Grady Health System will pay nearly $3 million to settle claims that it overbilled Medicaid for treatment provided to sick newborns.
The office of Georgia Attorney General Sam Olens announced Thursday the civil settlement agreement, in which Grady will pay the state $2.95 million to address allegations that it “inaccurately coded” claims for patients in the neonatal intensive care unit, or NICU. That coding resulted in “either unjustified or inflated outlier payments from Georgia Medicaid,” officials alleged.
“This settlement demonstrates our office’s continued commitment to protecting crucial Medicaid dollars from fraud and abuse,” Olens said in a statement. “The health of NICU patients is fragile, and we must ensure that every Medicaid dollar is properly spent on their care.”
The case was initially developed by an auditor with the Georgia Department of Community Health, officials said, and was investigated by several members of the Georgia Medicaid Fraud Control Unit. The settlement was reached by Senior Assistant Attorney General Nancy Allstrom.
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