West Tennessee health clinics received $4.7M in TennCare overpayments

(The Center Square) – The Tennessee Comptroller found a West Tennessee health care clinic was overpaid more than $4.7 million in TennCare reimbursements.

Grove Primary Care had clinics in Henderson, Middleton and Scotts Hill. All three facilities closed the day after comptroller’s office auditors contacted the clinic owners Oct. 30, 2019, about the payments.

The audit found through a review of quarterly invoices between January 2014 and June 2019 that Grove Primary Care overreported 44,342 patient visits and $2,213,082 in payments received from managed care organizations, third parties and patients.

The overreported patient visits led to TennCare’s overpayment of more than $4.7 million. TennCare is the state’s Medicaid program.

The investigation did not determine whether the accounting issues were the result of fraud or error.

“Grove Primary Care is obligated to return overpayments and may be subject to liability under the federal False Claims Act, which could trigger a fine and triple the amount of damages, known as ‘treble damages,’ if owners conceal or knowingly and improperly avoid or decrease an obligation to pay money to the federal government,” a news release Thursday from the comptroller’s office said.

The Tennessee attorney general’s office also is investigating Grove Primary Care for violating the Tennessee Medicaid False Claims Act.

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