CenterLight Health Pays $47 Million to Settle Medicaid Fraud Case

375 Grand St.

375 Grand St.

The state attorney general’s office last week announced a $47 million settlement with CenterLight Healthcare in a Medicaid fraud case. The organization operates a health care facility and diagnostic treatment center at 375 Grand St.

CenterLight was accused of fraudulently billing Medicaid for services it did not provide to more than 1200 patients. More from the news release distributed by AG Eric Schneiderman’s office:

Under the settlement, CenterLight Healthcare admitted that it enrolled Medicaid beneficiaries who were referred by social adult day care centers even though the beneficiaries were not eligible to receive managed long-term care under the plan, and that the centers were providing services that did not qualify for reimbursement under New York State Department of Health standards, or CenterLight’s contract with DOH.  CenterLight receives over $3,000 a month per member from New York’s Medicaid program as part of its MLTCP. Under the settlement, New York’s Medicaid program will receive $28,050,652.04 and the United States will receive $18,700,434.70.  The U.S. Department of Justice’s Southern District of New York reached a parallel agreement with CenterLight.

The non-profit organization was founded more than 90 years ago. It operates more than 40 facilities across the city. City Council member Margaret Chin, chair of the aging committee: put out the following statement:

Healthcare providers like CenterLight that seek to take advantage of the skyrocketing demand for social adult day care services are not just defrauding the system – they are betraying the trust of the elderly patients they serve. Social adult day care programs provide essential services to thousands of functionally impaired older adults throughout our city, and I congratulate Attorney General Schneiderman and his staff for their efforts to protect these vulnerable New Yorkers.

Chin authored legislation in 2014 setting up an “Office of the Social Adult Day Care Ombudsperson” to investigate complaints.