New York Downtown Hospital to pay $13.4M to settle Medicaid fraud, kickback charges

New York Downtown Hospital agreed to pay $13.4 million to settle Medicaid fraud and kickback charges, reports the New York Post yesterday. Downtown Hospital allegedly paid healthcare firm and co-defendant Special Care Hospital Management for referrals and then admitted the same patients multiple times to its unlicensed inpatient detox program. The hospital submitted more than 2,000 Medicaid claims worth more than $9.15 million, according to the article.

Downtown Hospital knowingly submitted false and fraudulent claims to Medicaid from 2002 to 2006, Amy Held, special assistant for the state Attorney General medical fraud control unit, said in the 2008 complaint, reports the Post. It also allegedly paid a monthly fee of $38,500 to Special Care for patient referrals, violating anti-kickback laws.

"The United States and the state of New York have reached agreements in principle to settle these actions as to defendants Special Care Hospital Management Corp., Robert McNutt [its CEO] and New York Downtown Hospital,'' Richard Hayes, assistant U.S. attorney for the Eastern District, said in a letter to the judge.

Last month, the Centers for Medicare & Medicaid Services (CMS) issued a Medicaid final rule, in which it would specifically target Medicaid fraud, waste, and abuse with the goals of saving an estimated $2.1 billion over the next five years.

For more information:
- read the New York Post article

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