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Date: 09-14-2018

Case Style:

United States of America v. Centers Plan for Healthy Living (“Centers Plan”)

Eastern District of New York Courthouse - Brooklyn, New York

Case Number: 14-CV-6129 (ENV)

Judge: Eric N. Vitaliano

Court: United States District Court for the Eastern District of New York (Kings County)

Plaintiff's Attorney: Joseph A. Marutollo for the United States of America

Benjamin Natan Leftin, Daniel M. Felber and Joseph Anthony Marutollo for relator

Defendant's Attorney: Not Available

Description: Brooklyn, NY - Staten Island-Based Health Care Service Agrees to Pay More than $1.6 Million to Settle False Claims Act Suit Alleging Fraudulent Billing Practices

Centers Plan for Healthy Living (“Centers Plan”), a Staten Island-based company that provides services to people who are chronically ill or who need long-term health care services, has agreed to pay $1,650,000 to settle civil fraud allegations that Centers Plan billed the Medicaid Program for services that it did not provide to Medicaid beneficiaries. The settlement agreement, which resolved claims under both the Federal and New York State False Claims Acts, was approved yesterday by United States District Judge Eric N. Vitaliano.

“When health care providers engage in fraudulent billing practices to improperly obtain Medicaid funds, they jeopardize the very integrity of Medicaid, a critical program that provides health coverage to millions of Americans,” stated United States Attorney Donoghue. “This Office will continue to vigorously prosecute those who seek to exploit Medicaid for their own enrichment.” Mr. Donoghue thanked the Medicaid Fraud Control Unit of the Office of the New York State Attorney General and the Office of the Inspector General of the U.S. Department of Health and Human Services for their assistance in the investigation.

The government’s investigation revealed that, from April 2013 through December 2015, Centers Plan fraudulently enriched itself at the expense of Medicaid by knowingly and systematically submitting false claims for payment to Medicaid. In one scheme, Centers Plan improperly enrolled into its managed long-term health care plan individuals who were actually only eligible for Social Adult Day Care or transportation services. In another scheme, Centers Plan failed to disenroll members from its managed long-term health care plan who were no longer receiving qualified community-based long-term care services.

The allegations were brought to the government’s attention through the filing of a complaint pursuant to the qui tam provisions of the False Claims Act. Under the Act, private citizens can bring suit on behalf of the United States and share in any recovery.

Outcome: 09/13/2018 15 PARTIAL UNSEALING ORDER, The seal shall be lifted as to this Order, the United States' and the State's respective Notices of Partial Intervention, and any matter occurring in this action hereafter. All documents filed before August 28, 2018 in the Court's file in this action shall remain under seal and not be made public, except for Relator's Complaint. So Ordered by Judge Eric N. Vitaliano on 9/11/2018. (Lee, Tiffeny) (Entered: 09/13/2018)
09/13/2018 16 NOTICE of Appearance by Joseph Anthony Marutollo on behalf of United States of America (aty to be noticed) (Marutollo, Joseph) (Entered: 09/13/2018)
09/13/2018 17 STIPULATION of Dismissal for the Court's endorsement by United States of America (Marutollo, Joseph) (Entered: 09/13/2018)
09/13/2018 18 NOTICE of Appearance by Andrew Jerome Gropper on behalf of State Of New York (aty to be noticed) (Gropper, Andrew) (Entered: 09/13/2018)

Plaintiff's Experts:

Defendant's Experts:


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