CenterLight Healthcare to pay $47 million over charge it fraudently billed Medicaid

By Mark Iandolo | Jan 26, 2016

NEW YORK (Legal Newsline) — CenterLight Healthcare will pay $47 million to resolve allegations it fraudulently billed Medicaid for services it did not actually provide, New York Attorney General Eric T. Schneiderman has announced.

CenterLight Healthcare admitted under the settlement that it enrolled Medicaid beneficiaries into their select Medicaid managed long-term care plan even though these beneficiaries were not eligible to receive managed long-term care. The centers were allegedly also providing services that did not qualify for reimbursement under New York State Department of Health standards.

“It’s simple: CenterLight Health Care did not play by the rules,” Schneiderman said. “We won’t tolerate companies that seek to exploit the system for profit. My office will continue to be vigilant in protecting Medicaid against fraud.”

New York’s Medicaid program will receive $28,050,652.04 and the United States will receive $18,700,434,70. In addition, CenterLight has entered into a two-year agreement with an independent compliance monitor, as well as the attorney general’s Medicaid fraud control unit, to make sure it follows rules going forward.

Associate special auditor investigator Svetlana Volchyok and associate special auditor investigator Milan Shah handled the case, along with senior investigator Wayne Rivers and data analyst Nicholas Furnari.

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