Mas­sachusetts sues UHS in Med­i­caid false claims case

Modern Healthcare - - REGIONAL NEWS -

The state of Mas­sachusetts sued Univer­sal Health Ser­vices in federal court last week, ac­cus­ing it of il­le­gally charg­ing Med­i­caid for out­pa­tient men­tal health ser­vices by un­qual­i­fied staff.

Mas­sachusetts’ com­plaint will be added to that of Julio Escobar and Car­men Cor­rea, who first filed suit on be­half of their daugh­ter who died at a UHS fa­cil­ity.

The state al­leges that UHS sub­mit­ted false claims to MassHealth pro­gram, charg­ing for men­tal health­care given by un­li­censed per­son­nel. UHS is ac­cused of prop­a­gat­ing a cul­ture of non­com­pli­ance that em­pha­sized profit over good clin­i­cal prac­tices through­out its fa­cil­i­ties, not just in Mas­sachusetts. Ear­lier this year, a Buz­zfeed in­ves­ti­ga­tion al­leged the for-profit hospi­tal op­er­a­tor kept psy­chi­atric pa­tients longer than nec­es­sary to milk their in­sur­ance.

UHS did not re­spond to a re­quest for com­ment, but the com­pany has fought back against pre­vi­ous al­le­ga­tions.

In a U.S. Supreme Court rul­ing on the Escobar case, the high court sup­ported the the­ory that a com­pany can be held li­able if its em­ploy­ees falsely cer­tify com­pli­ance with all ap­pli­ca­ble laws and reg­u­la­tions when sub­mit­ting claims to Med­i­caid or Medi­care.

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