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VOL. 43 | NO. 14 | Friday, April 5, 2019

Audit: Tennessee clinic received $6M in overpayments

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NASHVILLE (AP) — State auditors say a Tennessee health clinic has been overpaid more than $6 million by submitting false reimbursement information for services provided to Medicaid patients.

Almost immediately after the audit was released on Wednesday, Attorney General Herbert H. Slatery III announced his office had filed a lawsuit seeking $18.7 million in damages against Franklin-based ProHealth Rural Health Services Inc.

The damages amount is nearly three times the alleged fraudulent amount received by the clinic.

According to auditors, the clinic over-reported the number of Tennessee Medicaid patients who visited its clinics by roughly 56,250 visits between 2012 and 2017.

ProHealth officials told auditors they didn't intentionally submit false claims to the state and contend they acted in good faith. The clinic plans on appealing to the Department of Finance and Administration.

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