Inova pays $2.37M to settle False Claims Act allegations

Three Inova Health entities have agreed to pay more than $2.37 million to settle claims that Inova submitted Medicaid claims containing falsified information.

The U.S. Attorney’s Office for the Eastern District of Virginia announced on Friday the agreement with Inova Health System Foundation, Inova Health Care Services and Inova Physician Partners, settling the False Claims Act allegations.

The Falls Church-based Northern Virginia regional health care system submitted written disclosures to the U.S. Attorney’s Office and the Virginia Attorney General’s Office stating that between Jan. 1, 2020, and Aug. 31, 2020, it submitted claims to Medicaid for reimbursement — including resubmitted claims  — for sterilization and hysterectomy procedures containing improperly modified documentation. One or more Inova employees improperly modified the documentation or requested the modifications, according to the disclosure, resulting in falsified information in the claims.

After an internal investigation, Inova “took remedial actions” and agreed that more than $1.58 million it’d received from Medicaid was improper, according to a news release from the U.S. Attorney’s Office for the Eastern District of Virginia.

In a statement, Inova said: “Inova identified an error in how certain Medicaid claims were submitted for reimbursement and we promptly self-reported and took corrective action to resolve the matter. As noted in the [Department of Justice] press release, ‘Inova received full credit under the Justice Department’s guidelines for taking disclosure, cooperation and remediation into account in False Claims cases.’”

The civil claims settled are allegations only, according to the U.S. Attorney’s Office, and no determination of civil liability has been made.

The U.S. Attorney’s Office for the Eastern District of Virginia, the Department of Health and Human Services’ Office of Inspector General and the Medicaid Fraud Control Unit in the Virginia Office of the Attorney General coordinated on the case, according to a news release.

Inova Health has more than 24,000 employees across its five hospital campuses and multiple other care facilities, including Northern Virginia’s only Level 1 trauma center. The system treats more than 1 million patients a year, with more than 4 million patient visits annually.