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Clinton Hospital Agreed to Pay $2.3 Million for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services Submitted without Proper Documentation

After it self-disclosed conduct to OIG, UMass Memorial Health Alliance - Clinton Hospital, Inc. (UMass HA-Clinton), Massachusetts, agreed to pay $2,331,641.67 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that UMass HA-Clinton admitted Medicare beneficiaries and submitted claims for payment without properly documenting that an impatient psychiatric hospitalization was a reasonable and medically necessary treatment for the patient's condition. OIG also alleged that the medical records did not consistently contain the appropriate documentation to satisfy Medicare requirements for continued treatment.

Action Details

  • Date:December 18, 2018
  • Enforcement Types:
    • Fraud Self-Disclosures