Inova Health System Pays Millions Over Falsified Medicaid Claims

ALEXANDRIA, Va. – Falls Church-based Inova Health System has agreed to a $2.37 million settlement following allegations of submitting falsified Medicaid claims. The settlement resolves both federal and state civil claims tied to improper billing for sterilization and hysterectomy procedures.

Between January and August 2020, Inova submitted claims to Medicaid that included altered documentation. These modifications, made by or at the request of Inova employees, were uncovered after the organization conducted an internal investigation. Inova determined that $1.59 million in Medicaid reimbursements had been improperly obtained.

Inova voluntarily disclosed these issues to federal and state authorities and cooperated fully during the investigation. Their transparency earned them credit under the Department of Justice’s guidelines for addressing False Claims Act violations.

The settlement involves the Inova Health System Foundation, Inova Health Care Services, Inc., and Inova Physician Partners, LLC. Authorities praised the coordinated efforts between the U.S. Attorney’s Office for the Eastern District of Virginia, the Virginia Medicaid Fraud Control Unit, and federal health investigators in resolving the matter.

While this case brings attention to a significant lapse in internal oversight, Inova’s proactive approach to addressing the issue and implementing corrective actions suggests steps have been taken to prevent similar incidents in the future.