Tuesday, February 18 2014, 03:01 PM EST
Chattanooga Mental Health Facility Pays Penalty for False Claims
The A.I.M. Center, Inc. (AIM), which operates a community mental health facility in Chattanooga, has agreed to pay $800,000 to settle allegations that it violated the federal False Claims Act (FCA) and the Tennessee Medicaid False Claims Act (TNMFCA).
The government said that from 2009 through 2012, the AIM Center knowingly submitted numerous false claims to the TennCare/Medicaid program by overcharging for services provided to TennCare/Medicaid facility members. In a news release the state attorney general said the AIM Center engaged in a practice commonly known as “upcoding,” by submitting claims for services that were more lengthy and more expensive than the services actually provided. For example, the AIM Center submitted claims for a full day of services even when the patients spent less than an hour at the facility.
The government also said the AIM Center knowingly concealed its obligation to return funds to the TennCare/Medicaid program that were improperly paid and retained as a result of “double billing.”
The payment made by the AIM Center in the settlement is intended to compensate the TennCare/Medicaid program. The AIM Center has also entered into a comprehensive 5-year Corporate Integrity Agreement (CIA) with the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) to ensure its future compliance with federal health care benefit program requirements.
“Mental and behavioral health services are a vital component of the care provided to TennCare recipients,” Tennessee Attorney General Bob Cooper said. “This Office will continue to pursue providers that improperly bill for these needed services.”