According to the Justice Department, Arizona-based NextCare Inc. has agreed to pay the U.S. and Arizona state governments $10 million to settle allegations that the company submitted false claims to TRICARE, Medicare, and the Federal Employees Health Benefits Program, as well as state Medicaid programs in Arizona, Texas, Colorado, North Carolina, and Virginia.
NextCare clinics allegedly billed these healthcare programs for unnecessary respiratory panel, H1N1 virus, and allergy testing. In addition, NextCare allegedly upcoded urgent care services, a scheme that fraudulently inflated NextCare’s billings.
NextCare’s settlement agreement also requires the company to enter into a Corporate Integrity Agreement. Under that agreement, NextCare will be monitored for five years to ensure its future compliance with healthcare program rules.
NextCare’s alleged fraud was exposed through a False Claims Act lawsuit brought by a former NextCare employee. Whistleblower Lorin Cohen filed suit under qui tam provisions of the False Claims Act, which provides that private citizens with knowledge of fraud against the government can bring a lawsuit on behalf of the government and are entitled to share in any recovery. In this case, the whistleblower will receive over $1.6 million.
The company owns a chain of urgent care facilities located in Arizona, Texas, Colorado, Ohio, North Carolina, and Virginia.
Waters & Kraus is a national firm with highly skilled lawyers practicing qui tam litigation in four offices, including Dallas, Los Angeles, San Francisco, and Baltimore. Our attorneys have decades of experience successfully representing whistleblowers in a variety of fraud cases. Contact us or call our attorneys at 800.226.9880 to learn more about our practice and how we can assist.