Attorney General Tong Announces $560,718 False Claims Settlement with Hospital Owners and Medical Group
(HARTFORD, Conn.) – Attorney General William Tong and U.S. Attorney General Vanessa Roberts Avery today announced that Northeast Medical Group (NEMG) and Yale-New Haven Health Services Corporation (YNHH) have established federal and announced that it has entered into a civil settlement agreement with the state government. I am due to pay $560,718 to settle allegations that I overcharged the federal Medicare and Connecticut Medicaid programs.
Northeast Medical Group is a group of physicians and affiliated providers affiliated with Yale-New Haven Health Services Corp., which owns several hospitals, including Bridgeport Hospital. Whistleblowers have filed false claims with Medicaid and Medicare by NEMG and YNHH for services purportedly provided by physicians and mid-level healthcare providers (pre-enrolled nurses and physician assistants) at Bridgeport Hospital. filed a lawsuit claiming that provider. Services offered only by mid-tier providers are reimbursed at lower rates. A joint state and federal investigation into the allegations followed.
The Government determined that NEMG and YNHH had submitted a claim to the federal Medicare and Connecticut Medicaid programs for physician fee services provided by a lower-level provider, and that NEMG and YNHH had knowledge of this improper billing. , or that they should have known but did not take appropriate steps to stop it. that. To settle these claims, NEMG and YNHH agreed to pay $560,718. Medicaid’s contribution to the settlement is $110,042.
The whistleblower will receive 19% of the total settlement amount, or $106,536.Cases resolved by this settlement are captioned Excludes US and Connecticut. Kadaryu v. Northeast Medical Group and others. (Reference number 19-cv-904).
“Northeast Medical Group and YNHH are said to have filed hundreds of thousands of dollars in claims against government health care programs. Thank you to our whistleblowers for reporting these questionable allegations and stepping forward to protect public health care costs.” Attorney General Ton said.
Anyone who knows of suspected fraud or abuse in the public health system should contact the Attorney General’s Government Programs Fraud Section at 860-808-5040 or email email@example.com. You will be asked to contact us at or the Department of Human Services Fraud Reporting Hotline at 1-800-842-2155, online at www.ct.gov/dss/reportingfraud, or email at firstname.lastname@example.org.
Assistant Attorney General Rick Porter and Forensic Fraud Examiner Lisa Bailey assisted the Attorney General in this matter under the supervision of Gregory K. O’Connell, head of the Office of Government Programs Fraud. Assistant US Attorney Sarah Gruber is prosecuting the case on behalf of the United States.
- twitter: @AGWilliamTong
- Facebook: CT Attorney General