New York Hospital to Pay $7M to Settle Qui Tam Suit Alleging Medicaid Billing Fraud

New York’s Westchester Medical Center has agreed to pay $7 million to settle a lawsuit brought by Richard Anderson, the administrative head of Westchester’s behavioral health center.  Anderson filed his qui tam suit alleging Medicaid fraud in July 2011.

From August 2001 to June 2010, the mental health center at Westchester Medical Center allegedly billed Medicaid for millions of dollars for outpatient services without the proper documentation such as the required progress reports and treatment plans. Although the hospital was aware that it did not provide the required documentation with submitted claims, it did not take action to address the problem until after an audit by the New York State Department of Health inspector general in 2010. Even after the audit uncovered fraud, the hospital did not return the funds to Medicaid.

When discussing this Medicaid lawsuit on Wednesday, Preet Bharara, U.S. Attorney for the Southern District of New York, said, “We have absolutely no tolerance for those who fail to comply with the program, particularly in these lean times when budgets are stretched thin and belts are being tightened.”

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Tagged: Fraud Types, Medicare Fraud