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Attorney General Jason R. Ravnsborg

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SOUTH DAKOTA JOINS SETTLEMENT OF FRAUD ALLEGATIONS AGAINST UNITED HEALTH SERVICES, INC.

FOR IMMEDIATE RELEASE: Thursday, August 6, 2020

PIERRE, S.D. – Attorney General Jason R. Ravnsborg announced today that South Dakota has joined 49 other states, territories, and the federal government to settle allegations of fraud against Universal Health Services, Inc.

The total value of the settlement is $117 million. The total portion of the settlement amount recovered by South Dakota is $152,461, of which $81,851 will be retained by the federal government as the federal Medicaid share. The remaining $70,610 will go to the state general fund to offset alleged Medicaid damages in this case. 

The settlement resolves allegations that during the period from January 1, 2007, through December 31, 2018, UHS and related entities 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
  • 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 civil settlement resolves the claims against UHS brought in qui tam lawsuits in the United States District Court the Middle District of Florida and transferred to the Eastern District of Pennsylvania.   

A National Association of Medicaid Fraud Control Units (“NAMFCU”) Team participated in the investigation and in settlement negotiations.  The Team included representatives from the Offices of the Attorneys General for the states of Virginia, Florida, North Carolina, Massachusetts, California, Texas, Indiana, and Ohio.

The South Dakota Medicaid Fraud Control Unit of the South Dakota Office of Attorney General, and the South Dakota Department of Social Services, assisted in recovering the settlement money.

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The Office of the Attorney General is the chief legal officer for the State of South Dakota and provides legal advice to agencies, boards, and commissions of the State as well as representing the State in state and federal court.  The Office of Attorney General also handles prosecutions, felony criminal appeals, civil matters, consumer protection issues, and issues formal opinions interpreting statutes for agencies of the state.  Visit www.atg.sd.gov to learn more.

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CONTACT: Tim Bormann, Chief of Staff, (605) 773-3215