Applied Consulting and Applied Case Management Two New York City Consulting Companies Settle Whistleblower Case With Federal Government; Latest Milestone In False Claims Case; Two New York Hospitals Earlier Settled Related Medicaid Fraud Allegations

NEW YORK CITY — Two alcohol and substance abuse treatment consulting firms in New York City, Applied Consulting, Inc., and Applied CaseManagement, Inc., have settled civil Medicaid fraud charges with the Federal Government. It’s the latest milestone in a qui tam whistleblower case brought under the federal False Claims Act (“FCA”) that two New York state hospitals, Catskill Regional Medical Center and Mount Vernon Hospital, settled earlier this year, Manhattan-based attorneys Timothy J. McInnis and David A. Koenigsberg announced.
Related filed court documents:

The Mount Vernon Hospital Mount Vernon Hospital Settles Whistleblower Charges of Operating an Unlicensed Alcoholism Treatment Facility and “Patient Brokering;” Agrees To Pay Government $2.65 Million; It Received “Several Millions” From Medicaid For Treating Substance Abuse Patients Illegally Referred by Consultant That Received Approximately $60,000 Per Month In Kickbacks, According To Complaint

NEW YORK CITY — A New York hospital today agreed to pay $2.65 million to settle charges that over a seven-year period it operated an unlicensed alcoholism treatment facility which took in several million dollars in Medicaid payments and kicked back approximately $60,000 per month to a firm that “brokered” the patients referred to it, according to attorneys Timothy J. McInnis and David A. Koenigsberg, who represent the whistleblower who brought the healthcare fraud allegations to the Government.

Catskill Regional Medical Center For Treating Thousands of Alcohol And Substance Abuse Patients A New York Hospital Received Millions, Paying $52,000 Monthly In Illegal Kickbacks To Unnamed “Entity” Under Sham Administrative Agreement, According To Federal Complaint And Qui Tam Whistleblower Suit Settlement; Catskill Regional Medical Center (“Catskill”) Agrees To Pay $1.5 Million For Illegal Referral Scheme And Cooperate In Government’s Continuing Investigation

NEW YORK CITY — From 1997 to 2000, an upstate New York hospital received millions of dollars for treating thousands of illegally referred alcohol and substance abuse inpatients, kicking back $52,000 monthly to an undisclosed referring “entity” under a sham “administrative services agreement”, according to attorneys Timothy J. McInnis and David A. Koenigsberg, who represent the whistleblower who brought the case to the Government. A federal civil Complaint was unsealed today by the U.S. Attorney’s Office, along with a Settlement Agreement.
Related filed court documents:

Montefiore Medical Center One Of America’s Oldest Academic Medical Centers Settles Whistleblower-Initiated Allegations That For Six Years It Hid And Failed To Repay More Than $10 Million In Medicare Overpayments It Received In Error; Montefiore Medical Center Simply Erased A $5.6 Million Debt And Stopped Paying On Another, According To Federal Complaint; Montefiore Will Pay $12 Million To U.S. Within 10 Days

NEW YORK CITY – One of America’s largest academic medical centers, Montefiore Medical Center (“Montefiore”), received in error more than $13 million in two Medicare payments from Empire Blue Cross and Blue Shield (“Empire”) then failed to disclose them as required by law. For six years Montefiore concealed and then summarily wiped its internal books clean of one payment. When Empire stopped sending statements to collect the second overpayment, Montefiore stopped repaying it as it had agreed, according to a federal Complaint and a Settlement Agreement resolving the matter that was filed simultaneously by the Federal Government.

Center for Pain Management Texas Back Pain MD and Wife Settle Federal Whistleblower Charges Sparked By Anesthesiologists Whose Billing Data Allegedly Used Without Their Permission On False Claims To Medicare, Medicaid, State and Federal Workers Compensation; Back Surgery Billed But Never Performed; Surgical Removal of Bony Lower Back Portion Previously Falsely Billed Are Alleged In Federal Complaint

McAllen, TX – A medical doctor whose South Texas, “Center for Pain Management, P.L.L.C.” (“CPM”) specializes in back pain treatment for elderly, Medicaid and injured worker patients has settled Medicare, Medicaid and state fraud allegations brought by whistleblowing anesthesiologists whose Medicaid and Medicare numbers were used without their permission on claims for patient treatment, attorneys Timothy J. McInnis and Brian P. Kenney announced.