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Attorney General Nessel joins $117M settlement to resolve fraud allegations at healthcare facilities

(WAGM)
Published: Jul. 15, 2020 at 12:17 PM EDT
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LANSING, Mich. (WILX) - Attorney General Dana Nessel announced on Wednesday that Michigan is set to receive at least $2.4 million of a $117 million settlement. An agreement between several state, federal, and other parties was reached to settle allegations against Universal Health Services Inc. (UHS) and its subsidiary. The subsidiary, UHS of Delaware Inc. (UHS of Delaware), is known to own and manage psychiatric and behavioral health care facilities.

For context, the UHS of Delaware Inc. (UHS of Delaware), provides management services to its parent company and other subsidiaries. UHS facilities in the state of Michigan include Forest View Hospital in Grand Rapids, Havenwyck Hospital in Auburn Hills and Cedar Creek Hospital in St. Johns. The company violated both the Federal False Claims Act and the Michigan Medicaid False Claim Act. 

“This agreement settles over a decade of alleged fraudulent activities and compensates Michigan and other states for the financial assistance lost while providing a taxpayer-funded benefit,” Nessel said. “Medicaid is a public benefit and exists to assist those individuals who need help with securing health care. When that system is taken advantage of, it is incumbent upon the Michigan Department of Attorney General and similar offices to intervene on behalf of our residents and taxpayers.”

The settlement resolves allegations that occurred between Jan. 1, 2007, and Dec. 31, 2018.

UHS submitted false claims to Medicaid resulting from its: “admission of Medicaid beneficiaries who were not eligible for inpatient or residential treatment; failure to properly discharge beneficiaries who no longer needed inpatient or residential treatment; keeping beneficiaries at UHS facilities for improper and excessively long stays; failure to provide adequate staffing, training, and/or supervision of staff; billing for services not rendered; improper use of physical and chemical restraints and seclusion; and its failure to provide inpatient acute or residential care in accordance with federal and state regulations, including, but not limited to, failure to develop and/or update individualized assessments and treatment plans, failure to provide adequate discharge planning, and failure to provide required individual and group therapy”.

This entire matter was handled by the Health Care Fraud Division.

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