LITTLE ROCK, Ark. (KNWA/KFTA) — Arkansas Attorney General Tim Griffin announced on April 28 that the state of Arkansas has settled with Northwest Arkansas Hospitals, LLC, the parent company of Northwest Health concerning payments for 246 Medicaid claims. The hospital will repay the state’s Medicaid program $1,112,631.54.
According to a press release from the Attorney General’s Office, the claims were based on medical evaluations, diagnoses and supporting documentation certified by Dr. Brian Hyatt and nonphysician providers working under his control and supervision.
The release says at the time the appeals were filed, Hyatt was a subcontractor with Northwest Arkansas Hospitals. In this settlement, the hospital denies that it knowingly violated the Arkansas False Claims Act but acknowledges that many of the medical records supporting the covered claims contain templates created and used by Hyatt and that records may lack certain details and may be difficult or impossible to audit.
According to the release, the hospital cooperated at all points during the investigation.
“While state and federal law give great deference to the diagnosis made by a medical doctor, all Medicaid providers must maintain complete and accurate records that justify claims filed and fully document the medical necessity of all services,” the release states.
Griffin released a statement in response to the settlement:
“Northwest will repay the state’s Medicaid program $1,112,631.54. My office investigated these claims pursuant to the Arkansas Medicaid False Claims Act, and the settlement is a result of audit work conducted by the Arkansas Foundation for Medical Care (AFMC). AFMC reviewed the medical records submitted by Northwest and determined that on 246 occasions the documentation provided did not justify or support the medical necessity requirement for hospitalizations.
“My office’s Medicaid Fraud Control Unit (MFCU) led the investigation and settlement, assisted by the Office of the Arkansas Medicaid Inspector General, as well as by Special Agent Joseph Moore of the U.S. Department of Health and Human Services Office of Inspector General’s Office of Investigation. I would like to say a special thanks to Deputy Attorney General Lloyd Warford and Special Agent Greg McKay for their good work on this case.”Arkansas Attorney General Tim Griffin
A spokesperson for Northwest Health also released a statement in response to the settlement:
“Northwest Health has entered into a settlement agreement with the State of Arkansas related to claims submitted for behavioral health services provided to Medicaid patients. The submissions were based on medical evaluations, diagnoses and other supporting documentation created by the unit’s former independent medical director Dr. Brian Hyatt and non-physician providers working under his supervision and direction in the unit. While we believe hospital personnel complied with Arkansas law in all respects, Arkansas law heavily relies on the treating physician’s assessment of the patient, which was provided by Dr. Hyatt. And, while there is no evidence that the hospital intended to submit improper claims, we also believe settlement is in the best interest of the organization at this time.”Nothwest Health
Hyatt faces mounting legal trouble stemming from his time at Northwest Health. At least 11 former patients have filed suit so far against him. Three of those patients had to get court orders to be released from Hyatt’s care.
Hyatt was named as a defendant in several lawsuits alleging false imprisonment and assault among other accusations. The state attorney general’s office has also launched an investigation into Hyatt.