Palomar Health
Outcome
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Details
Palomar Health — $3,084,315 Fine
Outcome: Official websites use .gov A .gov website belongs to an official government organization in the United States.
Official websites use .gov A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
After it self-disclosed conduct to OIG, Palomar Health, California, agreed to pay $3,084,315.48 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Palomar Health submitted claims to Federal health care programs through its Intensive Outpatient Psychiatric program for outpatient therapy services that lacked medical necessity and were not supported by the medical records.
HHS Office of Inspector General
How Crucible Prevents This
Crucible's compliance monitoring controls for Behavioral Health / SUD Treatment would have detected the patterns underlying this violation through automated screening, documentation enforcement, and real-time alert escalation.
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