The complaint, filed in a Manhattan federal court, alleged VNS Choice failed to timely remove 365 Medicaid recipients that were no longer receiving health services from VNS, which caused VNS to collect Medicaid payments it was not entitled to obtain.
The lawsuit further alleged that after VNS Choice disenrolled these beneficiaries, the health plan kept the improper Medicaid payments.
New York and VNS Choice are under contract, which requires members of the managed long-term care plan to be disenrolled under various circumstances and requires timely removal from the plan.
VNS Choice admitted collecting the Medicaid payments for beneficiaries who should have been disenrolled and to keeping the improper Medicaid payments, according to the DOJ.
More articles on legal and regulatory issues:
8 latest lawsuits involving hospitals
Reliant Care Group to pay $8.3M to resolve false claims allegations
Hospice company settles false billing case for $2M
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.