Attorney General Ford Settles Whistleblower Lawsuit Involving Behavioral Health Care Facilities

July 22, 2020

Carson City, NV – Today, Nevada Attorney General Aaron D. Ford announced that Nevada and 46 other states, territories and the federal government are settling allegations of fraud against Universal Health Services, Inc. (UHS). UHS is a for-profit holding company that directly or indirectly owns the assets or stock of inpatient and residential psychiatric and behavioral health facilities. These facilities provide health care services to individuals, including beneficiaries of some federal health care programs. The case also involved UHS of Delaware, Inc., a subsidiary of UHS, Inc., which provides management services to UHS and its subsidiaries.  

UHS is based in King of Prussia, Pennsylvania and is one of the nation’s largest providers of hospital and healthcare services. The total value of the settlement is $117,000,000. Of this amount, Nevada will receive $442,331.56. 

“My Medicaid Fraud Control Unit holds individuals and businesses accountable for the services they provide or promise to provide to Nevadans,” said AG Ford. “Today’s settlement should send a message to any Medicaid providers attempting to engage in fraud. Government assistance programs are reserved for those in need, and my office will not stand for any unlawful activity.” 

The settlement resolves allegations that during the period from January 1, 2007 through December 31, 2018, UHS and certain UHS entities submitted or caused to be submitted false claims for services provided to Medicaid beneficiaries resulting from UHS’s:

  • 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 supervision of staff;
  • Billing for services not rendered;
  • Improper use of physical and chemical restraints and seclusion; and
  • Failure to provide inpatient acute or residential care in accordance with federal and state regulations, including, but not limited to, 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 that UHS’s conduct violated the Federal False Claims Act and the NRS 357, resulting in the submission of false claims to the Nevada’s Medicaid program.  

This settlement results from 18 whistleblower lawsuits originally filed in the U.S. 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 18 whistleblower lawsuits named at least one plaintiff state, and all but three of the cases were transferred to the U.S. District Court for the Eastern District of Pennsylvania.

This matter was handled by the Attorney General’s Medicaid Fraud Control Unit.