AG Curtis Hill Announces $117 Million Settlement With Health-Facility Operator That Allegedly Defrauded Medicaid System

(INDIANAPOLIS) – Attorney General Curtis Hill announced Monday that Indiana has joined with 48 other states and territories — and the federal government — to settle allegations of fraud against two companies involved with the operation of psychiatric and behavioral health facilities across the United States.

The two companies are Universal Health Services Inc. (UHS) and UHS of Delaware Inc. (UHS of Delaware). UHS is a for-profit holding company that directly or indirectly owns the assets or stock of inpatient and residential psychiatric and behavioral health facilities, and UHS of Delaware is a subsidiary that provides management services to UHS and its other subsidiaries. UHS is based in King of Prussia, Penn., and is one of the nation’s largest providers of hospital and healthcare services.

The total value of the settlement is $117 million, and of this amount, Indiana will receive $107,844.22.

“Exposing waste, fraud and abuse is part of our responsibility as stewards of the public trust,” Attorney General Hill said. “We work every day to recover taxpayer funds taken wrongfully through fraud and other illegal means. Indiana Medicaid serves more than 1 million Hoosiers across the state, and we must continue working to ensure that funds set aside to help society’s most vulnerable members are truly used for that purpose.”

The settlement resolves allegations that during the period from Jan. 1, 2007, through Dec. 31, 2018, UHS and certain enumerated UHS entities submitted or caused to be submitted false claims for services provided to Medicaid beneficiaries at facilities nationwide, including six in Indiana, resulting from UHS’s:

  • admission of beneficiaries who were not eligible for inpatient or residential treatment;
  • failure to properly discharge beneficiaries when they no longer needed inpatient or residential treatment;
  • improper and excessive lengths of stay;
  • 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
  • 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.

The government alleges that UHS’s conduct violated the Federal False Claims Act and the State of Indiana False Claims Act, resulting in the submission of false claims to the Indiana Medicaid program.

This settlement results from 18 whistleblower lawsuits originally filed in multiple U.S. district courts. A National Association of Medicaid Fraud Control Units (NAMFCU) Team participated in the investigation and settlement negotiations on behalf of the states and included representatives from the Office of the Indiana Attorney General.

The Indiana Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a federal grant. The remaining 25 percent is funded by the State of Indiana.

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