Community Assistance Resources & Extended Services INC
Case Management
New York, New York
NPI: 1396049987
Risk Tier
Critical
Total Paid
$1.04B
$1,042,893,317
Total Claims
2.8M
Beneficiaries
240K
Avg Cost/Claim
$378.25
Active billing period: 63 months (2019-10 to 2024-12)
Statistical Fraud Flags (7)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $378.16 per claim for H2014 (Skills training & development, per 15 min), which is 4.5× the national median of $83.88.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $1.6M (2020) to $112.6M (2021) — a 6886% swing with $111.0M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 9 procedure codes: H2015 at 5.8× median, H2014 at 4.5× median.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 6886% from 2020 to 2021.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
High Claims Per Patient
Filing an unusually high number of claims per beneficiary compared to peers.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 11.0x in 2021-10 — a statistically significant structural change in billing behavior was detected.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024