Breon Peace, United States Attorney for the Eastern District of New York, announced a settlement agreement with New York-Presbyterian/Queens Hospital. The settlement agreement, which requires a payment of over $2.5 million, addresses allegations that a former physician at New York-Presbyterian/Queens performed services that were not medically necessary and then billed federal healthcare programs for those services. The services involved the replacement of implantable cardioverter defibrillator (ICD) pulse generator batteries.
A physician who was formerly affiliated with New York-Presbyterian/Queens repeatedly replaced ICD batteries earlier than was necessary. That is, he repeatedly replaced ICD batteries before they reached the elective replacement interval (ERI). Such batteries were functioning normally. He therefore subjected his patients to unneeded and risky surgical procedures. New York-Presbyterian/Queens then submitted claims for payments to federal healthcare programs for these procedures. As a result of an internal investigation, New York-Presbyterian/Queens learned of the physician’s conduct. It voluntarily self-disclosed that conduct to the United States Department of Health and Human Services, Office of Inspector General. The settlement, which requires New York-Presbyterian/Queens to pay $2,588,882.50 to the United States, resolves claims that the conduct violated the federal False Claims Act.
