Chicago healthcare company settles upcoding allegations

A Chicago-based healthcare company and its former owners agreed to pay $2 million to settle allegations that it submitted false claims to Medicare and Medicaid.

The settlement resolves allegations that KareFirst Management, an independent nurse practitioner group, developed a patient charting software and required its nurse practitioners to use it, despite knowing that it resulted in fraudulently upcoded claims being submitted to and paid by Medicare and Medicaid, according to a June 18 Justice Department news release.

KareFirst and its former owners will pay the $2 million settlement to Medicare and Medicaid over the next three years, according to the release.

The agreement resolves a civil lawsuit filed by a former KareFirst employee under the whistleblower provisions of the False Claims Act, according to the release. The settlement resolves allegations only, and there was no determination of liability.

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