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Attorney General of Virginia

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Commonwealth of Virginia
Office of the Attorney General

Mark Herring
Attorney General

202 North Ninth Street
Richmond, Virginia 23219

 

For media inquiries only, contact:  
Charlotte Gomer, Press Secretary
Phone: (804)786-1022 
Mobile: (804) 512-2552
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

UNIVERSAL HEALTH SERVICES INC. AND UHS OF DELAWARE, INC. TO PAY $117 MILLION TO SETTLE ALLEGATIONS INVOLVING IMPROPER ADMISSIONS AND DISCHARGES AT ITS INPATIENT AND RESIDENTIAL PSYCHIATRIC AND BEHAVIORAL HEALTHCARE FACILITIES

~ As part of the settlement, Virginia’s Medicaid program will receive $6,208,526 ~

RICHMOND Attorney General Mark R. Herring today announced that Virginia has joined 49 other states, territories, and the federal government to settle allegations of fraud against Universal Health Services, Inc. (UHS, Inc.) and UHS of Delaware Inc. As part of the settlement, UHS, Inc. will pay $117 million to resolve allegations that its hospitals and other facilities submitted false claims to Medicare, Medicaid, and other federal healthcare programs for inpatient behavioral health treatments that were medically unnecessary or not reasonable. Additionally, UHS, Inc. failed to provide appropriate or adequate services for both adults and children who were admitted to its facilities. As part of the settlement, Virginia’s Medicaid program will receive $6,208,526 of which $3,604,922 represents the Commonwealth’s portion of the recovery.

 

UHS, Inc. owns and provides management and administrative services for inpatient and residential psychiatric and behavioral health facilities that provide services to individuals, including beneficiaries of various federal healthcare programs. UHS of Delaware, Inc. is a subsidiary of UHS, Inc. that provides management services to UHS, Inc. and many of its subsidiaries. UHS is based in King of Prussia, Pennsylvania and is one of the nation’s largest providers of hospital and healthcare services.

 

“Healthcare fraud on a massive scale like this is utterly egregious not only because it wastes millions of taxpayer dollars, but it undermines a crucial system that provides millions of Virginians with important healthcare services,” said Attorney General Herring. “For over a decade UHS defrauded the Medicaid system and put profits and lining their own pockets over the wellbeing and care of their patients. I’m incredibly proud of my Medicaid Fraud Unit for their hard work on this really important case and we will continue to collaborate with state and federal partners to hold businesses accountable for fraud and abuse in Virginia and around the country.”

 

The settlement resolves allegations that during the period from January 1, 2007, through December 31, 2018, UHS and many of its entities submitted false claims for services provided to Medicaid beneficiaries 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
  • 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 coalition alleges that UHS’s conduct violated the Federal False Claims Act and the Virginia Fraud Against Taxpayers Act, resulting in the submission of false claims to the Virginia Medicaid program.

 

This settlement results from eighteen whistleblower lawsuits originally filed in the United States District Court for the Middle District of Florida, Northern District of Illinois, Eastern District of Pennsylvania, Northern District of Georgia, Middle District of Georgia, Eastern District of Virginia, Western District of Virginia, Western District of Michigan, and Eastern District of Michigan. Fourteen of the eighteen whistleblower suits named at least one plaintiff state and all but three of the cases were transferred to the United States District Court for the Eastern District of Pennsylvania.

 

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 Offices of the Attorneys General for the states of California, Florida, Indiana, Massachusetts, North Carolina, Ohio, Texas, and Virginia. Virginia Assistant Attorney General Kimberly Bolton served as the team lead for this matter.

 

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