Urgent care chain to pay $9.1M to settle false claims allegations on physician visits

Total Access Urgent Care agreed to pay more than $9.1 million to settle allegations that it submitted false claims to Medicare. 

From April 2017 to November 2021, the Ballwin, Mo.-based urgent care chain allegedly submitted claims to Medicare and Tricare that falsely indicated that physicians performed office visits, when a non-physician practitioner had actually done so, according to a Dec. 21 news release from the Justice Department. 

Additionally, from November 2015 to November 2021, the urgent care chain allegedly submitted upcoded office visit claims, including claims to a federal program that reimbursed for the testing and treatment of COVID-19 for uninsured patients in the latter half of that period. 

The settlement also resolves the company's self-disclosure to CMS that bonuses paid to certain physicians it employed were in part based on the volume or value of their referrals. 

According to the release, Total Access Urgent Care did not admit liability in the settlement agreement.

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