Attorney General Tim Fox announced today Montana joined with other states and the federal government to settle allegations of fraud against Universal Health Services, Inc. (UHS, Inc.), and subsidiary UHS of Delaware, Inc., to settle allegations involving improper admissions and discharges at its inpatient and residential psychiatric and behavioral healthcare facilities.

Pennsylvania-based UHS is one of the nation’s largest providers of hospital and healthcare services. The settlement resolves allegations that from January 1, 2007 through December 31, 2018, UHS and some of its entities submitted, or caused to be submitted, false claims for services provided to Medicaid beneficiaries resulting from:

• The admission of beneficiaries who were not eligible for inpatient or residential treatment; • Failure to properly discharge beneficiaries when they no longer needed inpatient or residential treatment; • Improper and excessive lengths of stay; • Failure to provide adequate staffing, training, and/or staff supervision; • Billing for services not rendered; • Improper use of physical/chemical restraints and seclusion; and • Failure to provide inpatient acute or residential care in accordance with federal/state regulations, including failure to develop and/or update individualized assessments and treatment plans, failure to provide adequate discharge planning, and failure to provide required individual and group therapy.

The government alleges UHS’s conduct violated the Federal False Claims Act and Montana False Claims Statute 17-8-403, resulting in the submission of false claims to Montana Medicaid. The settlement totals $117,000,000; Montana will receive $73,896.15.

“This corporation provided services to vulnerable Montana youth with mental and behavioral health challenges. Whistleblower settlements like this are important because they seek to hold companies accountable for their allegedly improper conduct while also distributing funds back to public programming,” said Attorney General Tim Fox. “I’m pleased that the Montana Department of Public Health and Human Services will now receive nearly $74,000 in restitution and other recoveries for the Medicaid program,” Fox added. DPHHS administers the Medicaid program in Montana.

The settlement results from eighteen whistleblower lawsuits originally filed in the United States District Court for the Middle District of Florida, Northern District of Illinois, Eastern District of Pennsylvania, Northern District of Georgia, Middle District of Georgia, Eastern District of Virginia, Western District of Virginia, Western District of Michigan, and Eastern District of Michigan. Fourteen of the eighteen whistleblower suits named at least one plaintiff state; all but three were transferred to the United States District Court for the Eastern District of Pennsylvania. The National Association of Medicaid Fraud Control Units participated in the investigation and settlement negotiations on behalf of the states.

Thanks to an amendment to the Montana False Claims Act requested in the 2013 legislature by Fox and sponsored by Representative Cary Smith (HD 55), the federal government now allows Montana to keep a greater share of damage awards and settlements in this and similar fraud cases.