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Psych Hospital Settles FCA Case for $2.85M Over Detox Level of Care

By Nina Youngstrom

A psychiatric hospital in Pennsylvania agreed to pay $2.85 million to settle false claims allegations that it billed Medicare, Medicaid and the Federal Employees Health Benefits Program for hospital-level detoxification when patients only qualified for residential detoxification or there wasn’t documentation to support the higher level of service. As part of the settlement, Eagleville Hospital entered into a five-year corporate integrity agreement, the U.S. Attorney’s Office for the Eastern District of Pennsylvania said July 24.

The case was set in motion by Christopher Smith, a former nurse at 308-bed Eagleville Hospital, who filed a whistleblower complaint. He began working at the hospital in 2005 and became an evening shift nursing supervisor in 2015.

Eagleville Hospital provides both hospital-level and nonhospital-level residential treatment for substance use disorders. The definition of inpatient hospital is “the provision of detoxification or treatment and rehabilitation services, or both, 24 hours a day, in a hospital,” according to the Pennsylvania Department of Drug and Alcohol Programs. Inpatient nonhospital is “a nonhospital, residential facility, providing one or both of the following services: treatment and rehabilitation or detoxification. The client resides at the facility.”

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