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Lenox Hill Hospital will shell out $12.3M for submitting fraudulent claims to Medicare

Lenox Hill Hospital and its parent company will cough up a $12.3 million settlement to the Department of Justice for submitting phony Medicare claims, authorities announced Friday.

The hefty payout follows a civil fraud lawsuit in which federal prosecutors accused Lenox Hill and Northwell Health of fraudulently billing Medicare for simultaneous surgeries performed by the former head of the Hospital’s Urology Department, David Samadi.

Samadi frequently scheduled two different surgeries, one robotic and one endoscopic, at the same time in nearby operating rooms, the Department of Justice said — and then left patients in the care of unqualified medical residents or nurses as he hopped between the two.

“Patients put great trust in hospitals, particularly when it comes to surgery,” Manhattan US Attorney Geoffrey Berman said in a statement. “Hospitals cannot pay surgeons for their referrals, and they cannot run their operating rooms like assembly lines.”

As part of the settlement, Northwell Health — which operates 23 hospitals and 700 outpatient facilities — admitted to overcompensating Samadi for OR referrals billing Medicare for the simultaneous surgeries, and billing Medicare for procedures that did not need to happen in an OR.

Samadi’s employment status wasn’t immediately clear, but public records show he is still a licensed physician.

“The government’s investigation involved a former Lenox Hill surgeon who, during his time on Lenox Hill’s medical staff, achieved quality results for Lenox Hill’s patients,” a spokeswoman for Lenox Hill and Northwell Health said in a statement. “Lenox Hill is proud of its exemplary patient care services and distinguished medical staff, and is committed to continually refining and enhancing its compliance programs.”

A lawyer for the surgeon did not immediately return a message.

From New York Post Media

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