Universal Health Services, Inc., (UHS) and related entities agreed to pay a combined total of $122 million to resolve alleged violations of the False Claims Act for billing for medically unnecessary inpatient behavioral health services.
UHS said the settlement has fully resolved the civil aspects of the investigation involving UHS and its behavioral health division facilities conducted by the U.S. Department of Justice, Office of the Inspector General, Department of Health and Human Services and various state attorneys general.
UHS has agreed to pay the U.S. government $117 million to resolve allegations the King of Prussia hospital management company billed Medicare, Medicaid and government health plans covering veterans for unnecessary services.
Of the $117 million, the federal government will receive a total of $88.1 million and the remaining $28.9 million will be returned to individual states, which jointly fund state Medicaid programs.
In a separate civil settlement, Turning Point Care Center, LLC, a UHS facility in Moultrie, will pay $5 million to resolve allegations that it provided free or discounted transportation services to induce Medicare and Medicaid beneficiaries to seek treatment at Turning Point’s inpatient detoxification and rehabilitation program or intensive outpatient program.
Universal Health Services said that the settlement does not constitute a finding of improper conduct or failure to provide appropriate care and treatment in accordance with governing rules and regulations.
As a condition of this settlement, UHS has entered into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General (OIG), which will remain in effect for five years.
UHS must retain a government-selected independent monitor who will assess patient protections in the company’s behavioral health division and must undergo annual reviews of inpatient behavioral health claims to federal health care programs, prosecutors said.
UHS already has a compliance program in existence which includes elements required by the corporate integrity agreement, UHS said.