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CenterLight Healthcare Reaches $10M Medicaid Fraud Settlement

Posted in Fraud and Abuse, Home Healthcare, Litigation, Medicare and Medicaid, Reimbursement Matters, State Matters, White Collar

CenterLight Healthcare, a managed long-term care organization that provides and coordinates healthcare services in the New York City area, has agreed to a $10.3 million settlement with state and federal prosecutors. New York Attorney General Eric Schneiderman announced the joint settlement on March 28.CenterLight had been under investigation for billing the Medicaid program from 2012-15 for long-term care services to adult home residents that were never provided. It also failed to unenroll residents in its Medicaid managed long-term care plan when required to do so.

Medicaid is a joint state-federal program in which services are provided to beneficiaries through a contract with the state Department of Health. CenterLight’s services include home-based nursing services and therapies, home health aide services, and adult day care. The company is supposed to coordinate and oversee the provision of these services, but investigators found that almost 200 individuals did not receive any care during the months they were enrolled in CenterLight’s managed care plan.

The new settlement arose out of a whistleblower claim brought against CenterLight in February 2013. In January 2016, the company entered into a separate $46.7 million settlement with the federal government to resolve claims of improper enrollment and service provided to enrollees in its long-term care plan.

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