First, the ill person transfers all his assets to his or her spouse or a sibling. Then the patient applies for Medicaid for nursing-home care. The healthy spouse then invokes "spousal refusal" to dodge paying for the care, after disclosing financial assets.

One defendant who has refused to pay is Claire Stein, whose husband, Dr. Benjamin Stein, was founder-owner of Brunswick Hospital Center in Amityville. According to [Tom Suozzi]'s lawsuit, the Steins let taxpayers pick up $83,871 of Benjamin's bills for nursing care, despite having $1.42 million in income and other liquid assets.

Doris Pizzino of Valley Stream said she settled with Nassau and paid back much of the $80,221 in costs at Woodbury Health Care Center that Medicaid picked up for her husband, Michael, a World War II vet who worked in the pharmaceutical industry.