Turning Point Care Center: Transportation Inducements and the Separate Settlement

The Turning Point Care Center fraud case ended in a $5 million civil settlement over allegations that free or discounted transportation induced Medicare and Medicaid beneficiaries to seek treatment at the facility. For someone who worked in admissions, referrals or transportation, the important part is what the ride was meant to secure. The government alleged that Turning Point used it to bring patients into its own detoxification and rehabilitation treatment.

Turning Point was a Universal Health Services facility in Moultrie, Georgia. The Justice Department announced the settlement on July 10, 2020, with the agreed payment going to the United States and Georgia. A whistleblower’s qui tam case brought the transportation allegations into a separate action from the UHS cases about unnecessary admissions and inadequate care.

Free or Discounted Transportation to Bring Patients Into Treatment

The government alleged that Turning Point offered free or discounted transportation from January 2007 until May 1, 2019 to induce Medicare and Medicaid beneficiaries to seek treatment. The destinations were its inpatient detoxification and rehabilitation program or its intensive outpatient program.

The allegation was that Turning Point used a transportation benefit to win that business.

Our work with an insider is to connect the offer, the admission and the billing to the people who authorized the arrangement.

The Admissions Business Behind the Ride

Treatment admissions can bring insurance verification, facility selection and travel arrangements into the same operation. American Addiction Centers described that business structure in its 2018 company filing: a centralized admissions center handled benefits verification, insurer communications, screening, precertification, facility selection and logistics. Its marketing channels included owned addiction websites and professional and employee-assistance relationships.

That account helps explain why someone outside the clinical team may understand how patients reach a program. The person verifying coverage, the person selecting a facility and the person arranging travel can each see a different part of the same admission. An offer made while those choices are being settled can matter to the treatment business that follows.

The Journal of Health Care Compliance’s 2018 article Trends in Combating Fraud and Abuse in Substance Use Disorder Treatment describes a recurring recruitment pattern: operators paying marketers for patient referrals or offering prospective patients gifts, free airfare, housing or insurance premiums to enroll them and bill their insurance. It also describes outpatient clinics paying sober homes to house patients whose insurance the clinics bill.

The article also describes toll-free call centers whose marketers may conceal that a particular treatment facility pays them to send referrals to its program, regardless of a patient’s needs or location. The apparent source of help can have a financial stake in the destination. That is the wider recruitment market in which treatment offers need to be understood.

The financial incentive runs from the benefit to the insurance payment. A business can spend money on getting the patient into treatment because it expects to earn money from that patient’s coverage. Turning Point’s alleged benefit was transportation. The question inside that allegation is what the facility was buying when it allegedly supplied the ride.

Why Turning Point Had a Separate Settlement

The $122 million announcement combined the Turning Point transportation resolution with a larger UHS care resolution. UHS agreed to pay $117 million over allegations involving unnecessary inpatient behavioral health services and inadequate or inappropriate care. The transportation settlement resolved an additional whistleblower case of its own.

The UHS care agreement also covered Turning Point. The broader case concerned claims to Medicare, Medicaid, TRICARE, Department of Veterans Affairs and Federal Employee Health Benefit programs.

The care allegations concerned what happened during treatment. Across the covered UHS facilities, the government alleged unnecessary admissions, excessive stays, billing for services that were not provided, inadequate staffing, and missing required therapy and treatment planning. The transportation allegation concerned the benefit allegedly used to bring patients to Turning Point in the first place.

The Referral Pattern in Other Treatment Cases

Other treatment cases show transportation and housing functioning as benefits tied to a provider’s patient business. The closest transportation parallel is Oglethorpe, whose Ohio facilities faced allegations of free long-distance transportation to induce Medicare beneficiaries to use their treatment services.

That case also carried unnecessary-admission allegations specifically concerning Cambridge Behavioral Hospital and Ridgeview Behavioral Hospital.

Bournewood supplies a particularly clear account of a benefit tied to attendance. As the Justice Department described its civil settlement, the company acknowledged paying sober homes only while patients enrolled in and attended its partial hospitalization program. Payments stopped when attendance stopped, regardless of the patient’s continuing housing need.

The condition tells the story. A patient’s need for housing could continue while the provider’s payment ended. The paid benefit followed attendance at the program. Alongside Turning Point’s transportation allegations, that admission shows why the terms attached to a benefit deserve attention: they can reveal the treatment business the provider expects in return.

What Evidence Is Needed to Prove Fraud?

Our whistleblower experts review the evidence with you, including what patients were promised, how the destination was selected and who approved the arrangement. In this kind of healthcare case, we connect your account of the offer to the admissions and billing behind it.

The admissions process gives that review a practical focus. Coverage verification, program selection and travel logistics sit near each other in the business. A person working in one of those roles may know why a particular offer was made, while another person sees the treatment claim that followed.

The care-settlement distinction remains important here. A transport record speaks to a patient’s route into a facility. A therapy or staffing record speaks to what happened after admission. That is the work our whistleblower experts do with you.

How Much of a Settlement Does a Whistleblower Get?

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. The announcement assigned a separate reward to the whistleblower in the Turning Point transportation case.

In the broader UHS care settlement, the Justice Department announced nearly $16 million for the whistleblowers from the federal portion of the settlement. The separate transportation case demonstrates why knowledge of patient recruitment matters: the benefit used to bring patients into treatment can be the subject of a civil whistleblower case in its own right.

You Saw How Patients Reached the Program

If you know how transportation offers, admissions decisions and treatment billing fit together at your facility, speak to one of our whistleblower experts about how patients were brought in. We develop your case with you and bring in behavioral health fraud whistleblower lawyers who understand patient-referral arrangements. You have a partner from the first account of the offer through the pursuit of a recovery.