Mount Sinai Health System Agrees to $2.95 Million Fraud Settlement Owing to Medicaid

Attorney General Eric T. Schneiderman and United States Attorney Preet Bharara announced a $2.95 million fraud settlement with three hospitals in the Mount Sinai Health System resulting from Medicaid overpayments.

A whistleblower alleged that Mount Sinai Beth Israel, Mount Sinai St. Luke’s, and Mount Sinai Roosevelt knowingly retained over $844,000 in Medicaid overpayments beyond the 60-day repayment window, a violation of False Claims Acts (on both the state and federal levels). The hospitals’ former partnership group, Continuum Health Partners, Inc., experienced a software error in 2009, which sent hundreds of erroneous claims to Medicaid by 2011. These overpayments were not fully reimbursed to Medicaid for nearly two years. A $2.95 million fraud settlement was determined in a qui tam lawsuit, United States and the State of New York, ex rel. Robert P. Kane v. Healthfirst, Inc., et al.

The settlement could signal the beginning of a wave of similar lawsuits, with hospitals worried due to the FCA’s extensive statute of limitations of 10 years, to which an additional 6 years may be added due to a Centers for Medicare and Medicaid Services rule finalized in February of this year.

For further clarification regarding the above, please contact Adrienne Dresevic, Esq., at, or Carey Kalmowitz, Esq., at, or alternatively, please reach them at our offices by calling (248) 996-8510 or (212) 734-0128.

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