Behavioral health care giant Acadia Healthcare (Nasdaq: ACHC) will pay $19.85 million to the U.S. and several states’ governments to resolve allegations that it knowingly billed for medically unnecessary behavioral health services and endangered patients.
The U.S. Department of Justice (DOJ) alleged that Acadia falsely billed Medicare, Medicaid and TRICARE for inpatient behavioral health services that were not medically necessary and failed to provide adequate treatment plans between 2014 and 2017.
The DOJ also alleged that Acadia knowingly failed to properly staff its facilities and/or train and supervise its staff, “which resulted in assaults, elopements, suicides and other harm resulting from these staffing failures.” DOJ recapped the case against Acadia in a Thursday announcement.
“Federal health care programs rely upon the honesty and credibility of participating providers,” U.S. Attorney Roger Handberg for the Middle District of Florida said in the announcement. “The Justice Department will hold accountable those who seek to exploit these programs for personal gain, jeopardizing the health of patients.”
Acadia previously disclosed the DOJ’s investigation around these allegations in public financial filings. The company likewise disclosed the settlement amount.
“Acadia has been cooperating with the government since this matter was brought to our attention in 2017 and has consistently disclosed this in our public filings,” an Acadia spokesperson told Behavioral Health Business via email. “Importantly, the agreement includes no admission of wrongdoing or liability and resolves historical matters which allows us to ensure our focus remains on providing quality care to our patients and their families.”
The DOJ specifically alleged that Acadia admitted Medicare, Medicaid and TRICARE beneficiaries who were not eligible for inpatient treatment and did not discharge them when they were no longer in need of care, leading to “improper and excessive lengths of stay.” The allegations also suggest that the provider did not provide inpatient acute care that aligns with federal and state regulations, failing to actively treat patients, maintain individualized treatment plans, adequately plan discharges and provide individual and group therapy, among other failures.
Acadia will pay over $16.5 million to the United States to settle the claims of false Medicare, Medicaid and TRICARE billings. The provider will also pay over $3 million to the states of Florida, Georgia, Michigan and Nevada to resolve alleged violations of state regulations.
“The claims resolved by the settlements are allegations only,” the DOJ’s announcement notes. “There has been no determination of liability.”
The company has received negative attention for other matters in recent months.
In June, Acadia was one of several included in a report presented by the U.S. Senate Finance Committee highlighting systematic problems among youth residential treatment facilities that lead to “harms, abuses and indignities” to children.
Earlier this month, the New York Times published an article based on interviews with dozens of current and former employees and patients concluding that Acadia ensnared patients into treatment and held them there against their will, specifically focusing on four hospitals in Florida, Georgia and Missouri.
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