Medical practice settles fraud claim for $5.31 million

A settlement was reached in a civil fraud lawsuit that was filed against a medical practice with several offices in New York. On Oct. 21, the U.S. Attorney for the Southern District of New York announced that Hudson Valley Hematology Oncology Associates would pay $5.31 million and admit to misconduct. The medical practice has offices in Yorktown, Hawthorne, Poughkeepsie, Carmel, Mount Kisco and Fishkill.

Allegations of fraud were brought against Hudson Valley under the False Claims Act. The medical practice was accused of billing Medicare and Medicaid for million of dollars worth of improper charges. According to the complaint, Hudson Valley regularly waived copayments without any legal reason and then billed Medicare for them anyway. Hudson Valley was also accused of submitting false claims to Medicare and Medicaid for services that were not properly documented.

One of the claims against Hudson Valley concerned the way that the medical practice billed for evaluation and management services. When the medical practice billed for procedures like chemotherapy, it would often bill for evaluation or management services on the same date. However, the medical practice did not provide sufficient documentation to prove that any significant evaluation and management services were actually provided to patients.

People may want to speak with a criminal defense attorney as soon as they learn that they are being investigated for white collar crimes such as fraud. An attorney may be able to conduct a parallel investigation and determine what activities law enforcement is interested in. An attorney may then communicate with investigators and attempt to negotiate a settlement.

Source: Yorktown Patch, “Hudson Valley Medical Practice Settles $5.31M Medicare Fraud Lawsuit,” Michael Woyton, Oct. 21, 2016

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