The settlement with NaphCare LLC and its affiliate Proactive Health Care Medicine PLLC stems from a state investigation into deaths at the Onondaga County Justice Center in Syracuse between 2020 and 2022. The Attorney General's Office found that the Alabama-based company illegally practiced medicine in New York by controlling medical decisions at the jail despite lacking proper state licensing, while also failing to provide adequate care that resulted in three preventable deaths.
"Our investigation found that NaphCare illegally practiced medicine in New York and failed to adequately protect individuals in custody who relied on their care," said Attorney General James. "These failures put vulnerable individuals at serious risk and had devastating consequences." The investigation revealed that NaphCare created Proactive as a shell New York corporation to nominally serve as the medical provider while the parent company continued to illegally handle decision-making and oversight from Alabama.
Under the settlement terms, NaphCare must pay $875,000 in penalties and is prohibited from bidding on or entering contracts to provide correctional health services anywhere in New York for five years. For an additional five years beyond the initial ban, the company must provide advance notice to the Attorney General's Office and receive written approval before entering any such contracts. Violations of the agreement will result in $50,000 penalties per incident and potential additional enforcement action.
The Attorney General's investigation uncovered a pattern of corporate practice violations where NaphCare employees in Alabama regularly issued treatment orders, prescribed medications, and directed patient care in New York facilities through electronic systems. This arrangement violated New York's corporate practice of medicine laws, which prohibit non-medical corporations from owning medical practices or directly employing physicians to provide medical care in the state.
The most serious failures involved three deaths during NaphCare's tenure, including a pregnant woman who received no prenatal care and gave birth alone in her cell after being denied medical evaluation for over 30 hours despite reporting her water had broken. Her premature newborn died hours later. Another death involved a person who died by suicide after not receiving necessary mental health care, while a third person with known medical conditions died from cardiovascular disease following inadequate treatment and medication errors.
The case represents part of broader scrutiny of private correctional healthcare providers and highlights ongoing concerns about medical care quality in detention facilities. Many treatment decisions were made remotely through electronic systems, allowing providers in Alabama to issue orders without directly examining patients, according to the investigation.
The matter was handled by Assistant Attorney General Susan Lambiase under supervision of Health Care Bureau Chief Darsana Srinivasan as part of the Division for Social Justice. If NaphCare is ever permitted to return to New York, any medical providers delivering care to patients in the state must be employed by or contracted through a properly licensed New York professional medical entity.