Health First Urgent Care agrees to pay nearly $3 million to resolve claims it overbilled Medicare and Medicaid

SPOKANE – Health First Urgent Care which has locations in Richland and Pasco, has agreed to pay $2,807,729 to resolve claims that it fraudulently overbilled Medicare and Medicaid for diagnostic tests, according to a release from the U.S. Attorney’s Office – Eastern District of Washington.

The settlement agreement says that a False Claims Act arose from allegations that Health First Urgent Care fraudulently billed for polymerase chain reaction respiratory and urinary tract infection panel testing. These panel tests were a predetermined group of medical tests used to test for multiple pathogens from a single sample obtained from a patient.

The United States and State of Washington alleged that instead of billing for a single panel test, Health First Urgent Care improperly “unbundled” the panel test and billed for each individual test comprising the panel. This resulted in overbilling to Medicare and Medicaid programs. In addition, the State of Washington alleged that Health First Urgent Care improperly billed for panel tests that were more expensive and not medically necessary for individual patients, such as patients presenting with symptoms of Covid-19.

“Medicare and Medicaid exist to make sure families’ critical medical needs are met. It is vital that we protect the integrity of these programs,” Washington State Attorney General Nick Brown said. “This settlement will help ensure these funds are put to use as intended for Washingtonians.”

The settlement was the result of an investigation jointly conducted by the United States Attorney’s Office, the Washington State Attorney General’s Office and the Health and Human Services Office of Inspector General.

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Elkhorn Media Group