Qui Tam

HOSPITALS ACCUSED OF $50 MILLION MEDICARE FRAUD

By Marcella Auerbach

Albany N.Y.?According to The Associated Press, recent lawsuits allege that four New York hospitals (Columbia Memorial Physicians Hospital, Long Beach Medical Center, New York Downtown Hospital, St. Joseph?s Medical Center) paid kickbacks to elicit patients for drug treatment programs and billed Medicaid for unnecessary services that lacked state certification. Separately, the suits accuse four of the hospitals of engaging in a kickback scheme to illegally refer patients to the hospitals’ detox units. In a related series of events, Queens? Parkway Hospital, Our Lady of Mercy, and Benedictine Hospital were accused of paying people to solicit homeless individuals for a three-day detox unit in exchange for cigarettes, beer, food, and other items.  Several of the alleged hospitals were aided by SpecialCare Hospital Management Corp., who illegally referred patients for a fee.

Collectively, the aforementioned hospitals fraudulently billed Medicaid for more than $50 million over a total of 14,000 different claims.  Attorney General Andrew Cuomo asserts that these hospitals have violated New York’s anti-kickback laws, which prohibit individuals or entities from knowingly and willfully offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid or any other federally funded program (except the Federal Employees Health Benefits Program).. As of now, the state has settled for $4.5 million with Our Lady of Mercy, which denies any wrongdoing.  Likewise, the other hospitals and their management companies have denied all charges and filed motions to have the cases dismissed.
To learn more go here. or if you have a Medicare Fraud or False Claims Act case contact Nolan & Auerbach P.A.

Full post as published by Medicare Fraud 101 on January 19, 2009 (boomark / email).