Inova Health System Foundation, False Claims Act Violations, Virginia 2020

Falls Church Hospital System Accused of $2.37M False Claims Scheme

A hospital system in Falls Church, Virginia, has agreed to pay $2,378,731.06 to settle allegations that it submitted false claims to Medicaid for reimbursement. Inova Health System Foundation, Inova Health Care Services, Inc., and Inova Physician Partners, LLC, collectively known as Inova, are located in Falls Church.

The allegations date back to 2020, when Inova submitted claims to Medicaid for reimbursement for sterilization and hysterectomy procedures. However, an investigation found that the claims contained documentation that had been improperly modified by or at the request of Inova employees.

The modifications resulted in the claim containing falsified information, according to the U.S. Attorney’s Office. Inova voluntarily submitted written disclosures to the U.S. Attorney’s Office and the Virginia Attorney General’s Office, stating that the claims were improper.

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.

The matter was handled by Assistant U.S. Attorney John E. Beerbower and Kimberly M. Bolton, Assistant Attorney General, Virginia Medicaid Fraud Control Unit. A copy of this press release may be found on the website of the U.S. Attorney’s Office for the Eastern District of Virginia.

The civil claims settled are allegations only; there has been no determination of civil liability.

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