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Tuesday, March 31, 2020

S.D. hospital to pay $84K over Medicaid claim mistakes

By Mark Payne | Dec 1, 2014

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PIERRE, S.D. (Legal Newsline) - South Dakota Attorney General Marty Jackley reached a settlement on Wednesday with Avera Gregory Hospital regarding Medicaid claims that included errors.

As part of the settlement, the hospital in Gregory is not admitting liability for what it said 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, was required to pay $84,711.89 to South Dakota. Medicaid will be reimbursed for the misleading claims.

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 Department of Health and Human Services assisted South Dakota with the case.

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