was sentenced in federal court to 2-1/2 years in prison for selling at least 300 fake COVID-19 vaccination cards. Rodriguez and a co-conspirator from Queens, Jia Liu, had pleaded guilty to the scam. Liu will be sentenced…
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Doing telehealth from home? If you’re zoned out, take steps to fix it
June 14, 2023 | Rivkin Rounds Staff | Legislation and Public Policy | Telehealth
A June 12 article in Part B News, “Doing telehealth from home? If you’re zoned out, take steps to fix it,” discussed possible local zoning restrictions on providers who render telehealth services from their homes. Khoren Bandazian, a partner in Rivkin Radler’s Real Estate, Zoning and Land Use, and Health Services Practice…
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DSO’s Computer Systems Hacked
June 08, 2023 | Sean Simensky | Dentistry | Electronic Health Records
A recent data breach involving the computer systems of Great Expressions Dental Centers (GEDC) compromised the records of more than 500 Michigan patients. GEDC operates almost 350 dental practices in 10 states, including New York, New Jersey and Connecticut, making it one of the largest dental services organizations (DSOs) in…
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Implementing an Effective Compliance Program: A Focus on Element Seven
May 30, 2023 | Rivkin Rounds Staff | Fraud and Abuse | Hospitals | Legislation and Public Policy | Medicare and Medicaid
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Bob Hussar and John Queenan will discuss the seventh required elements of an Effective Compliance Program: Responding to Compliance Issues. Bob is a partner in Rivkin Radler’s Compliance, Investigations & White Collar and Health Services…
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NY Amends Home Care Worker Minimum Wage
May 22, 2023 | John Diviney, John Queenan and Jeffrey Ehrhardt | Employer/Employee | Home Health | Legislation and Public Policy
One of the many new provisions enacted as part of the 2023-2024 New York State Budget was an increase in the minimum wage for home care workers. Initially, it is important to note that the $1 hourly increase in the minimum wage for home care workers in New York State,…
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