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| NYC hospital agrees to $89M settlement in fraud case |
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September 16, 2008 - In a massive settlement involving the treatment of thousands of patients from the New York City area, Staten Island University Hospital has agreed to fork over nearly $89 million to the federal and state governments to clear up allegations it defrauded health care programs. September 16, 2008 Newsday.com BY ANTHONY M. DESTEFANO In a massive settlement involving the treatment of thousands of patients from the New York City area, Staten Island University Hospital has agreed to fork over nearly $89 million to the federal and state governments to clear up allegations it defrauded health care programs. The settlement, believed to be the biggest for one hospital, came in a lawsuit filed in federal court in Brooklyn by the federal government claiming that the hospital ripped off the Medicare, Medicaid and military health insurance program through years of false billing practices. Under the terms of the settlement, the hospital, without admitting wrongdoing, agreed to repay $74 million to the federal health care systems. It also agreed to pay $12.4 million to the state attorney general's office to cover damage claims to the state Medicaid program. About a third of the false billing settlement - $25 million - involved the hospital's stereotactic body radiosurgery treatment given on an outpatient basis. Federal investigators said that from 1996 to 2004, the hospital defrauded Medicare and the military-family medical system by using incorrect billing codes. The radiation treatment, popularized by the controversial Dr. Gilbert Lederman, was reimbursable by Medicare for treatments involving the head, said federal officials. But according to the officials and lawyers familiar with the case, the hospital billed Medicare for stereotactic treatments elsewhere in the body, a practice that wasn't allowed at the time. The allegations were made in a federal false claims lawsuit filed by Elizabeth M. Ryan, formerly of Brooklyn, whose husband died in October 2002 from the effects of metastatic pancreatic cancer. Under federal law, Ryan will receive $3.75 million of the settlement, officials said. The hospital said in a statement that the settlement wouldn't hurt its continuing operations and construction of a new trauma center. Also receiving $2.3 million of the settlement was Dr. Miguel Tirado, a former state doctor who first raised allegations of fraudulent billing involving the hospital's inpatient alcohol and substance abuse detoxification programs - a claim settled for $26 million. Email This e-mail address is being protected from spam bots, you need JavaScript enabled to view it Source: newsday.com/services/newspaper/printedition/tuesday/news/ny-nymeds165845199sep16,0,5884309.story Copyright © 2008, Newsday Inc. » Post Comment
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