Tri-City Clinic to Pay $2.8-Plus Million, for Fed. Overbilling Fraud
Health First Urgent Care came to the Tri-Cities in 2020, opening clinics near Columbia Point in Richland, and then taking over the old Cousins' restaurant on Road 68 in Pasco when COVID killed off the restaurant. Now, they're facing a $2.8-plus million dollar settlement.
US Attorney's Office says the company "fraudulently" billed Medicare, Medicaid
According to information released by the US Attorney's Office and US Attorney Pete Serrano, the company was accused of fraudulently 'unpacking' or separating medical test panels.
According to what the US Attorney's Office called the settlement:
"...instead of billing for a single panel test, Health First Urgent Care improperly “unbundled” the panel test and billed for each individual test comprising the panel. This resulted in overbilling to Medicare and Medicaid programs."
The overbilling was caught via auditing and reviewing billing statements. The overbilling was done on numerous PCR respiratory and urinary tract infection panel testing.
So, instead of billing one time for the 'group,' breaking them down into a line-item claim caused thousands of additional reimbursement claims to be sent to Medicaid and Medicare.
Attorney Serrano says the company will pay $2.807.729 to cover the overbilling. Officials did not elaborate otherwise on the situation, but the billing was repeatedly labeled as "fraud" by the US Attorney's Office.
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