Pasco, Lee hospitals named in $20M federal settlement

Acadia Healthcare, a Tennessee medical group with behavioral hospitals in Fort Myers and Wesley Chapel, has agreed to pay $19.85 million to settle allegations that it “knowingly” billed for unnecessary medical services and services not meeting federal and state regulations at hospitals nationwide.

The settlement with the medical organization was announced Thursday by the United States Department of Justice. DOJ says Acadia will pay $16.6 million of the fine to the federal government and $3.18 million to Florida, Georgia, Michigan and Nevada to resolve state claims.

Among the allegations are that Acadia admitted people not eligible for inpatient treatment, failed to release people no longer in need of care and did not provide adequate supervision leading to violence and suicide.

Acadia is based in the Nashville suburb of Franklin and operates behavioral health facilities nationwide. Two of those are along the Gulf Coast: Park Royal Hospital at 9241 Park Royal Dr. in Fort Myers and North Tampa Behavioral Health Hospital at 9910 State Road 56 in Wesley Chapel.

The Department of Justice, which says the investigation began with a whistleblower complaint, did not identify allegations at individual hospitals, but the statement names only five of the 253 behavioral healthcare facilities in Acadia’s network.

Acadia did not respond to a request for comment. (A call to the phone number for the media contact was forwarded to a general voicemail inbox. And as of 5:45 p.m. Thursday the company had not posted any statement to its website.)

Efforts to reach hospital officials at either local facility were also unsuccessful. A receptionist at Park Royal agreed to reach out to a supervisor but hung up before taking a call back number. And a receptionist at North Tampa said no one was available to talk.

According to the Justice Department, here is what happened: Between 2014 and 2017 Acadia knowingly submitted false claims to Medicare, Medicaid and TRICARE. These claims were for inpatient behavioral services “that were not reasonable or medically necessary.”

The DOJ says that Acadia facilities “admitted beneficiaries who were not eligible for inpatient treatment and failed to properly discharge beneficiaries when they no longer needed inpatient treatment and had improper and excessive lengths of stay.”

The government goes on to allege that Acadia failed to provide adequate staffing, training and supervision which led to assaults, suicides and “other harm resulting from these staffing failures.”

It also says that the health care group did not deliver inpatient acute care that met federal and state regulations, which included, but was not limited to, failing to provide active treatment, to develop and/or update individualized assessments and treatment plans, and to provide required individual and group therapy to patients.

Acadia, according to its corporate profile on its investor relations page, describes itself as “a leading provider of behavioral healthcare services” with 253 facilities and about 11,200 beds in 38 states and Puerto Rico.

Its core practice it to provide “behavioral health care and substance use services to its patients in a variety of settings, including inpatient psychiatric hospitals, specialty treatment facilities, residential treatment centers and outpatient clinics.”

The case was investigated by the Justice Department’s commercial litigation branch fraud section and the U.S. Attorney’s Office for the Middle District of Florida along with the National Association of Medicaid Fraud Control Units and the Department of Defense criminal investigative service.

Senior trial counsel Sarah Arni of the civil division’s Fraud Section and former senior litigation counsel Lindsay Griffin for the Middle District handled the matter.

“Federal health care programs rely upon the honesty and credibility of participating providers,” U.S. Attorney Roger B. Handberg for the Middle District of Florida says in the statement.

“The Justice Department will hold accountable those who seek to exploit these programs for personal gain, jeopardizing the health of patients.”