A Mississippi hospital has agreed to pay $1.1 million in fines to settle claims made by the Federal government that it billed Medicare for services that were not medically necessary nor reasonable.
The United States Justice Department said last week that Grenada Lakes Medical Center (GLMC) agreed to pay the fines to settle allegations brought under the False Claims Act (also known as the “Lincoln Law”) that it submitted claims for Intensive Outpatient Psychotherapy (IOP) to Medicare from early 2005 through the spring of 2013 that were not eligible for reimbursement.
Per the Justice Department, the services were provided by Allegiance Health Management (Allegiance) of Louisiana but billed to Medicare by GLMC directly. Almost two dozen other hospitals have already made similar settlements with the Federal government over allegations relating to IOP services carried out by Allegiance.
The instant suit was brought under the qui tam provisions of the False Claims Act, which allows whistleblowers to file an action under the Act on behalf of the United States. The Federal government oftentimes takes on the suit itself after an investigation of the charges.
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