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NewYork–Presbyterian Hospital has agreed to pay $801,000 for claims that two Brooklyn-based practices improperly billed Medicaid and the military health plan Tricare, the US attorney for the Eastern District of New York announced Thursday.
NewYork–Presbyterian Hospital had contracts with the two now-defunct facilities that provided outpatient radiation oncology services, according to the settlement, which was filed in federal court and approved on January 19.
“The defendants provided substandard care to cancer patients by not properly or timely reviewing medical imaging and then billed taxpayer funded healthcare programs for these shoddy services,” US Attorney Breon Peace said in a statement. “My office is committed to holding healthcare providers accountable for such conduct.”
The Eastern District of New York claims that the two radiology practices billed for imaging that weren’t reviewed or weren’t reviewed in a timely manner—rendering them “not reasonable and necessary.” The office’s investigation also found that some initial consultations were “billed at a higher coding level than appropriate.”
NewYork–Presbyterian Hospital will pay nearly $700,000 to the federal government and the rest to New York state, which administers the Medicaid program. The settlement between the hospital, one of the largest in New York City, and the government also indicates that there is no admission of liability.
“We are pleased to put this issue behind us,” the health system said in a statement. “Note, this occurred prior to NewYork—Presbyterian becoming the active parent of—and later merging with—Brooklyn Methodist Hospital.”