South Dakota Attorney General Marty Jackley reached a settlement on Wednesday with Avera Gregory Hospital regarding Medicaid claims that involved errors.
As part of the settlement, the hospital in Gregory, South Dakota, is not admitting liability for what it says were coding errors that led to the filing of misleading claims between January 2005 and April 2014.
“Avera fully cooperated throughout the entire process,” Jackley said. “Because the coding errors were mistakes and not made intentionally, we worked with the provider to resolve the matter. In this case, we were able to ensure Medicaid funds were properly utilized while treating the provider fairly.”
The hospital, which is owned by Avera McKennan Hospital and the University Health Center, will be required to pay $84,711.89 to the state of South Dakota, and the funds will then be given to Medicaid.
The South Dakota Department of Social Services, along with the South Dakota Attorney General's Medicaid Fraud Control Unit took care of the case. The United States Department of Health and Human Services assisted the state of South Dakota with the case.