WOWK 13 News

Huge health care fraud case in West Virginia

CHARLESTON, W.Va. (WOWK) – A company known as “Acadia Healthcare” has agreed to pay penalties and fines totaling $17 million. Acadia and it’s subcontractors admitted overcharging for drug testing of clients at drug treatment centers across West Virginia.

“Medicaid fraud is not a victimless crime. And I know there is a lot of folks that think that because we’re just talking about dollars. There’s victims. There are a lot of victims here. Not only those folks who get Medicaid but those taxpayers – all of us –  who pay into these funds,” said U.S. Attorney Mike Stuart, Southern District of West Virginia.

Here’s how the scheme worked. Drug tests were contracted at an average cost of $4 per patient. But when the company billed reimbursements to Medicaid, it charged $117 dollars per patient. That totaled $8.5 million in overpayments before they were caught. Health leaders are upset because that money could have been used for prevention and drug treatment.

“We do not have enough money to take care of this problem. The opioid problem and the substance use disorder problems in West Virginia are huge.  They’re the biggest public health problem this state has ever faced,” said Secretary Bill Crouch, WV Dept of Health & Human Resources. 

The state will receive 2-point-one million dollars, and the rest will go back into the federal medicaid fund which provides health care to low-income patients.

“When you look at all these treatment centers across West Virginia and their penalty, on top of the 8-point-5 million dollars reimbursed, a penalty of 8-5 million dollars. That’s a substantial penalty,” said Mike Stuart, U.S. Attorney.

The fines will be paid to West Virginia and the feds, within five days.

The U.S. Attorney says because Acadia Healthcare fully cooperated in the investigation and paid double what it owed, there will be no criminal prosecution.