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Post date: November 20 2001

Attorney General Recovers $300,000 From 4 N.y.c. Hospitals For Medicaid Double-billings

Attorney General Spitzer today announced that four New York City hospitals have repaid more than $300,000 to taxpayers as a result of having double-billed the Medicaid program for providing therapy services to patients.

An investigation by the Attorney General's Medicaid Fraud Control Unit (MFCU) revealed that the hospitals had submitted nearly 4,000 duplicate Medicaid claims, using two different rate codes, for having provided the same therapy services on the same day to the same recipients.

The overcharges occurred between December 1997 and April 2001, and involved billings on behalf of the hospitals' outpatient departments and part-time clinics.

The hospitals and the amount of their repayments are as follows: Staten Island University Hospital ($135,232); St. Vincent's Medical Center, of Staten Island ($108,259); New York Methodist Hospital, of Brooklyn ($33,316); and Our Lady of Mercy Medical Center, in the Bronx ($30,560).

"The recovery of these sorely needed tax dollars will help ensure that the needs of Medicaid patients are properly met," said Spitzer. "Once the problem was brought to the attention of the hospitals, they readily agreed to reimburse the State."

Deputy Attorney General Jos? Maldonado, Director of Spitzer's MFCU, noted that the duplicate billing issue was discovered during a MFCU investigation of an Albany diagnostic and treatment center and the hospitals that billed Medicaid for the services rendered by the center.

Using the unit's data warehouse computer system, which contains years of adjudicated Medicaid claims, the review was expanded statewide. "We then matched billings for the same patient on the same day and added the total amounts paid to the hospitals," Maldonado said. "What would have taken weeks to audit in the past was accomplished in a matter of minutes."

The statewide audit-investigation was conducted by Special Assistant Attorney General John P. Miller and Supervising Associate Auditor Investigator Anthony R. Mangini, both of MFCU's Albany Regional Office. All cases are handled under the direct supervision of Deputy Attorney General Jos? Maldonado.