The U.S. Department of Justice has reached a financial settlement with Evergreen Treatment Services, a non-profit based in Seattle, following allegations of double billing to government health programs, including Medicare. The settlement will see Evergreen pay $1,453,982 to the government, according to an announcement made by U.S. Attorney Tessa M. Gorman. This sum incorporates both restitution for the double-billed amounts and a penalty according to the False Claims Act.
"I want to commend the data analysis work done by our Affirmative Civil Enforcement unit and HHS-OIG to identify the double billing," Gorman stated, as cited by the U.S. Department of Justice, signaling the persistent effort of her team and the HHS-OIG in investigating billing practices at Evergreen. Underscoring the gravity of the situation Special Agent in Charge Steven J. Ryan of the U.S. Department of Health and Human Services Office of Inspector General conveyed his concern, noting "Providers that participate in Medicare are obligated to bill for services honestly and lawfully. Submitting false claims diverts funding from essential health services, including critical drug treatment, which puts both patient well-being and federal health care programs at risk."
Evergreen Treatment Services, which offers drug treatment services including medically assisted treatment, began billing Medicare when it started covering such services in January 2020. It came to light that between January 8, 2021, and February 26, 2021, Evergreen had submitted duplicate claims, resulting in $726,991 of improper reimbursement, claims which encompassed a bundled set of services, like counseling and therapy, all under a single billing code. The duplicitous billing practices coincided with a time when scrutiny over healthcare spending has been heightened due to the ongoing strain on the medical system brought on by public health concerns.
The enforcement action was driven by Assistant United States Attorney Matt Waldrop and investigative analyst Ryan Hardy from the U.S. Attorney’s Office. Their work was supplemented by significant investigative help from HHS-OIG and the DEA Diversion Control Division, the settlement representing a commitment on the part of federal authorities to preserve the integrity of taxpayer dollars and uphold the law in the management of crucial health care funding.
