Dallas-based Healthcare Associates of Texas was found guilty of knowingly submitting $2.8 million worth of fraudulent Medicare claims, the Dallas Morning Journal reported Nov. 21.
Six things to know:
1. The lawsuit was filed on behalf of a whistleblower who discovered the fraudulent claims while working in the physician practice management company's billing department, according to the report. The whistleblower, Cheryl Taylor, was allegedly fired when she raised concerns about the claims.
2. The lawsuit alleged that Healthcare Associates of Texas filed fraudulent claims in several ways, including billing for services as if they were provided by physicians when those services were actually provided by others, and misrepresenting the necessity of various lab panels and other screenings, according to the report. The clinic was also accused of manipulating medical charts for Medicare beneficiaries to conceal the improper approach.
3. The lawsuit alleged that more than 47,000 fraudulent claims were submitted between 2015 and 2021, according to the report. The jury found Healthcare Associates of Texas knowingly submitted 21,844 fraudulent claims. The jury also found seven of the clinic's employees conspired to violate the False Claims Act.
4. An attorney representing Healthcare Associates of Texas told the Dallas Morning News that the clinic "complied with applicable Medicare billing rules and continues to provide high-quality patient care. HCAT is disappointed in the verdict and will be pursuing all of its options."
5. The judge presiding over the case has not yet set a fine amount for Healthcare Associates of Texas.
6. UnitedHealth Group's Optum acquired Healthcare Associates of Texas in 2022 for $300 million.