Simi Valley Hospital Pays $5.15M Settlement Over Alleged Medicare Fraud
On Wednesday, Department of Justice officials announced that Simi Valley Hospital has paid $5.15 million in a settlement with the federal government over allegations of Medicare fraud involving in billing for psychiatric care, the Ventura County Star reports.
The case stemmed from a 2001 lawsuit filed by Timothy Field, who previously served as program director and administrative director for Simi Valley Hospital's Behavioral Medicine Services unit.
The lawsuit alleged that Simi Valley Hospital collected more than $5 million by submitting false claims to Medicare and Medi-Cal between 1992 and 1997. Medi-Cal is California's Medicaid program.
Field claimed the hospital improperly billed Medicare for:
- Overnight stays for patients who should not have been admitted;
- Psychiatric care for patients who actually were undergoing detoxification for chemical addictions; and
- Services to psychiatric patients without the required physician certification statements.
On Wednesday, a federal judge dismissed Field's lawsuit. As part of the settlement, Simi Valley Hospital agreed to pay Field $125,000 for legal fees and claims.
Darwin Remboldt, president of Simi Valley Hospital, said the hospital decided to settle partly because of the costs of litigation. Simi Valley Hospital admitted no wrongdoing in the settlement.
Remboldt said the allegations date back more than 12 years and relate to a psychiatric unit that no longer exists. Simi Valley's psychiatric campus closed five years ago because of financial reasons (Kisken, Ventura County Star, 11/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.