King of Prussia, Pa.-based Universal Health Services and two related entities agreed to pay $122 million to settle kickback allegations and claims that they billed for unnecessary inpatient behavioral health services, the U.S Justice Department said last week.
As part of the settlement, announced July 10, UHS and UHS of Delaware Inc. agreed to pay $117 million to resolve allegations that the hospitals and facilities knowingly submitted false claims to government insurers, including Medicaid, Medicare and Tricare.
Prosecutors alleged that the company billed for inpatient behavioral health services that were not medically necessary or failed to provide adequate services for patients admitted to its facilities. The alleged billing scheme occurred between January 2006 and December 2018, prosecutors said.
Turning Point, a UHS facility in Moultrie, Ga., also agreed to pay $5 million to resolve allegations that it provided free or discounted transportation services to induce more Medicare and Medicaid beneficiaries to seek treatment at the facility between January 2007 and May 2019.
The settlement resolves a series of investigations into the billing practices and care quality at UHS facilities brought by 19 different whistleblower lawsuits.
In addition to the civil settlement, UHS has entered into a five-year Corporate Integrity Agreement with the HHS Office of the Inspector General. Under the agreement, UHS must retain an independent monitor to assess and regularly review the organization's behavioral health division.
UHS denied the allegations and said "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 or an admission of facts or liability."