NY Hospital To Pay $7 Million In 'Mental Health' Medicaid Fraud Penalties

FierceHealthcare has; 
Hospital To Pay $7 Million In False Claims Settlement
October 26, 2012 | By Alicia Caramenico


Westchester Medical Center in New York will pay $7 million to settle civil fraud allegations that it submitted false claims to Medicaid for almost a decade, the Department of Justice announced yesterday.

From August 2001 through June 2010, the hospital submitted millions of dollars in Medicaid claims for outpatient services at its mental health center that lacked the core documentation required by Medicaid regulations, according to the complaint.

Even though hospital management knew for years that the outpatient mental health clinics didn't have adequate documentation, it didn't audit the clinics' records and only took "insignificant steps" to address the billing issues.

The hospital also kept the Medicaid funds it received for the outpatient services even though  it was well aware of overpayments, the DOJ noted.

"Medicaid is a vital resource for people who suffer from physical and mental illnesses and related conditions," Manhattan U.S. Attorney Preet Bharara said in a statement. "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."

Westchester Medical Center certainly has been making headlines this year. In August, it announced 100 layoffs, including patient care technicians and clerks. The hospital has layed off more than 600 people during the past year.

And in April, its executive pay came under fire as 26 West Chester Medical Center administrators in 2010 would have surpassed Gov. Andrew Cuomo's new $199,000 annual cap on nonprofit executive pay, FierceHealthcare previously reported. 

For more:
- here's the DOJ statement
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Thank You Fierce Healthcare and Ms Caramenico

From August 2001 through June 2010, the hospital submitted millions of dollars in Medicaid claims for outpatient services at its mental health center that lacked the core documentation required by Medicaid regulations, according to the complaint.

We'd like to say this is an amazing display of bravado on their part, but nothing shocks us anymore with 'Mental Health'. 

pic cred to Warner Bros.