Inova has agreed to pay nearly $2.4 million to settle allegations that it falsified Medicaid reimbursement claims tied to sterilization and hysterectomy procedures.
The settlement comes after Inova voluntarily disclosed issues to federal and state authorities, revealing that some Medicaid claims were improperly modified by employees between January and August 2020, the U.S. Attorney’s Office for the Eastern District of Virginia announced on Friday (Nov. 15).
“Inova had submitted claims to Medicaid for reimbursement, including resubmitted claims for reimbursement, for sterilization and hysterectomy procedures that contained documentation that had been improperly modified by or at the request of one or more Inova employees,” the U.S. Attorney’s Office said in a press release.
According to the release, an internal investigation confirmed inaccuracies, leading Inova to acknowledge receiving $1.59 million in improper payments from Medicaid during that time.
The Merrifield-based nonprofit health system didn’t admit wrongdoing but agreed to the settlement to resolve the matter,
An Inova spokesperson told FFXnow the hospital system self-reported the error and took corrective action but didn’t elaborate on if any employees were disciplined.
The agreement resolves civil claims under the federal False Claims Act and Virginia state laws, and Inova received credit for reporting the issue, cooperating with investigators and implementing corrective measures, per the release.
The case was handled by the U.S. Attorney’s Office, the Department of Health and Human Services Office of Inspector General and the Virginia Attorney General’s Medicaid Fraud Control Unit.
