WASHINGTON - Staten Island University Hospital (SIUH) has agreed to pay the United States $74,032,565 to settle claims that the hospital defrauded Medicare, Medicaid and the military's health insurance program, TRICARE, announced Benton J. Campbell, U.S. Attorney for the Eastern District of New York and Gregory G. Katsas, Assistant Attorney General for the Justice Department's Civil Division. In addition, the hospital will pay the State of New York $14,883,883, representing damages sustained by the state's Medicaid Program. In total, SIUH will pay $88,916,448.

This week's settlement, in part, resolves suits filed on behalf of the government in the United States District Court for the Eastern District of New York by two individuals. Dr. Miguel Tirado, a former SIUH Director of Chemical Dependency Services, who filed suit under the federal False Claims Act and the New York State False Claims Act, alleged that the hospital had fraudulently billed Medicaid and Medicare for inpatient alcohol and substance abuse detoxification treatment. The government's investigation established that, during the period July 1, 1994 through June 30, 2000, SIUH submitted claims for payment for detoxification treatment provided to patients in beds for which SIUH had received no certificate of operation from the New York State Office of Alcoholism and Substance Abuse Services (OASAS).

Although SIUH was authorized to provide inpatient detoxification care to patients in 56 beds, it administered treatment in 12 additional beds located in a locked, separate wing and concealed the existence of the wing from OASAS. SIUH has agreed to pay the United States $11,824,056 and $14,883,883 to the state of New York according to an agreement that has been approved by U.S. District Judge Edward R. Korman. New York State's claim was litigated by the New York State Attorney General's Office, Medicaid Fraud Control Unit.
Elizabeth M. Ryan, widow of an SIUH cancer patient, asserted in her federal False

Claims Act suit that SIUH fraudulently billed Medicare for stereotactic body radiosurgery treatment that was provided on an out-patient basis to cancer patients. The investigation established that from1996 through 2004, SIUH defrauded Medicare and TRICARE by knowingly using incorrect billing codes for cancer treatment performed at the hospital. By using incorrect codes, SIUH obtained reimbursement for treatment that was not covered by Medicare or TRICARE. SIUH will pay the United States $25,022,766 to settle this claim according to an agreement that has been approved by U.S. District Judge John Gleeson.

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