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Continuum Health Partners, Medicaid Fraud, New York 2011
Continuum Health Partners, a hospital group that operates several facilities in New York City, has agreed to pay $2.95 million to settle a civil fraud lawsuit related to Medicaid overpayment claims. The settlement resolves claims under the federal False Claims Act and the New York State False Claims Act.
According to the lawsuit, Continuum Health Partners delayed repayment of over $800,000 in Medicaid overpayments for more than two years. The hospital group was required to repay the funds within 60 days of discovering the overpayments, but instead took nearly two years to complete the repayment.
Manhattan U.S. Attorney Preet Bharara said, ‘When Continuum learned that it had received over $800,000 in potential overpayments from Medicaid in 2011, it had an obligation under the law to return those funds within 60 days. Instead, Continuum delayed repayment for more than two years and only fully repaid the Medicaid program in 2013. With this settlement, Continuum has made admissions and is paying $2.95 million for its fraud on Medicaid.’
HHS-OIG Special Agent in Charge Scott J. Lampert added, ‘Any threat to the financial health of Medicaid is a threat to the vulnerable citizens who depend upon it for critical services. Today’s settlement should send a message to providers that this behavior will not be tolerated, and we will pursue justice in these cases.’
New York State Comptroller Thomas P. DiNapoli said, ‘Our audits of the defendants revealed $700,000 in Medicaid overpayments. After we were contacted about this matter, we quickly partnered with law enforcement to recover taxpayer dollars, including further overpayments that came to light only afterwards.’
The lawsuit alleges that Continuum Health Partners was alerted to the software error that led to the overpayments in 2010, but failed to bring the issue to the attention of the government and took nearly two years to complete the repayments. The hospital group has made admissions as part of the settlement.
The settlement is a result of a whistleblower qui tam lawsuit filed under the False Claims Act. The case was investigated by the U.S. Attorney’s Office for the Southern District of New York and the New York State Attorney General’s Office, with assistance from the HHS-OIG and the New York State Comptroller’s Office.
The settlement is a significant blow to Continuum Health Partners, which operates several hospitals in New York City, including Mount Sinai Beth Israel and Mount Sinai St. Luke’s and Mount Sinai Roosevelt. The hospital group has agreed to pay $2.95 million to settle the lawsuit and has made admissions as part of the settlement.
Key Facts
- State: New York
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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