- Universal Health Services has finalized its settlement with the U.S. Department of Justice and state attorneys to resolve allegations of fraudulent billing for Medicare and Medicaid services at its behavioral healthcare facilities for $122 million.
- UHS continues to deny the allegations and does not admit guilt. Criminal charges were dropped when the settlement was first announced roughly a year ago.
- As of late last week, the King of Prussia, Pennsylvania-based health system had paid $117.3 million before accrued interest, fees and individual claims on behalf of third parties and other costs. In a Friday statement, the system, which brought in $11.4 billion in revenue in 2019, said it was "pleased to have resolved this matter to avoid future distractions and the high costs of litigation, while ensuring that our focus remains steadfast on providing excellent care to our patients and their families."
UHS and a behavioral health subsidiary in Georgia, Turning Point Care Center, are paying a combined total of $122 million to resolve allegations of medically unnecessary billing for inpatient behavioral health services, inadequate patient care and paying financial incentives to federal beneficiaries for using their facilities.
The investigation, which dates back to February 2013 and includes 19 whistleblower lawsuits, alleges these activities took place between 2006 and 2019 across about 30 psychiatric facilities.
As of Thursday, UHS has paid $88.1 million to the federal government, $28.9 million to individual states and $10 million to settle individual False Claims Act cases. UHS, which is covering $6.2 million in attorneys' fees and other costs, was credited about $9.7 million in funds from its behavioral health facilities that were suspended during the investigations, per an SEC filing.
Turning Point will pay the federal government and state of Georgia $5 million in a separate civil settlement.
Thirty-six whistleblowers will split $15.9 million from the federal government's $88.1 million share.
UHS, which operates nearly 200 acute care inpatient psychiatric hospitals and residential psychiatric and behavioral treatment facilities nationwide, has been saving up money for the settlement in a pre-tax reserve totaling $134 million.
UHS has entered into a five-year corporate integrity agreement with the Office of the Inspector General as part of the deal. UHS will retain an independent monitor selected by OIG and create a compliance committee to assess activities and finances at its behavioral health facilities.