Universal Health Services, Inc. and Related Entities have agreed to pay $122 million to settle allegations of multiple False Claims Act violations. Universal Health Services, Inc. and UHS of Delaware, Inc. (together, UHS) manage over 200 inpatient psychiatric hospitals and residential psychiatric and behavioral treatment facilities across the country. UHS has agreed to pay the state and federal governments $117 million. Turning Point Care Center, LLC (Turning Point), located in Moultrie, Georgia, has agreed to pay $5 million to settle allegations that it provided discounted transportation as an incentive to receive treatment at its addiction treatment facilities.
This settlement is the resolution of 18 different qui tam, or whistleblower cases in Pennsylvania, Michigan, and Georgia. The government alleges that between 2006 and 2018, UHS admitted patients who did not qualify for care and kept patients after they no longer required care. The government further asserts that UHS billed Medicare, Medicaid, and TRICARE for service it did not render, while improperly training staff and misusing chemical and physical restraints. Additional allegations accuse UHS of misusing isolation, or solitary confinement, as a treatment for psychiatric patients. In addition to these charges, the government alleges that UHS failed to provide plans for patient treatment, patient discharge, and group and individual patient therapy. UHS will pay over $88 million to the federal government and over $28 million to various state governments to settle these allegations of False Claims Act violations.
Turning Point Care Center will pay $5 million to the federal government and to Georgia to resolve claims that it created incentives for patients to seek treatment with its detoxification and addiction unit. From 2007 to 2019, Turning Point allegedly ran a program of free or steeply discounted transportation to its inpatient or intensive outpatient programs. This program unfairly encouraged Medicaid and Medicare patients to seek treatment for problems they may not have had while billing government healthcare programs. Incentives like this undermine the integrity of our state and federal medical programs. UHS will enter a Corporate Integrity Agreement (CIA) with the U.S. Department of Health and Human Services, under which it will receive increased oversight of its programs for five years. This agreement will help to protect patients from further medical fraud.
Although the Department of Justice did not identify them, at least two whistleblowers were involved in this settlement. Because whistleblowers are entitled to 15 to 30% of the total funds recovered by the government, these individuals will be eligible for monetary rewards. In the federal case against UHS, the whistleblower will receive over $15 million in reward money, while the whistleblower in the state of Georgia against Turning Point case will receive over $800,000. Once again, the False Claims Act has proven effective in prosecuting medical fraud at the state and federal levels.