ALBANY, N.Y. (AP) — Two years after a 33-year-old mentally disabled man died at a state institution in Queens, and one year after his sister filed a lawsuit accusing the staff of killing him, New York officials have sent her an $11.67 million bill. 
 
 The claim against Rasheen Rose's estate cited his total Medicaid assistance from Aug. 6, 2002, through Aug. 6, 2012, the day he died. 
 
 A spokeswoman for the Office for People with Developmental Disabilities, which runs the center, said Wednesday officials were following federal Medicaid obligations in seeking reimbursement. 
 
 "Not doing so would be a violation and could put federal Medicaid funding at risk," spokeswoman Jennifer O'Sullivan said. 
 
 Medicaid, a state and federal program for the poor, doesn't typically demand reimbursement. 
 
 But Ilann Maazel, an attorney who has filed lawsuits against the state after others died in state care, said other claim notices recently have been sent to families suing. 
 
 "This is something new we're seeing ... and it's problematic," he said Wednesday. 
 
 Assemblyman Harvey Weisenberg, an advocate for the disabled whose adult son gets state-funded residential care, called it "retaliation" and "an outrage" to send the bill to someone who lost a loved one from abusive care. "They're going to punish these people because they brought it to view of justice," he said. 
 
 The New York medical examiner concluded Rose's death was a homicide and that he "became unresponsive" while being restrained at Fineson Developmental Center. The Queens district attorney's office said it wasn't notified about the death until that homicide ruling was made four months later. Investigators found no criminal conduct but have left the case open, spokesman Kevin Ryan said. 
 
 Shaneice Luke, Rose's sister, is seeking unspecified punitive and other damages in a federal lawsuit. She alleges that at least three staff threw Rose to the ground and one sat on him, while other staff stood by. She also alleges a history of abuse at Fineson and failure by supervisors and the state to address that or to train staff properly. 
 
 "Rasheen Rose did not receive care remotely associated with the amount of money collected by OPWDD for Rasheen Rose over the 10-year period," attorney Aaron DePass replied to the state agency on Luke's behalf. Because he was actually killed by his supposed caregivers, "it is clear that the quality of care he received does not warrant any payment for services whatsoever," he wrote. 
 
 In federal court papers, all seven staff named in the lawsuit denied any wrongdoing, saying they acted within their professional judgment. The state attorney general and private lawyers are defending them. 
 
 Two years ago, a congressional oversight committee reported that New York's residential centers for the developmentally disabled like Fineson, which have largely emptied in an ongoing shift to community-based programs and group homes, cost Medicaid about $1.9 million a year for each patient. 
 
 The Cuomo administration last year announced plans to close four developmental centers over four years, including Fineson in 2017. ||||| Shawn Inglima for New York Daily News Rasheen Rose died at a Queens state development care facility while being restrained by workers, his family's attorney said. 
 
 A Harlem woman has been hit with a whopping $11.67 million medical bill from a state institution she says killed her mentally disabled brother. 
 
 Shaniece Luke, 39, said her jaw dropped when she received the bill from the state Office for People with Developmental Disabilities. 
 
 “I thought it was ridiculous. I couldn’t believe it!” Luke told the Daily News Wednesday. 
 
 She and her lawyers contend the astronomical bill is in retaliation for filing a wrongful death lawsuit against the agency and the Queens developmental center where her brother, Rasheen Rose, died in 2012. 
 
 “It has to be,” Luke said. “But they were the ones who killed my brother.” 
 
 The notarized bill, sent to Rose’s estate in March, was for paid Medicaid assistance from August 2002 up to Rose’s death. The state agency is demanding to be paid the staggering amount if Luke prevails in her suit and is awarded punitive damages. 
 
 New York Daily News Shaneice Luke received this bill for $11,672,701.66. 
 
 “The number is mind-boggling. And it becomes more egregious because Rasheen died at the hand of one of their workers,” Luke’s attorney, Aaron DePass, told The News. 
 
 Rose, 33, who was born with severe autism and was never able to communicate verbally, died on Aug. 6, 2012 at the Bernard Fineson Developmental Center in Queens Village. 
 
 The city medical examiner ruled the death a homicide in December 2012, citing evidence that Rose died from injuries caused by being physically restrained. 
 
 Luke’s attorneys said their investigation showed that the 5-foot-7, 175-pound Rose was restrained in a dangerous prone position for up to 30 minutes by three staffers, including a 275-pound worker who sat on him. 
 
 “He was basically crushed to death,” DePass said. 
 
 Mike Groll/AP Assemblyman Harvey Weisenberg called it 'retaliation' and 'an outrage' to send the bill to someone who lost a loved one from abusive care. 
 
 Robert Santoriella, Depass’ law partner, said at least nine other staff members, including two doctors and two nurses, were in the room when Rose became unresponsive. 
 
 Citing the pending litigation, the office for People with Developmental Disabilities declined comment. 
 
 Attorney Ilann Maazel said others who have filed lawsuits on behalf of loved ones who have died in state care have received similar bills. 
 
 Assemblyman Harvey Weisenberg (D-Long Island) said the bills are clearly meant as retaliation. 
 
 “It’s an outrage,” he said. 
 
 With News Wire Services ||||| MaineCare Expansion Debate 
 
 Despite being rejected five times previously, once again, a push to expand MaineCare—the state’s Medicaid program—will be debated. For the sixth time, the LePage Administration and this Department will stand against it 
 
 The truth is Maine has already experienced the devastating consequences of expanding Medicaid under previous Administrations. When Maine expanded in 2001 and again in 2003, it led to annual shortfalls in MaineCare of $50 million to more than $100 million . As a result, the state stopped paying its bills, racking up hundreds of millions in debt owed to Maine’s hospitals. 
 
 We cannot afford to abandon the sound financial management that exists within the program today that has directed resources to our elderly, disabled, and has allowed the state to responsibly manage without a perpetual financial crisis. The Maine Department of Health and Human Services has refocused the program on its neediest and most vulnerable beneficiaries by funding our nursing homes, strengthening home care options and providing services to those with intellectual and developmental disabilities that had been languishing on waitlists. 
 
 Currently, the Legislature cannot afford to care for our neediest and most vulnerable, it will only get worse if expansion is passed. Governor LePage’s biennial budget sought increases of $46 million in funding to reduce waiting lists for services for the intellectually and developmentally disabled; $28 million to expand access to primary care; and $22 million to adequately fund Maine’s nursing homes. Ultimately, the Legislature only funded a portion of these requests (e.g., $16 million for the waitlists), leaving considerable funding requirements in the program for our neediest and most vulnerable. These would only worsen if Maine chose to add thousands of able-bodied childless adults to its Medicaid rolls. 
 
 Medicaid expansion backers ignore key facts when it comes to discussing Medicaid Expansion. 
 
 Expanding MaineCare would cost Maine taxpayers approximately $315 million over the next five years . Despite claims that expansion is free—it is not. MaineCare accounts for 24 percent of Maine’s General Fund. Over the next two fiscal years, expansion would cost nearly $100 million, or enough to fund the Department of Marine Resources, Department of Labor, Department of Environmental Protection, and Department of Defense, Veterans and Emergency Management over that period of time. 
 
 Costs would continue to rise from there: 
 
 By 2021, the additional funds needed for Medicaid expansion could fund nearly half of the University of Maine’s annual budget. 
 
 Expansion would not affect children or pregnant women . MaineCare enrollment peaked at 354,000 in 2011. Today, enrollment is approximately 282,000. Medicaid expansion would allow childless, able-bodied adults into the program and increase eligibility for parents of dependent children. 
 
 An overlooked fact is that any individual who earns at least 100 percent of the federal poverty level is eligible to purchase heavily subsidized health insurance on the federal exchange. Simply put, most childless, able-bodied adults and all parents have access to subsidized health insurance under the current system. 
 
 There are options for the uninsured . Currently, the only Mainers who are not eligible for Medicaid or subsidized health insurance are able-bodied, childless adults earning less than 100 percent of the federal poverty level-- $11,770 in 2016. 
 
 For those uninsured, federally qualified health centers provide no-cost healthcare to low income individuals without insurance. They receive enhanced rates in other areas like Medicaid reimbursements. Hospital-owned physician practices also provide care to anyone regardless of ability to pay. 
 
 Expansion would not solve the drug epidemic . Medicaid Expansion supporters argue that expanding Medicaid is the key to resolving Maine’s substance abuse problem. There is no evidence this is true. Maine already funds more than $20 million annually on treatment and prevention for the uninsured, and expansion states like New Hampshire and Vermont have some of the highest fatal overdose numbers in the country. The latest data from New Hampshire’s medical examiner shows that 414 people suffered fatal overdoses in 2015, up from 326 in 2014 and 192 the year before. 
 
 Due to underestimated enrollment and overly optimistic savings projections, numerous expansion states are facing significant budget shortfalls . 
 
 Vermont : The state now projects a $30 million shortfall for the current fiscal year and a $60 million gap in the next fiscal year due to Medicaid expansion. 
 
 : The state now projects a $30 million shortfall for the current fiscal year and a $60 million gap in the next fiscal year due to Medicaid expansion. Massachusetts : The state Medicaid caseload spiked in fiscal year 2014, leading to an increase in spending of more than $1.1 billion. While the federal government covers a significant portion of Medicaid costs, the expense paid by state taxpayers was $5.1 billion, up from $4.7 billion in 2013. “The administration is taking several other steps to rein in costs, including holding flat most of the rates paid to providers and moving more MassHealth members into managed care plans, in which the state pays insurance companies set budgets to coordinate the care of patients.” (Boston Globe, January 28) 
 
 : The state Medicaid caseload spiked in fiscal year 2014, leading to an increase in spending of more than $1.1 billion. While the federal government covers a significant portion of Medicaid costs, the expense paid by state taxpayers was $5.1 billion, up from $4.7 billion in 2013. New Mexico : The state projected large savings as a result of Medicaid expansion. Those savings have not materialized, leaving a Medicaid shortfall of $85 million in FY 2017. As a result, the state likely will cut reimbursement rates to hospitals, doctors and social workers, as well as increase copays for those patients in the government insurance program. “What we've done, unfortunately, is double down on borrowed money to pay for the state operating expenses," said Rep. Brian Egolf, a Santa Fe Democrat who serves as the House minority leader.” (The Santa Fe New Mexican, February 18) 
 
 : The state projected large savings as a result of Medicaid expansion. Those savings have not materialized, leaving a Medicaid shortfall of $85 million in FY 2017. As a result, the state likely will cut reimbursement rates to hospitals, doctors and social workers, as well as increase copays for those patients in the government insurance program. 
 
 As this issue is debated once again, it is important to remember the financial crisis our state was in less than 10 years ago and how our neediest and most vulnerable paid the price. As well as the hundreds of millions of dollars it would cost Maine taxpayers over the next decade.
– Rasheen Rose died while being restrained at Fineson Developmental Center, a state institution in Queens, on August 6, 2012—a death that was ruled a homicide by the New York medical examiner, and into which the district attorney's investigation is still open. Shaneice Luke, Rose's sister, filed a lawsuit accusing the staff of killing her brother, who "became unresponsive" after at least three staff members allegedly threw him to the ground and put him in a "prone position" for as long as 30 minutes; one 275-pound worker sat on him, while others, including doctors and nurses, stood by, the New York Daily News reports. Rose, who had severe autism and could not communicate verbally, "was basically crushed to death," says Luke's lawyer. But now, New York officials are billing Luke for $11.67 million, the AP reports. The claim against Rose's estate cites his total Medicaid assistance over a period of 10 years, up until the day he died at age 33. Medicaid doesn't typically demand reimbursement, but an attorney who has worked with others who've received similar bills after suing the state says officials have recently begun this "problematic" practice. A spokesperson for the Office for People with Developmental Disabilities, which runs Fineson, says officials are simply following federal Medicaid obligations so that they don't lose their Medicaid funding, but an assemblyman who advocates for people with disabilities calls it "retaliation." Last year, Gov. Andrew Cuomo announced plans to close Fineson in 2017.