Acadia Healthcare Company Inc., a Delaware corporation based in Franklin, Tennessee, has agreed to settle allegations that it violated the False Claims Act and related state statutes. The company is accused of billing for medically unnecessary inpatient behavioral health services or services that did not meet federal and state regulations.
The United States government claimed that between 2014 and 2017, Acadia submitted false claims to Medicare, Medicaid, and TRICARE for inpatient behavioral health services. These claims included admitting beneficiaries who were not eligible for inpatient treatment and failing to discharge them when they no longer needed such treatment. Additionally, Acadia allegedly failed to provide adequate staffing, training, and supervision of staff, resulting in incidents such as assaults, elopements, suicides, and other harm.
Principal Deputy Assistant Attorney General Brian M. Boynton stated: "This settlement demonstrates the Justice Department’s commitment to ensuring that federal healthcare programs pay only for services that are needed and properly provided." U.S. Attorney Roger B. Handberg added: "The Justice Department will hold accountable those who seek to exploit these programs for personal gain."
Special Agent in Charge Tamala E. Miles emphasized the importance of following the law when billing federally funded health care programs: "This settlement illustrates HHS-OIG’s commitment to protecting the integrity of these taxpayer-funded programs."
Rear Admiral Matthew Case highlighted the impact on TRICARE: "Billing TRICARE for medically unnecessary inpatient behavioral health services impacts our ability to reimburse providers in a timely manner."
Under the settlement agreement, Acadia will pay $16,663,918 to resolve its liability under the False Claims Act for its allegedly false billings. Additionally, Acadia will pay $3,186,082 to Florida, Georgia, Michigan, and Nevada under separate agreements.
The case also includes claims brought under the whistleblower provisions of the False Claims Act by former employees Franka Tirado, Brian Snyder, and Jamie Thompson. The whistleblowers will receive $3,166,144.42 from the federal portion of the settlement.
The resolution was achieved through coordination between various branches of the Civil Division's Commercial Litigation Branch and U.S. Attorney’s Office for the Middle District of Florida with assistance from HHS-OIG and other agencies.
Senior Trial Counsel Sarah Arni and former Senior Litigation Counsel Lindsay Griffin handled this matter.
It should be noted that these claims are allegations only; there has been no determination of liability.
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