The U.S. Attorney’s Office for the Southern District of New York and New York Attorney General’s Office filed intervening complaints in a whistleblower lawsuit against Continuum Health Partners, Inc., Beth Israel Medical Center, and St. Luke’s-Roosevelt Hospital Center for failing to repay money they received after improperly billing the state’s Medicaid Program. According to the complaints, between 2009 and 2010, Beth Israel and St. Luke’s-Roosevelt submitted improper claims to Medicaid due to a computer error. In February 2011, Continuum, the former operator of the two hospitals, allegedly identified 900 potentially improper claims worth nearly $1 million to Medicaid, but failed to return all of the payments–repaying only small batches over the next two-plus years.

The case was initiated by Robert Kane, a former employee of Continuum who was tasked with the company’s internal investigation of improper claims.  Kane was allegedly fired after his review turned up $1 million in overpayments.

Read the SDNY USAO’s press release, “Manhattan U.S. Attorney Files Civil Fraud Suit Against Hospital Group For Fraudulently Delaying Repayment Of Nearly $1 Million Of Medicaid Overcharges”
Read the NY AG’s press release, “A.G. Schneiderman Announces Lawsuit Against Continuum Health Partners, Beth Israel Medical Center And St. Luke’s-Roosevelt”
Read the entire article, “Software Glitch Sparks FCA Suit Against Hospitals for Late Repayment of Medicaid Reimbursements”