Ascension Providence Agrees to Pay Over $6.5M to Settle False Claims Allegations
TL/DR –
Providence Park (Ascension Living Providence Village) and Ascension Providence have agreed to pay over $6.5 million to settle allegations of fraud under the Federal False Claims Act and the Texas Health Care Program Fraud Prevention Act. The settlement follows allegations that the companies submitted medically unnecessary therapy claims and false claims for outpatient therapy services to federal healthcare programs. The companies cooperated with the investigation, disclosing results of their internal investigation and overpayment refunds, and have enacted corrective actions to address identified issues.
Ascension Living Providence Village and Ascension Providence to Pay Over $6.5M
Providence Park, Inc., operating as Ascension Living Providence Village, and Ascension Providence, previously known as Providence Health Services of Waco, have agreed to a settlement of $6,526,851.64. This resolves allegations under the Federal False Claims Act and the Texas Health Care Program Fraud Prevention Act.
Alleged Unnecessary Claims Submitted
The U.S. Attorney’s Office alleges that Providence Park, a skilled nursing facility in Waco, submitted medically unnecessary Ultra-High Resource Utilization Group therapy claims to federal healthcare programs. Ascension Providence, an acute care hospital in Waco, also allegedly submitted false claims for outpatient therapy services at multiple locations when group therapy was being provided or when there was not a plan of care approved by a physician.
Cooperation Credit Earned in Settlement
Under the terms of the settlement, both Providence Park and Ascension Providence earned cooperation credit in line with the Department of Justice’s Guidelines for Taking Voluntary Disclosure, Cooperation and Remediation into Account in False Claims Act Matters.
Proactive Behavior During Investigation
These entities cooperated during the investigation by revealing the results of an internal investigation at Ascension Providence, disclosing overpayments for outpatient therapy services, and identifying corrective actions to address these issues in response to the Department of Health and Human Services Office of Inspector General Healthcare Fraud Self-Disclosure Protocol.
Whistleblower Lawsuit Resolved
The U.S. Attorney’s Office reports that the civil settlement concludes a whistleblower lawsuit under the False Claims Act, which permits private parties to sue on behalf of the United States for false claims, and potentially share in a part of the government’s recovery.
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