CityMD, the largest provider of urgent care practices across New York and New Jersey, agreed to pay approximately $12 million as part of a settlement with the Department of Justice (DOJ) addressing the alleged submission of false claims for payment for Covid-19 testing.
The details: From February 2020 through April 2022, CityMD “knowingly submitted or caused to be submitted false claims for payment for Covid-19 testing” to the Health Resources and Services Administration’s program for uninsured patients for individuals who had health insurance coverage, the DOJ alleged in a press release Friday.
The agency claimed CityMD did not adequately confirm whether the individuals had health insurance coverage before submitting the claims and caused outside laboratories to submit false claims for Covid-19 testing related to its erroneous determinations.
The case resolved claims brought under the qui tam provisions of the False Claims Act by a CityMD patient. The individual will receive more than $2 million of the settlement recovery.
Compliance considerations: CityMD received credit for voluntary disclosure, cooperation, and remediation, according to the DOJ.
An example of its cooperation was its voluntary retention of a third party to assist the government in determining the amount of the losses it contended were caused by the false claims CityMD submitted to the uninsured program, the agency noted.
CityMD did not immediately respond to a request for comment. The settlement did not include a determination of liability.
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