NEWARK, NJ — W City Medical of the Upper East Side PLLC, Summit Medical Group P.A., Summit Health Management LLC, and Village Practice Management Company LLC, operating collectively as “CityMD,” have agreed to a $12.04 million settlement. This agreement resolves allegations that they violated the False Claims Act by improperly billing for COVID-19 testing through a federal program intended for uninsured patients.
CityMD, which manages approximately 177 urgent care facilities across New Jersey and New York, was accused by the Justice Department of submitting false claims from February 4, 2020, through April 5, 2022. The claims were for COVID-19 tests administered to insured individuals, yet billed to the Health Resources & Services Administration’s (HRSA) program for the uninsured.
The HRSA’s Uninsured Program reimburses healthcare providers at Medicare rates for testing, treating, and vaccinating uninsured individuals for COVID-19. According to the allegations, CityMD failed to verify insurance coverage adequately before billing the Uninsured Program, despite having insurance information for some patients.
The settlement was reached following CityMD’s voluntary disclosure and cooperation with the federal investigation. This cooperation included contracting with a third party to help determine the extent of losses incurred by the government due to these improper claims.
U.S. Attorney Philip R. Sellinger and Principal Deputy Assistant Attorney General Brian M. Boynton emphasized the critical nature of the Uninsured Program during the pandemic and reiterated the government’s commitment to protecting such emergency funding from misuse. The settlement underscores the ongoing efforts to ensure pandemic relief funds are used appropriately.
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