Ballwin, Mo.-based Total Access Urgent Care will pay more than $9.1 million to settle allegations it submitted false claims to Medicare and other federal healthcare programs.
From 2017 to November 2021, the urgent care chain allegedly submitted payment claims to Medicare and Tricare indicating that a physician performed office visits when a nonphysician practitioner had actually done so, according to a Dec. 21 Justice Department news release.
Total Access Urgent Care is also accused of submitting upcoded claims to Medicare and Tricare for office visits from November 2015 through November 2021, according to the release. In the latter portion of that period, the company allegedly submitted upcoded office visit claims to the HRSA's COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program.
The company did not admit liability in the settlement agreement, according to the release.
The settlement also resolve's Total Access Urgent Care March 2021 self-disclosure to CMS that bonuses paid to certain physicians it employed were in part based on the volume or value of their referrals for designated health services.