An Arizona-based company, has agreed to pay $10 million to settle allegations that it submitted false claims for unnecessary testing and inflated charges.  The company owns a chain of urgent care facilities in Arizona, Colorado, Texas, North Carolina, Ohio and Virginia.

At issue are allegedly false claims for  allergy, H1N1 virus, and respiratory panel testing submitted to Medicare, TRICARE, the Federal Employees Health Benefits Program, as well as the Medicaid programs of Colorado, Virginia, Texas, North Carolina and Arizona, by billing for unnecessary.  The government also alleged that it inflated billings for urgent care medical services, a practice known as upcoding.

The allegations were initially raised by a former employee who initiated a qui tam suit under the False Claims Act.  The Act allows individual citizens, known as "relators," to bring suit on behalf of the United States and share in the recovery.   The relator in this action will receive $1.614 million.

In addition to the payment of $10 million, the settlement also involves a Corporate Integrity Agreement with the Department of Health and Human Services, Office of Inspector General, under which the company will be monitored for five years to ensure future compliance with all federal healthcare program rules.

John Howley, Esq.
New York, New York

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