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Louisiana Department of Health to pay $13.42 million to settle alleged false medicaid claims

Christian Fernsby |
The Louisiana Department of Health has agreed to resolve allegations that it submitted false and inflated Medicaid claims for long-term nursing home and hospice care, the Department of Justice announced.

Topics: LOUISIANA DEPARTMENT OF HEALTH   

Under the settlement agreement, the state agency has agreed to pay $13,422,550.

“Today’s settlement demonstrates that we will take whatever steps are appropriate in our effort to protect federal healthcare programs, including Medicaid, from false claims,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division.

“Anyone who seeks to profit at the expense of Federal taxpayers, including state agencies, will face appropriate consequences.”

The United States alleged that the Louisiana Department of Health knew that the rates determining the federal share of Louisiana’s Medicaid payments were set to decrease following the months of December 2010, March 2011, June 2011, and September 2013.

To receive the higher Federal share percentage rates in effect during these months, the Louisiana Department of Health fraudulently caused its healthcare contractor, Molina Medical Solutions, to prepare, submit, and pay claims for nursing home and hospice services in these months, before the providers had submitted to Louisiana any claims for them. Louisiana then claimed Federal reimbursement for those premature payments.

As a result, the Louisiana Department of Health received a Federal share based upon the higher percentage rate in effect in those months, rather than the lower percentage rate in effect the following months when the providers actually submitted their claims to Louisiana.


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