Health Quest Systems, Inc. and Putnam Health Center Pay $14.7 Million to Resolve False Claims Act Allegations
Syracuse, New York – Health Quest Systems, Inc. and Putnam Health Center have agreed to pay over $14.7 million to resolve allegations of violations of the False Claims Act by submitting inflated and otherwise ineligible claims for payment.
The settlement announced today resolves three lawsuits brought by former employees of Health Quest. The allegations against Health Quest and Putnam Health Center include submitting claims for evaluation and management services without sufficient documentation, submitting claims for home health services that lacked sufficient medical records, and allegedly false claims for inpatient and outpatient services referred by two orthopedic physicians.
Health Quest Systems, Inc. and Putnam Health Center admitted, acknowledged, and accepted responsibility for certain facts involving the submission of improper claims for various health-related services.
The United States alleged that Health Quest submitted claims for health-related services that were not supported by the medical record, including evaluation and management services billed at a higher level than supported by the medical record, and home health services that lacked sufficient medical records to support the claim.
In a separate matter, Health Quest subsidiary hospital, Putnam Health Center, submitted allegedly false claims for inpatient and outpatient services referred to PHC by two orthopedic physicians, in alleged violation of the Physician Self-Referral Law. The two physicians had a direct financial relationship with PHC for providing administrative services and received compensation from PHC.
“This resolution is a testament to our deep commitment to protecting the integrity of federally-funded healthcare programs,” said Acting Assistant Attorney General Chad A. Readler for the Justice Department’s Civil Division. “We are determined to hold accountable healthcare providers that knowingly claim taxpayer funds to which they are not entitled.”
As part of the settlements announced today, Health Quest will pay an additional $895,427 to the State of New York, which jointly funds the State’s Medicaid program with the federal government. The settlement resolves three lawsuits brought by former employees of Health Quest.
Health Quest Systems, Inc. and Putnam Health Center agreed to enter into a Corporate Integrity Agreement (CIA) with HHS-OIG to address future compliance.
The settlement resolves allegations of violations of the False Claims Act by submitting inflated and otherwise ineligible claims for payment. Health Quest Systems, Inc. and Putnam Health Center admitted, acknowledged, and accepted responsibility for certain facts involving the submission of improper claims for various health-related services.
Defendant: Health Quest Systems, Inc. and Putnam Health Center
Criminal Charges: Violations of the False Claims Act
City and State: Syracuse, New York
Exact Date: April 1, 2009 through June 23, 2015
Sentence or Outcome: $14.7 million settlement, plus an additional $895,427 to the State of New York
Dollar Amounts: $14.7 million settlement, plus an additional $895,427
Key Facts
- State: New York
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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