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July 03, 2012

NextCare to pay $10M for false claims


Urgent care organization, NextCare, has settled to pay $10 million for submitting false claims to federal and state healthcare agencies. ()

WASHINGTON (UPI) -- NextCare, based in Arizona, agreed to pay $10 million to settle state and federal allegations it submitted false claims, the Justice Department said Monday.

The settlement resolves allegations NextCare submitted false claims to federal and state healthcare agencies by billing for unnecessary allergy, H1N1 virus and respiratory panel testing, Justice officials said in a release.

The United States also alleged NextCare inflated billings for urgent care medical services, a practice known as "up-coding."

NextCare is an owner of a chain of urgent care facilities in Arizona, Colorado, North Carolina, Ohio, Texas and Virginia.

"This settlement demonstrates the Justice Department's commitment to ensuring that federal healthcare dollars are spent appropriately," said Stuart Delery, acting assistant attorney general for the Civil Division. "Healthcare providers who administer unnecessary services or who overcharge for care will be held accountable."

NextCare also is required to enter into a Corporate Integrity Agreement with the Inspector General of the Health and Human Services Department. Under the agreement, the company will be monitored for five years to ensure it complies with all federal healthcare program rules.

The allegations resolved by Monday's settlement were first raised in a lawsuit against NextCare by former employee Lorin Cohen under the False Claims Act, Justice officials said. Under certain conditions, private citizens can bring suit on behalf of the United States and share in the recovery.

Cohen will receive $1.614 million, the department said.

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