New York-Presbyterian Hudson Valley Hospital will pay $6.8 million to settle allegations that it improperly paid a Westchester, N.Y.-based oncology practice to induce referrals that were then billed to Medicare and Medicaid, according to a Dec. 22 Justice Department news release.
What happened
- The complaint alleges that between 2011 and 2012, the hospital entered into three contracts with the oncology practice. Under the agreements, the hospital would pay the practice hundreds of thousands of dollars per year for work tied to several proposed initiatives, including planning for a melanoma center, planning for a breast cancer center and developing an intraoperative radiation therapy service line
- Between 2011 and 2019, the hospital paid the practice more than $4 million under the agreements. Federal officials allege the practice often failed to perform the work, did not perform it as required or did not maintain documentation to support the payments, according to the release.
- Despite the lack of documentation, the hospital allegedly continued making payments while receiving referrals from the practice that generated millions of dollars in Medicare and Medicaid reimbursements.
- The hospital admitted and accepted responsibility for certain conduct alleged by the government, including that it paid the oncology practice more than $4 million for work that was not performed, not performed as required or lacked time records.
- By October 2016, the complaint alleges the hospital either knew or should have known that the practice was performing only a portion of the work required under the radiation therapy agreement and was not completing most of the work under the melanoma directorship agreement. However, the hospital continued paying under both agreements for another three years, officials said.
New York-Presbyterian Hudson Valley Hospital declined to respond to Becker’s requests for comment.
