Attorney General Eric T. Schneiderman today announced a $47 million settlement with CenterLight Healthcare and CenterLight Health System, resolving allegations that CenterLight Healthcare’s Select Medicaid Managed Long Term Care Plan (“MLTCP”) fraudulently billed Medicaid for services they did not provide to more than 1,200 Medicaid recipients.

Under the settlement, CenterLight Healthcare admitted that it enrolled Medicaid beneficiaries who were referred by social adult day care centers even though the beneficiaries were not eligible to receive managed long-term care under the plan, and that the centers were providing services that did not qualify for reimbursement under New York State Department of Health standards, or CenterLight’s contract with DOH. CenterLight receives over $3,000 a month per member from New York’s Medicaid program as part of its MLTCP.

“It’s simple: CenterLight Health Care did not play by the rules,” Attorney General Schneiderman said. “We won’t tolerate companies that seek to exploit the system for profit. My office will continue to be vigilant in protecting Medicaid against fraud.”

In addition to its payment of the $47 million under the settlement, CenterLight is entering into two-year agreement with an independent compliance monitor and the Attorney General’s Medicaid Fraud Control Unit. That agreement requires CenterLight to comply with all terms of its MLTCP contract and DOH policies, and monitor and revise compliance policies if necessary.

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