Acadia Healthcare Company Inc. (Acadia) has agreed to settle a lengthy court battle and pay a $19.85m financial penalty after false Medicare and Medicaid claims.
The monetary fine resolves allegations that Acadia knowingly violated the False Claims Act by billing federal healthcare programs for unnecessary inpatient behavioral care.
Acadia Healthcare pay the price for False Claim breach
Between 2014 and 2017, the Justice Department alleged that healthcare providers had submitted illicit claims for federal healthcare programs. Acadia’s Florida, Georgia, Michigan, and Nevada facilities charged Medicare, Medicaid, and TRICARE.
Further to the claims that the federal healthcare programs were improperly billed, Acadia also knowingly failed to provide staffing, training, and supervision of staff, which would result in several serious, sensitive incidents occurring at their facilities.
According to the resolution, Acadia allegedly “failed to provide inpatient acute care in accord with federal and state regulations, including, but not limited to, by failing to provide active treatment, to develop and/or update individualized assessments and treatment plans, to provide adequate discharge planning and to provide required individual and group therapy.”
“Medical providers who participate in federally funded health care programs must follow the law when billing Medicare, Medicaid and Tricare,” said Special Agent in Charge Tamala E. Miles of the Department of Health and Human Services Office of Inspector General (HHS-OIG).
The services that the healthcare provider billed were deemed unnecessary by the joint investigation of the Civil Division’s Commercial Litigation Branch, Fraud Section, and U.S. Attorney’s Office for the Middle District of Florida, as well as the National Association of Medicaid Fraud Control Units, with assistance from HHS-OIG and the Department of Defense Criminal Investigative Service.
The United States will receive a payment of $16,663,918 to resolve Acadia’s liability under the False Claims Act for its allegedly false Medicare, Medicaid, and TRICARE billings. The company will pay $3,186,082 to Florida, Georgia, Michigan, and Nevada to resolve legal claims in each state.
“Federal health care programs rely upon the honesty and credibility of participating providers,” said U.S. Attorney Roger B. Handberg for the Middle District of Florida. “The Justice Department will hold accountable those who seek to exploit these programs for personal gain, jeopardizing the health of patients.”
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