WA Attorney General Seeks $72M in SeaMar Fines

Washington State’s Attorney General is seeking $72 million in civil penalties from SeaMar Community Health Centers for alleged “improper Medicaid claims.”

The AG’s office points to a questionable $7 million in claims for Medicaid services since 2006, according to The Seattle Times. If the allegations prove true, penalties set at over ten times the cost would be disastrous for some of Washington’s most vulnerable populations.

We reached out to SeaMar for a comment.  Ricardo Sánchez, SeaMar’s Director of Communications, had this to say:

We find the Attorney General’s analysis of back payments to be wrong and discussions of penalties excessively-so. Our billing procedures will hold up to regulator scrutiny. However, few non-profits like us, can take a $72 million dollar hit. The Washington State Attorney General’s Office needs to understand that there’s tremendous harm for Washington’s marginalized populations as 90% of SeaMar’s patients are low-income.

According to SeaMar, they are being asked to foot the bill long after most treatments occured–plus fines which they deem “excessive.”

Before the ACA, the penalty for such action was set at 200%.  Changes from the Affordable Care Act allow for additional penalties which significantly extend beyond the pre-ACA 200% limit, as shown above.

Two things we’re keeping our eye on are:

  1. Will other healthcare providers be hit with similar ex post facto fines?
  2. What will happen to SeaMar, and the patients they serve, should the allegations prove true?