New York Downtown Hospital Settles Allegations of Medicaid Fraud for $13.4 Million

The New York Attorney General’s Office recently settled with New York Downtown Hospital (NY Downtown Hospital) for $13.4 million following two whistleblower complaints of Medicaid fraud against the hospital. According to the Attorney General, NY Downtown Hospital allegedly operated an unlicensed drug and alcohol treatment program and submitted false claims to the New York Medicaid program. Further, the hospital was charged with paying an out-of-state vendor $38,500 a month in illegal kickbacks to refer patients to the hospital’s drug and alcohol treatment program. The Attorney General also alleged that the hospital furnished services that were not medically necessary in violation of state Medicaid requirements.

The settlement was reached after an investigation by the Attorney General’s Medicaid Fraud Control Unit and the United States Attorney’s Office. Consequently, NY Downtown Hospital will be required to refund $12.6 million to Medicaid and $800,000 to Medicare for violations of federal and state laws and regulations.

The press release on the New York Downtown Hospital settlement is available at: http://www.ag.ny.gov/press-release/ag-schneiderman-announces-134-million-settlement-nyc-hospital-illegally-charging.

New York State Office of the Attorney General. “A.G. Schneiderman Announces $13.4 Million Settlement With NYC Hospital For Illegally Charging Medicaid.” Press Release. 5 Sept. 2012.