By: Christopher A. Parrella, Esq., CPC, CHC, CPCO Parrella Health Law, Boston, Ma. A Health Care Provider Defense and Compliance Firm

In a recent settlement, Acadia Healthcare Company Inc., a major player in the behavioral health industry, has agreed to pay $19.85 million to resolve allegations of submitting false claims to Medicare, Medicaid, and TRICARE. The case highlights how Acadia’s behavioral health facilities allegedly billed for medically unnecessary inpatient services and services that failed to comply with federal and state regulations. This settlement is a significant reminder for all health care providers of the importance of compliance with government health care program requirements, especially when serving vulnerable populations.

The government’s investigation revealed that between 2014 and 2017, Acadia allegedly admitted patients who did not qualify for inpatient care and failed to discharge patients who no longer required such care, leading to improperly extended stays. Additionally, Acadia allegedly failed to provide adequate staffing and proper supervision, which contributed to several serious incidents, including patient assaults, elopements, and even suicides.

This case underscores the government’s strict enforcement of the False Claims Act (FCA) in the healthcare industry. The settlement resolves claims brought by whistleblowers under the qui tam provisions of the FCA, with three former Acadia employees—Franka Tirado, Brian Snyder, and Jamie Thompson—being awarded $3.16 million as their share of the settlement.

For healthcare providers, this case serves as a critical reminder to ensure that services billed to federal programs are medically necessary and compliant with all regulatory standards. Failure to do so can result in significant penalties, not only in terms of financial liability but also reputational damage.

At Parrella Health Law, we understand the complexities of healthcare compliance and can guide providers in maintaining rigorous standards to avoid FCA violations. Contact us today at 857.328.0382 or cparrella@parrellahealthlaw.com to ensure your compliance practices are robust and secure your business against legal risks.