AG’s office reaches $750k settlement with LI pediatric practice

Federal and state officials have settled with a Long Island pediatrics practice, which has a location in Wading River, and its physicians to the tune of $750,000 over allegations that it filed false Medicaid claims.

Two weeks ago, New York State Attorney General Eric Schneiderman announced the joint federal-state settlement with former practice owner Freed, Kleinberg, Nussbaum, Festa & Kronberg MD, LLP, and some current and former partner physicians, including Drs. Arnold Scherz, Mitchell Kleinberg, Michael Nussbaum, Robert Festa and Jason Kronberg, who did business as Pediatrics and Adolescent Medicine.

The group currently operates as Pediatric & Adolescent Medicine, a division of the ProHEALTH Care Associates LLP umbrella, which acquired it in 2012. The practice has locations in Holbrook, Port Jefferson and Shirley as well as Wading River.

According to a press release from Mr. Schneiderman’s office, between July 1, 2004 and Dec. 31, 2010, the practice and its partners did not enroll all of the employees who treated Medicaid patients as providers in the Medicaid program. Instead, the partners used their own Medicaid provider identification numbers to bill for treatment of these patients, which was actually delivered by unenrolled personnel. The state said this is a direct violation of Medicaid regulations.

New York’s Medicaid program will receive $450,000 as part of the $750,000 settlement. The deal was inked March 6.
During an investigation, the attorney general’s office found that the false claims occurred at many of the practice’s four Long Island locations.

“Providers who are not properly enrolled in Medicaid before treating Medicaid beneficiaries undermine the integrity of the program and its efforts to serve our neediest New Yorkers,” Mr. Schneiderman said. “Those serving Medicaid beneficiaries must be properly credentialed and thoroughly vetted prior to Medicaid enrollment to ensure that beneficiaries get the care they deserve from qualified professionals.”

The United States Attorney’s Office for the Eastern District of New York assisted in this investigation.

The practice submitted a financial statement of corporate debtor, saying it lacks the assets and ability to make immediate full restitution and a payment scheduled was set up for the $750,000 plus 2.25 percent per annum in interest dating back to Oct. 9, 2017, when the deal was initially reached.

Because of the payment schedule, the practice has to provide the New York State Attorney General with a copy of its tax returns each year.

A call to the main office in Holbrook was never returned.

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