Inova Health System, Falsified Medicaid Claims, Virginia 2020

Falsified Medicaid Claims Land Inova Health System in Hot Water

In a shocking case of deception, Inova Health System Foundation, Inova Health Care Services, Inc., and Inova Physician Partners, LLC, collectively known as Inova, located in Falls Church, Virginia, has agreed to pay a staggering $2,378,731.06 to settle claims that they submitted falsified information to Medicaid.

The allegations, which date back to January 1, 2020, and August 31, 2020, stated that Inova had submitted claims to Medicaid for reimbursement, including resubmitted claims, for sterilization and hysterectomy procedures that contained documentation that had been improperly modified by or at the request of one or more Inova employees.

The modifications resulted in the claim containing falsified information. Following an internal investigation, Inova took remedial actions and agreed that $1,585,820.71 received from Medicaid was improper.

The settlement resolves federal and state civil claims under the federal False Claims Act, Virginia Code §§ 32.1-312, 32.1-313, and 8.01-216 et seq, and common law remedies.

Inova received full credit under the Justice Department's guidelines for taking disclosure, cooperation, and remediation into account in False Claims Act cases.

The resolution obtained in this matter was the result of a coordinated effort between the U.S. Attorney's Office for the Eastern District of Virginia, the Department of Health and Human Services, Office of Inspector General, and the Office of the Attorney General for the Commonwealth of Virginia, Medicaid Fraud Control Unit.

Defendant: Inova Health System Foundation, Inova Health Care Services, Inc., and Inova Physician Partners, LLC (collectively, Inova)

Criminal Charges: Falsified Medicaid Claims

City and State: Falls Church, Virginia

Exact Date: January 1, 2020, and August 31, 2020

Sentence or Outcome: $2,378,731.06 settlement

Dollar Amount: $2,378,731.06

Assistant U.S. Attorney John E. Beerbower and Kimberly M. Bolton, Assistant Attorney General, Virginia Medicaid Fraud Control Unit, handled the matter.

Source: https://www.justice.gov/usao-edva/pr/virginia-hospital-system-agrees-237m-false-claims-settlement