Settlement Details

New York-Presbyterian Hudson Valley Hospital, ​based in New York City, will ⁣pay $6.8‌ million to resolve allegations of improperly incentivizing referrals from a Westchester, New York-based oncology practice, according to a December 22, 2023, news‌ release from the⁣ Department of Justice.

The Alleged ⁣Scheme

Federal officials ⁢allege​ the hospital entered into three contracts with the oncology ‌practice between 2011 ‍and 2012. These agreements involved payments totaling hundreds of thousands of dollars annually ‌for work related‍ to proposed projects, ‌including planning for a‌ melanoma center, a breast‍ cancer center, and the advancement of an intraoperative radiation therapy service line.

Between 2011 and 2019, the hospital paid the practice over $4 million, ​the ⁤complaint states.

Lack of Documentation and Continued ‌Payments

Officials⁢ claim the practice frequently failed to perform the contracted work, did not meet the required standards, or lacked sufficient documentation – including time records – to justify the payments. Despite this, ‍the hospital continued to pay the practice and receive‌ referrals that generated millions⁢ in Medicare and Medicaid reimbursements.

By October 2016, the hospital reportedly knew, or should have known, that the practice was only ⁢partially fulfilling its obligations under the radiation therapy​ agreement and completing very little work under ⁣the ⁣melanoma directorship agreement. Yet, payments continued under both agreements for an additional three years.

Hospital’s Response

The hospital admitted duty for certain conduct alleged by the government, specifically acknowledging ​payments exceeding $4 million for⁣ work that was either not performed, not performed to standard, or lacked supporting time records. New York-Presbyterian Hudson Valley Hospital declined to ⁢comment further when contacted ⁢by Becker’s.