by Ben Vernia | August 16th, 2018
On August 7, the Department of Justice announced that Granada Lake Medical Center of Granada, Mississippi, will pay $1.1 million to settle allegations, originally brought by a whistleblower, that the hospital billed federal healthcare programs for medically unreasonably or unnecessary services. According to DOJ’s press release:
The Justice Department announced today that Grenada Lakes Medical Center (GLMC), a publicly-owned hospital which at various times has been operated by the University of Mississippi Medical Center and by the Grenada Lake Medical Center Board of Trustees, has agreed to pay more than $1.1 million to resolve False Claims Act allegations that the hospital sought and received reimbursement from Medicare for services that were not medically reasonable or necessary.
The settlement resolves allegations that, beginning in January 2005 and continuing until April 2013, the hospital submitted claims for Intensive Outpatient Psychotherapy (IOP) services that did not qualify for Medicare reimbursement. The IOP services in question were performed on GLMC’s behalf by Allegiance Health Management (Allegiance), a post-acute healthcare management company based in Shreveport, Louisiana, but billed to Medicare by GLMC directly.
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Today’s settlement with GLMC follows a recent settlement with Allegiance, as well as previous settlements with more than twenty other hospitals where Allegiance provided IOP services.
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According to DOJ, the relator, a former employee of Allegiance, will receive $195,000 of the settlement (a relator’s share of approximately 17.7%).
