In a significant move, Acadia Healthcare Company Inc. has come to an agreement to settle serious allegations regarding its billing practices.
The company, which is based in Franklin, Tennessee, operates numerous inpatient behavioral health facilities across the United States.
This resolution addresses claims that Acadia knowingly submitted false bills to federal healthcare programs for services that were either unnecessary or failed to meet established regulations.
Details of the Allegations
Between 2014 and 2017, the U.S. government contended that Acadia submitted claims for inpatient behavioral health services that were neither reasonable nor medically necessary.
Allegations included the admission of patients who were ineligible for such treatment, failing to discharge patients when they were no longer in need of inpatient care, and maintaining excessively long stays.
Moreover, the government claimed that Acadia did not provide adequate staff training or supervision, leading to various serious incidents, including assaults and suicides.
They also alleged that the company did not adhere to federal and state regulations for acute care, failing to offer necessary treatments and discharge planning.
Financial Settlement and Implications
As part of the settlement, Acadia will pay $16,663,918 to the U.S. government to resolve claims under the False Claims Act related to its Medicare, Medicaid, and TRICARE billings.
Additionally, they will pay another $3,186,082 to states such as Florida, Georgia, Michigan, and Nevada to settle their state law claims against the company.
Commitment to Compliance
The Justice Department underscored its commitment to ensuring that federal healthcare programs only reimburse for services that are necessary and appropriately provided.
Principal Deputy Assistant Attorney General Brian M. Boynton emphasized the importance of compliance, especially when it involves vulnerable populations in behavioral health facilities.
Accountability in Healthcare Programs
U.S. Attorney Roger B. Handberg for the Middle District of Florida reiterated the need for honesty in federal healthcare programs.
The Justice Department is determined to hold accountable those who exploit these systems for personal gain, jeopardizing patient health.
Tamala E. Miles, Special Agent in Charge of the HHS Office of Inspector General, also stressed the importance of following the law when billing these programs.
Whistleblower Contributions
The settlement also involves claims brought forward by former Acadia employees Franka Tirado, Brian Snyder, and Jamie Thompson, under the qui tam provisions of the False Claims Act.
These whistleblowers played a crucial role in exposing the alleged misconduct, and their share of the federal portion of the settlement amounts to $3,166,144.42.
Collaborative Efforts in Investigation
This outcome resulted from a collaborative effort involving the Civil Division’s Commercial Litigation Branch, the U.S. Attorney’s Office for the Middle District of Florida, and other law enforcement agencies.
The resolution reflects the government’s ongoing emphasis on combating healthcare fraud and misuse of taxpayer funds.
Moving Forward
While the allegations have been settled, it is important to note that the claims are just that—allegations.
No liability has been determined at this time.
The case highlights the government’s commitment to protecting the integrity of healthcare programs and ensuring compliance within the industry.
For anyone with knowledge of potential fraud, waste, or abuse in healthcare, tips can be reported to HHS at 800-HHS-TIPS (800-447-8477).
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