Eagleville Hospital, Improper Billing, Pennsylvania 2020

PHILADELPHIA – A Pennsylvania hospital has been forced to pay $2.85 million to resolve allegations of improper billing for detox treatment. Eagleville Hospital, which provides substance use disorder treatment in Eagleville, Pennsylvania, has agreed to the settlement after a whistleblower alleged that the hospital submitted false claims to Medicare, Medicaid, and the Federal Employees Health Benefits Program for hospital-level detoxification treatment services when the patients were ineligible or lacked documentation.

The allegations were made under the qui tam provisions of the False Claims Act, which allow private citizens to bring civil actions on behalf of the United States and share in any recovery. The whistleblower, who was represented by David Caputo and Joseph Trautwein, will receive over $500,000 of the recovery.

Contemporaneous with the civil settlement, Eagleville Hospital also entered into a five-year Corporate Integrity Agreement with the Department of Health and Human Services, Office of Inspector General. The agreement requires the implementation of a risk assessment and internal review process to identify and address evolving compliance risks.

As part of the agreement, Eagleville Hospital will also undergo training, auditing, and monitoring to address the conduct at issue in the case. The settlement resolves allegations for claims from January 2011 through December 2018.

First Assistant U.S. Attorney Jennifer Arbittier Williams praised Eagleville Hospital’s willingness to negotiate a prompt resolution and thanked the whistleblower for bringing the matter to their attention.

Maureen R. Dixon, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services, also thanked the whistleblower and Eagleville Hospital for their cooperation.

The case was handled by Assistant United States Attorney Anthony D. Scicchitano with investigative assistance from auditor Dawn Wiggins, HHS-OIG, and the Office of Personnel Management Office of Inspector General.

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