New York City-based VNS Choice will pay $4.4 million to settle a civil fraud lawsuit alleging it collected payments from Medicaid beneficiaries that should have been removed from its managed long-term care plan, according to the Department of Justice.
The complaint, filed in a Manhattan federal court, alleged VNS Choice failed to timely remove 365 Medicaid recipients that were no longer receiving health services from VNS, which caused VNS to collect Medicaid payments it was not entitled to obtain.
The lawsuit further alleged that after VNS Choice disenrolled these beneficiaries, the health plan kept the improper Medicaid payments.
New York and VNS Choice are under contract, which requires members of the managed long-term care plan to be disenrolled under various circumstances and requires timely removal from the plan.
VNS Choice admitted collecting the Medicaid payments for beneficiaries who should have been disenrolled and to keeping the improper Medicaid payments, according to the DOJ.