Inova settles false Medicaid claims

Inova has agreed to pay nearly $2.4 million in a settlement involving Medicaid claims with false information, the U.S. Attorney’s Office for the Eastern District of Virginia announced Nov. 15.

The hospital system stated that, between Jan. 1, 2020, and Aug. 31, 2020, it had submitted claims to Medicaid for reimbursement for sterilization and hysterectomy procedures that contained documentation that had been improperly modified by one or more Inova employees.

These modifications resulted in the claims containing falsified information. Following an internal investigation, Inova took remedial actions and agreed that about $1.6 million received from Medicaid was improper.

The hospital system voluntarily disclosed the falsified claims to the U.S. Attorney and Virginia General Attorney. Inova received full credit under the Justice Department’s guidelines for taking disclosure, cooperation, and remediation into account in False Claims Act cases.

The settlement agreement lists 585 payments from Medicaid that Inova determined needed to be repaid.

The settlement calls for Inova to pay nearly $1.3 million to the commonwealth and $2.8 million to the federal government.