New York-Presbyterian/Brooklyn Methodist Hospital settles health care fraud claims for $17.3 Million

March 13, 2024 Robert Abruzzese, Courthouse Editor

Eastern District of New York Federal Court in Brooklyn — the site where New York-Presbyterian/Brooklyn Methodist Hospital's $17.3 million settlement was announced, resolving allegations of healthcare fraud through unlawful kickbacks to physicians.
Brooklyn Eagle photo by Rob Abruzzese

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New York-Presbyterian/Brooklyn Methodist Hospital has agreed to a $17.3 million settlement on Tuesday to resolve allegations of health care fraud. U.S. Attorney for the Eastern District of New York Breon Peace announced that the settlement addresses claims related to unlawful kickbacks paid to physicians at the hospital’s chemotherapy infusion center.

The allegations center on a contractual arrangement that purportedly linked physicians’ compensation to the volume of referrals made for services at the center. The agreement resolves claims that physicians at the infusion center failed to adequately supervise chemotherapy services, a violation of both federal and New York State False Claims Acts.

The hospital has agreed to pay $16.410 million to the federal government and $890,000 to New York State, following a voluntary disclosure of the issues by the hospital itself.

“This settlement addresses a compensation scheme that incentivized physicians to make referrals for services based on how much they would be paid and were essentially kickbacks,” U.S. Attorney Breon Peace said. “New York-Presbyterian/Brooklyn Methodist Hospital voluntarily self-disclosed the conduct to the United States, which allowed it to mitigate the penalties associated with the conduct.”

The settlement includes strict enforcement of Medicare and Medicaid rules designed to prevent financial incentives from influencing patient care decisions. These rules explicitly prohibit remuneration for patient referrals to ensure that medical decisions prioritize patient needs over financial gain.

The rules also mandate direct involvement and supervision by billing physicians in the services provided to patients.