Simi Valley Hospital Pays $5.15 Million Settlement

Simi Valley Hospital has paid $5.15 million to settle a civil lawsuit that accused the hospital of filing false Medicare and Medi-Cal claims, the U.S. Department of Justice announced. The allegations the hospital’s Behavioral Medicine Services unit knowingly submitted false claims to Medicare for chemical dependency and psychiatric patient services performed between 1991 and 1997 were made in 2001 by a former employee who served as the unit’s program director, and then as its administrative director. Simi Valley Hospital paid the settlement on Oct. 27 without admitting any wrongdoing. The lawsuit specifically alleged that the hospital improperly billed Medicare and Medi-Cal for the following: providing psychiatric care, even though the patients were receiving chemical dependency detoxification services; providing psychiatric overnight stays and inpatient services for patients who did not qualify for the care; and paying a medical director $12,000 per month to establish and admit patients into a non-existent program for women dealing with post-traumatic stress disorder. The investigation into the allegations was conducted by the U.S. Department of Health and Human Services, the Office of Investigations and the Defense Criminal Investigative Service. A statement released by Simi Valley Hospital said the hospital is fully cooperating with the Department of Health and Human Services’ Office of Inspector General and with the terms of the settlement. “We believe that our hospital follows fair and accurate billing practices, and are settling to avoid the expense and inconvenience of lengthy litigation,” the statement said. Jessica Vernabe