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Griffin: ‘Northwest will repay the state’s Medicaid program $1,112,631.54’
LITTLE ROCK – Attorney General Tim Griffin today announced that the State of Arkansas has settled with Northwest Arkansas Hospitals, LLC concerning payments for 246 Medicaid claims. Griffin released the following statement:
“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.”
Background
The claims were based on medical evaluations, diagnoses and supporting documentation certified by Dr. Brian Hyatt and non-physician providers working under his control and supervision. At the time the appeals were filed, Hyatt was a subcontractor with Northwest. In this settlement, Northwest categorically denies that Northwest 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 the records may lack certain details and may be difficult or impossible to audit. Northwest has cooperated at all points during this 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 Arkansas MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $2,751,612 for the federal fiscal year (FY) 2023. The remaining 25 percent, totaling $917,204 for FY 2023, is funded by the state of Arkansas.
To read the settlement, click here.
About Attorney General Tim Griffin
Tim Griffin was elected attorney general of Arkansas on November 8, 2022. He was elected lieutenant governor of Arkansas on November 4, 2014, and was re-elected for his second four-year term on November 6, 2018. From 2011-2015, Griffin served as the 24th representative of Arkansas’s Second Congressional District. For the 113th Congress, he was a member of the House Committee on Ways and Means while also serving as a Deputy Whip for the Majority. In the 112th Congress, he served as a member of the House Armed Services Committee, the House Committee on Foreign Affairs and the House Committee on the Judiciary.
Griffin is a graduate of Magnolia High School, Hendrix College in Conway, and Tulane Law School in New Orleans. He attended graduate school at Oxford University. Griffin has served as an officer in the U.S. Army Reserve’s Judge Advocate General’s (JAG) Corps for over 25 years and currently holds the rank of colonel. In 2005, Griffin was mobilized to active duty as an Army prosecutor at Fort Campbell, Kentucky and served with the 101st Airborne Division (Air Assault in Mosul, Iraq). He is currently serving as the Staff Judge Advocate (SJA) for the 81st Readiness Division at Fort Jackson, South Carolina. Prior to his current post, Griffin served as the Commander of the 134th Legal Operations Detachment (LOD) at Fort Bragg, North Carolina and a senior legislative advisor to the Under Secretary of Defense for Personnel and Readiness at the Pentagon. Griffin holds a master’s degree in strategic studies from the U.S. Army War College, Carlisle Barracks, Pennsylvania. He also served as U.S. Attorney for the Eastern District of Arkansas and Special Assistant to the President and Deputy Director of Political Affairs for President George W. Bush. Griffin lives in Little Rock with his wife, Elizabeth, a Camden native, and their three children.
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