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Beth Israel Medical Center Settles Medicaid Case for $2.95 Million
Continuum Health Partners, Inc. and two of its subsidiaries, Beth Israel Medical Center and St. Luke’s-Roosevelt Hospital Center, have agreed to pay $2.95 million to settle a civil fraud lawsuit alleging that they willfully delayed repayment of over $800,000 in Medicaid overpayments.
The settlement resolves claims under the federal False Claims Act and the New York State False Claims Act. Manhattan U.S. Attorney Preet Bharara said that Continuum had an obligation to return the funds within 60 days but delayed repayment for more than two years.
The hospitals and Continuum willfully delayed repayment of over $800,000 in Medicaid overpayments, with Continuum fully repaying the Medicaid program in 2013. The settlement includes a $2.95 million payment for the fraud on Medicaid.
According to the complaint, Continuum learned that it had received over $800,000 in potential overpayments from Medicaid in 2011 and failed to bring this to the attention of the government. The whistleblower, who filed the qui tam lawsuit, created a list of claims affected by a software glitch, but Continuum terminated the whistleblower and took nearly two years to complete its repayments.
The government’s complaint alleges that between 2009 and 2010, the defendants erroneously billed 444 claims to Medicaid, which were identified in the whistleblower’s list in February 2011. However, the defendants did not fully repay these claims until March 2013, in violation of a Federal law requiring recipients of Government funds to repay the Government within 60 days of discovering the overpayment.
With this settlement, Continuum has made admissions and is paying $2.95 million for its fraud on Medicaid. The case is a result of a long-standing investigation by the U.S. Attorney’s Office for the Southern District of New York, the New York State Attorney General, and the U.S. Department of Health and Human Services’ Office of Inspector General.
New York State Comptroller Thomas P. DiNapoli said that the audits of the defendants revealed $700,000 in Medicaid overpayments and thanked U.S. Attorney Preet Bharara and his office for their perspicacity in seeing that justice was served.
Defendant: Beth Israel Medical Center d/b/a Mount Sinai Beth Israel
Criminal Charges: Willfully delaying repayment of over $800,000 in Medicaid overpayments
City and State: New York, New York
Exact Date: 2013
Sentence or Outcome: $2.95 million settlement
Dollar Amounts: $2,950,000, $800,000
Key Facts
- State: New York
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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