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Contracts Keyed to Dawson
Universal Health Services, Inc. v. United States
Citation:
136 S. Ct. 1989.Facts
Yarushka Rivera, a beneficiary of the Massachusetts’ Medicaid program, received counseling services from Arbour Counseling Services (a subsidiary of Universal Health). Rivera had an adverse reaction from a medication prescribed by Arbour and died of a seizure. In order to receive payment for a Medicaid beneficiary’s care, Universal Health submitted reimbursement claims to Medicaid using payment codes representing the types of treatment provided. Additionally, Arbour made further representations using National Provider Identification numbers corresponding with specific job titles. Rivera’s parents later learned that Arbour was in violation of various basic staff and licensing requirements for mental health facilities and that few Arbour employees were actually licensed to provide mental health counseling or authorized to prescribe medication.
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