By: Richard L. Smith
CityMD, which operates around 177 urgent care practices in New Jersey and New York, has agreed to pay $12.04 million to resolve allegations of violating the False Claims Act.
According to a statement released by the United States Attorney, CityMD submitted or caused the submission of false claims for payment for COVID-19 testing to a Health Resources & Services Administration (HRSA) program for uninsured patients.
The Justice Department alleged that from February 4, 2020, through April 5, 2022, CityMD knowingly submitted claims for COVID-19 testing to the HRSA Uninsured Program for individuals who actually had health insurance coverage.
This was done without adequately confirming their uninsured status.
According to the statement, the United States Attorney, CityMD, also caused outside laboratories to submit false claims by issuing requisition forms incorrectly indicating patients were uninsured.
CityMD received credit for voluntary disclosure, cooperation, and remediation in the settlement.
They cooperated with the investigation by contracting with a third party to help determine the losses caused by the false claims.
U.S. Attorney Philip R. Sellinger emphasized the importance of protecting emergency funding intended for uninsured Americans during the pandemic.
Principal Deputy Assistant Attorney General Brian M. Boynton echoed this sentiment, highlighting the critical support provided by the Uninsured Program during the pandemic.
This settlement also resolves claims brought under the qui tam provisions of the False Claims Act by Steven Kitzinger, a CityMD patient, who will receive $2.05 million as part of the recovery.
The resolution was the result of a coordinated effort between various branches of the Justice Department and the U.S. Department of Health and Human Services Office of Inspector General.