Universal Health Services is the largest psychiatric services provider in the nation. Last year the company treated approximately 450,000 patients. With 200 facilities, the company serves patients in all but a handful of states. Despite its huge size (the company has 72,000 employees), most people have never heard of the name Universal Health Services. That is because the hospital chain doesn’t use the name with any of its facilities. We think it is because of the chain’s long history of problems.
How bad are those problems? A thoroughly researched investigative report from BuzzFeed last week suggests that the company often “kidnaps” patients and keeps them hospitalized against their will until their insurance runs out or Medicare will no longer pay. Only when the money runs out are the patients miraculously “cured” and allowed to leave the facility.
Are the allegations true? There appears to be both employees and former patients ready to back up those claims. Unfortunately, we have seen this type of behavior at facilities not run by Universal Health Services. In fact, we believe the problem extends beyond psychiatric hospitals and also includes drug addiction and rehab facilities.
Rosalind Adams, the BuzzFeed journalist, and her team interviewed 175 present and former Universal employees. Many said they were instructed “to fill beds by almost any method — which sometimes meant exaggerating people’s symptoms or twisting their words to make them seem suicidal.” Only when their benefits ran out were the released.
One commenter claimed to be a former psychiatric nurse. (S)he says, “I spent ten years as a geriatric psych nurse in locked units… Once you’re in, you are in. I worked at a dozen facilities in that time, and chemical restraints, bad patient care, medication theft, you name it. The entire industry has very little oversight…”
We are shocked by the allegations but have heard similar stories before. Private psychiatric hospitals make their money by filling up beds. As long as Uncle Sam or a private insurance plan is paying for a patient’s stay, the facility has no incentive to release people. Instead of rewarding doctors or administrators who are able to quickly get patients back on their feet, the financial incentives do the opposite.
Remember, unlike ordinary hospitals, many of the people in these specialized psychiatric hospitals are there under a judicial commitment order. They can’t just walk out.
In most states patients that believe they are being held illegally or that they are not a risk can ask to have their commitment reviewed by a physician. If the doctor works for the company, it can be difficult to get an unbiased evaluation.
In almost every state, patients can also ask for their case to be reviewed by a judge but that often takes months. When the hearing date finally arrives, it is your word against a highly trained doctor. Who does the court believe?
Obviously not every psychiatric hospital kidnaps patients and holds them against their will. We have heard enough stories to know that there is a problem. In some cases, it may be a psychiatric hospital that fills its beds by holding people until their insurance runs out. Other times it is a rehab or halfway house for recovering addicts. These folks will sometimes offer free room and board in return for requiring the resident to attends daily counselling session even if there is no medical reason to do so.
A patient recruiter in Detroit tells us that he was paid to cruise inner city areas and pick up homeless and down trodden people. They are offered a free medical screening and promised room and board if they “correctly” answer certain questions about depression. Basically, the recruiter told Medicare / Medicaid eligible patient I can get you a nice place to stay for the winter but you must say that you are thinking of hurting yourself. The recruiter was paid by the facility for each new patient that was admitted.
Is Universal Health Services the New Wells Fargo?
When the story broke that claimed Wells Fargo opened 2 million new accounts without their customers’ permission, Congress and the public were outraged. Instead of admitting guilt, the bank initially blamed its front line employees. Suddenly, over 500 tellers, branch managers and relationship managers were terminated.
Instead of accepting responsibility, senior management tried to blame the workers. While we don’t believe that former Wells Fargo CEO John Stumpf ordered thousands of workers to commit crimes, he created the situation that allowed the crimes to occur. By giving employees impossible sales goals and paying bonuses to those that created the most accounts, Wells Fargo created the environment for the crimes to occur.
The bank also had a long history of compliance problems. Looking at the recent history of Universal Health Services, the similarities are striking.
In 2010, both Medicare and the State of California threatened to decertify or revoke the licenses of several Universal’s facilities.
In 2012, Universal paid $6.9 million to settle a False Claims Act lawsuit claiming the company submitted false claims to Medicaid. The suit said the company provided substandard psychiatric services to kids.
Whistleblower Awards and Patient Kidnappings / Involuntary Admissions
The federal False Claims Act pays large cash awards to whistleblowers with inside information about fraud involving Medicare, Medicaid and Tricare (government employees). Under the Act, the government can pay up to 30% of whatever the government collects from the wrongdoers. (15% to 25% awards are the most common.)
To earn an award, you must generally be the first to file and have inside information about the fraud. If your information appears to qualify, we will file a sealed complaint on your behalf in federal court. The government is then given an opportunity to investigate. While under investigation, the case remains sealed meaning secret.
Improper involuntary admissions and providing treatment that is not medically necessary violate the False Claims. Medicare and Medicaid should not pay for services that are not needed. Obviously, holding people against their will without any medical need is also a huge human rights violation.
A person feeling a bit down or depressed should be able to seek treatment and not worry about being detained simply because he or she has insurance. If the allegations against Universal Health Services are accurate, truly needy but poor patients may get no treatment while those that have insurance and don’t need inpatient care are held against their will.
MahanyLaw Open Medicare Fraud Investigations
If you have information about any psychiatric healthcare provider that is detaining people without medical necessity, prescribing treatment or counseling that is not needed, paying kickbacks for psychiatric or addiction recovery referrals or charging for services not provided, contact us immediately. You may be eligible for an award. We also want to hear from insiders who know of unqualified professionals delivering care to patients.
For more information, please visit our Medicare fraud information page or contact us directly. All inquiries are protected by the attorney – client privilege and kept confidential. The author of this post, attorney Brian Mahany, can be reached at *protected email* or by phone at (414) 704-6731 (direct).
MahanyLaw – America’s Whistleblower Lawyers
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