NY-AG v. CenterLight

CenterLight appears to have submitted fraudulent requests to New York’s Medicaid program for monthly premiums and failed to repay Medicaid for falsely-obtained payments, violating New York and federal False Claims Acts, according to NY-AG. CenterLight also appears to have submitted false claims for monthly capitation payments for 186 CenterLight MLTCP members who lived in adult homes and who, for at least some portion of their enrollment in the CenterLight MLTCP, did not receive community-based long-term care services as required by contract and therefore should have been dis-enrolled; and knowingly failed to repay Medicaid for monthly capitation payments that CenterLight Healthcare received for many of the 186 Adult Home MLTCP Members after it became aware that the members should have been dis-enrolled earlier, meaning that CenterLight Healthcare was not entitled to those payments, according to NY-AG.

Summary generated from official New York Attorney General press release