Judge Orders Mt. Sinai Hospital to Settlement Conference in Whistleblower Case

NEW YORK, May 16, 2017 /PRNewswire/ -- On May 16, 2017, Judge Richard M. Berman, of the United States District Court for the Southern District of New York, issued a decision and order in a healthcare fraud whistleblower case against New York City-based Mount Sinai Hospital, denying, in part, the hospital's motion to dismiss the case and ordering all parties to appear at a settlement conference on June 12, 2017, according to the whistleblowers' attorney Timothy J. McInnis, of McInnis Law in Manhattan.

The case is being pursued by two Mount Sinai employees.  They allege the hospital, and its Medical School and Radiology Department, fraudulently billed Medicare and New York Medicaid for outpatient radiology services.  Among other things, the whistleblowers' complaint alleges that employees from Mount Sinai falsified the names of certain rendering radiologist and referring physicians and billed for services other than those that were actually provided.

The lawsuit was initiated under the so-called "qui tam" provisions of the federal and New York State False Claims Acts.  The original complaint was filed under seal so that each government could investigate its allegations.  Both declined to join the action and the whistleblowers went forward on their own, as they are entitled to do under the False Claims Acts, Attorney McInnis explained.

After the discovery phase of the case, the Mount Sinai defendants filed a motion for summary judgment asking the judge to dismiss the case.  Judge Berman refused.  He concluded that the undisputed and competing disputed facts established during discovery entitled the whistleblowers an opportunity to prove their case at trial.  In the meantime, Judge Berman ordered all of the principals to appear in court on June 12, 2017 for a settlement conference.

According to Attorney McInnis the whistleblowers here could receive up to 30% of any funds paid by the defendants to Medicare and/or Medicaid, from either a settlement or judgment after trial, plus attorneys' fees and litigation costs and expenses.

The case is: UNITED STATES and STATE OF NEW YORK ex rel. XIOMARY ORTIZ and JOSEPH GASTON, v. MOUNT SINAI HOSPITAL, MOUNT SINAI SCHOOL OF MEDICINE, and MOUNT SINAI RADIOLOGY ASSOCIATES, 1:13-cv-04735-RMB-BCM (S.D.N.Y.).

For additional information or a copy of the decision, contact Timothy McInnis of McInnis Law at (212)292-4573.

SOURCE McInnis Law