NY hospital will pay $89M to settle False Claims Act claims

Anne Zieger — Tue, 16 Sep 2008 09:22:05 -0400

Staten Island University Hospital has agreed to pay the U.S. Department of Justice and the state of New York nearly $89 million to settle a handful of False Claims Act allegations brought by both the feds and private whistleblowers. The hospital, which admitted no wrongdoing, said in a written statement that it had already put programs into place to address the problems addressed by these allegations when the investigation began.

One whistleblower suit charges that the hospital defrauded Medicare and Tricare by consciously using the wrong billing codes for stereotactic radiosurgery from 1996 to 2004 in care for her now-deceased husband. To settle this charge, the hospital will pay $25 million to the federal government, of which the widow, Elizabeth Ryan, will get $3.75 million.

Another, separate whistleblower complaint alleges that the hospital operated and hid a locked wing of 12 inpatient detox beds without a state CON from 1994 to 2000. The whistleblower, Miguel Tirado, was the hospital's former director of chemical dependency services. Staten Island University Hospital will pay $11.8 million to the DoJ and $14.9 million to the state of New York to settle this complaint. Tirado will get about $5 million.

Meanwhile, the hospital will pay $35.7 million to the feds to resolve their assertion that it inflated the number of residents on its Medicare cost reports from 1996 to 2003 to get bigger graduate medical education reimbursements. It will also pay $1.5 million over charges that it billed Medicare and Medicaid for treatment of psychiatric patients in unlicensed beds from 2003 to 2005.

To learn more about the suit:
- read this Modern Healthcare piece

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NY hospital, nursing home closure plans progress

Anne Zieger — Thu, 03 Jul 2008 11:17:18 -0400

The state of New York continues to make progress in its plan to merger or restructure more than 50 hospitals and nursing homes. The plan, which is design to cut down on duplication of services and eliminate excess capacity, has already had an impact at almost 80 facilities. The process began when a commission, the Commission on Health Care Facilities in the 21st Century, made a sweeping set of recommendations designed to trim waste from the state's healthcare system.

As part of the process, nine hospitals with almost 1,700 beds will close by January of next year. Meanwhile, another 1,700 hospitals beds will be removed from the market by 2010, through a combination of hospital and nursing home mergers, cooperative agreements and other measures. Meanwhile, seven nursing homes with 1,100 beds will have closed--and the state expects to cut another 1,600 such beds by the end of 2010.

To learn more about the commission's work:
- read this Modern Healthcare article (reg. req.)

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State Of New York

NY hospital will pay $89M to settle False Claims Act claims

NY hospital, nursing home closure plans progress