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Friday, March 29, 2024

Georgia-based pediatric facility to pay $2.4 million to Pennsylvania for allegedly not returning Medicaid overpayments

Medicaid

Pediatric Services of America, Inc. will pay $2.4 million to the state of Pennsylvania as part of a national settlement with 19 other states over allegations it didn't return overpayments made by Medicaid, said Attorney General Kathleen Kane. | Shutterstock

HARRISBURG, Pa. (Legal Newsline) - A pediatric health center will pay $2.4 million to the state of Pennsylvania as part of a national settlement with 19 other states over allegations it didn't return overpayments made by Medicaid, said Attorney General Kathleen Kane on Monday.

Georgia-based Pediatric Services of America Inc. was accused of round up claims to the nearest whole hour and overcharging for some nursing services in addition to the claims of non-repayment, Kane said.

The $2.4 million in the settlement will go toward the state's Medicaid programs, Kane said. Pennsylvania will also receive about $81,000 in restitution and other recoveries that will go to the state's Department of Human Services, Kane said.

The overpayments occurred between January 2007 and June 2013, and the rounded up hours at the nursing homes occurred between January 2008 and October 2014, according to the settlement agreement.

Pediatric Services has agreed to a corporate integrity agreement with the U.S. Department of Health and Human Services' Office of the Inspector General. Under the agreement, the company will develop new procedures in order to avoid similar issues in the future.

The U.S. Attorney's Office for the Northern District of Georgia initially investigated the claims, along with the Southern District of Georgia, the U.S. Department of Health and the National Association of Medicaid Fraud Control Units.

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