Saint Vincent’s to Pay $29M Over Alleged False Claims Act Violations

Saint Vincent’s Catholic Medical Centers of New York will pay $29 million to settle allegations of False Claims Act violations related to overpayments from the Department of Defense for healthcare services provided to retired military members and their families.

Saint Vincent’s participated in the Uniformed Services Family Health Plan (USFHP) program, which provides healthcare coverage funded by the Defense Health Agency (DHA). According to the government, the organization knowingly retained overpayments received due to calculation errors in its capitated rates. Instead of returning the funds or informing DHA, Saint Vincent and other USFHP participants allegedly took steps to conceal the overpayments and continued submitting claims at inflated rates.

The case originated from a whistleblower lawsuit filed under the False Claims Act’s qui tam provisions by Jane Rollinson and Daniel Gregorie, former executives at another USFHP provider. As part of the settlement, they will receive over $5.6 million. The U.S. government is continuing to pursue claims against other entities involved.

This settlement underscores the government’s commitment to combating healthcare fraud and ensuring responsible use of taxpayer dollars. The False Claims Act remains a key tool in addressing financial misconduct in federal healthcare programs.