Staten Island University Hospital to Pay the U.S. $74 Million to Settle Claims of Defrauding Federal Health Care Programs

WASHINGTON - Staten Island University Hospital (SIUH) has agreed to pay the United States $74,032,565 to settle claims that the hospital defrauded Medicare, Medicaid and the military’s health insurance program, TRICARE, announced Benton J. Campbell, U.S. Attorney for the Eastern District of New York and Gregory G. Katsas, Assistant Attorney General for the Justice Department’s Civil Division. In addition, the hospital will pay the State of New York $14,883,883, representing damages sustained by the state’s Medicaid Program. In total, SIUH will pay $88,916,448.

Today’s settlement, in part, resolves suits filed on behalf of the government in the United States District Court for the Eastern District of New York by two individuals. Dr. Miguel Tirado, a former SIUH Director of Chemical Dependency Services, who filed suit under the federal False Claims Act and the New York State False Claims Act, alleged that the hospital had fraudulently billed Medicaid and Medicare for inpatient alcohol and substance abuse detoxification treatment. The government’s investigation established that, during the period July 1, 1994 through June 30, 2000, SIUH submitted claims for payment for detoxification treatment provided to patients in beds for which SIUH had received no certificate of operation from the New York State Office of Alcoholism and Substance Abuse Services (OASAS). More...

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  1. NEWS RELEASE
    Staten Island University Hospital Pays $25 Million To Settle Medicare Fraud Cancer Treatment Case Brought By A Whistleblower

    September 15, 2008 — As part of one of the largest global settlement of health care fraud cases against a single hospital in the United States, Staten Island University Hospital (SIUH) has agreed to pay over $25 million dollars to the United States to settle claims of Medicare fraud brought in a Qui Tam (whistleblower) lawsuit concerning radiosurgery cancer treatment.
    This Medicare fraud settlement includes $25 million in partial settlement of a Qui Tam (False Claims Act) lawsuit brought by whistleblower Elizabeth M. Ryan against SIUH and the hospital's then Chief of Radiation Oncology, Gilbert Lederman, MD, who advertised radiosurgery cancer treatment extensively on the radio. Her attorney, Richard Reich of the New York law firm of Lifflander & Reich, filed the Qui Tam case in 2004 in the federal district court in Brooklyn against the hospital and Dr. Lederman, asserting in the federal complaint that their Stereotactic Body Radiosurgery cancer treatment was not eligible for reimbursement under the federal Medicare program and that through fraudulent billing practices, the hospital and Dr. Lederman caused the Medicare program to wrongfully pay them millions of dollars for body radiosurgery cancer treatment of thousands of patients. Subsequently, the Unites States, following an investigation of the Ryan claims, intervened in the case against SIUH and Dr. Lederman
    Dr. Lederman has not settled with the United States and the government and Mrs. Ryan are continuing the case against him.
    Mr. Reich said: "Staten Island University Hospital sought to exploit the Medicare program and obtained millions of dollars in payments which it was not entitled to at the expense of vulnerable cancer patients, as well as the public. The example of this case should discourage greedy institutions and health care providers from wrongfully diverting money from the Medicare program while encouraging whistleblowers to come forward to protect the integrity of government health care programs." Lifflander & Reich represents whistleblowers in Qui Tam lawsuits.
    Mrs. Ryan will receive approximately 15% of the hospital's settlement with the United States. According to her Attorney, Richard Reich, "Whistleblowers, known as 'relators,' are rewarded for bringing fraud to the government's attention when and if the government gets its money back. Relators are entitled to 15% to 30% of the amount recovered by the government as a result of False Claims Act/Qui Tam lawsuits. Under the applicable law, these Qui Tam cases must be brought under seal and kept confidential until the government has the opportunity to investigate and decide if it wants to pursue the case. Today, a number of states, including New York, have False Claims Acts, comparable to that of the United States."
    Mr. Reich made note of the professionalism and effectiveness of Assistant US Attorneys Laura D. Mantell, and Richard K. Hayes, of the US Attorneys Office in the Eastern District of New York and the efforts of the Department of Justice in Washington in investigating and bringing about a settlement with SIUH.
    According to a recent Justice Department report, whistleblowers bringing Qui Tam lawsuits have helped the government recover over $9.3 billion from drug companies and health care providers.
    Contact:
    Richard Reich, Esq.
    (212) 332-8830
    Email: rreich@lifflander.com
    Lifflander & Reich LLP
    1221 Avenue of the Americas
    New York, New York 10020




    --
    Rachel Noerdlinger
    President, Noerdlinger Media
    (646) 981-5903

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  2. Congratulaions to Elizabeth and her attorney Richard Reich. I commend you for having the courage and moral fiber to expose the fraudulent acts you witnessed. I wish you continued success in pursuing Dr. Lederman.

    John W. Schilling
    Author - Undercover
    www.ethicsolutionsllc.com

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