As a result of the settlement, Tirado will receive $2.3 million from the federal government and $2.97 million from New York. Ryan will receive $3.75 million as her portion of the federal recovery. The federal False Claims Act and newly-enacted New York state False Claims Act permit private individuals to file suits on behalf of the government and receive a portion of the recovery.

The government's other two claims were resolved prior to the filing of suit. The United States had determined that SIUH deliberately inflated its resident count from the 1996 cost report year through the 2003 cost report year. Medicare pays a share of the cost of Graduate Medical Education at teaching hospitals such as SIUH. The amount paid is determined by Medicare annually based upon "cost reports" submitted by the hospitals. SIUH has agreed to pay the United States $35,706,754 to settle this claim.


Also, the settlement concerns SIUH's billings to Medicare and Medicaid for treatment of psychiatric patients in unlicensed beds during the period July 2003 through September, 2005. The hospital has agreed to pay the United States $1,478,989 to settle this claim.

The United States' investigation was led by the United States Attorney's Office for the Eastern District of New York.

"Those who defraud and jeopardize the nation's vital, federally-funded health care programs will be aggressively investigated and held to account," stated Benton J. Campbell, U.S. Attorney for the Eastern District of New York. "Only by ensuring that the billing and cost guidelines of Medicare and Medicaid are scrupulously followed can we have confidence that affordable healthcare will continue to be available for those in need."

"The resolution of these claims against SIUH demonstrates the federal government's continuing commitment to protect federally-funded health care programs from any and all attempts by those who would knowingly seek improper payments," said Gregory G. Katsas, Assistant Attorney General for the Justice Department's Civil Division.

In addition, SIUH has agreed to enter into a Corporate Integrity Agreement with the Office of Inspector General, Department of Health and Human Services (OIG-HHS) under which the hospital will maintain a compliance program to help ensure against a recurrence of fraud.

"Settlements such as this demonstrate yet again that submitting fraudulent claims to Medicare and Medicaid artificially raises health care costs and in turn steals from those who depend on these government medical programs," said HHS Inspector General Daniel R. Levinson. "The Office of Inspector General, working with our federal and state law enforcement partners, will continue to aggressively investigate and prosecute such fraud."

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