Health First Urgent Care, which operates clinics in Richland and Pasco, Washington, has agreed to pay $2.8 million to resolve allegations of overbilling Medicare and Medicaid for diagnostic tests. The settlement was announced by United States Attorney Pete Serrano.
The claims stem from accusations that Health First Urgent Care improperly billed for polymerase chain reaction (PCR) respiratory and urinary tract infection panel testing. Instead of charging for a single comprehensive test panel, the clinic allegedly billed for each individual component of the panel, leading to higher costs for government health programs. Additionally, the State of Washington alleged that the clinic billed for more expensive tests that were not medically necessary, including in cases where patients had symptoms consistent with Covid-19.
United States Attorney Pete Serrano stated, “Ensuring that healthcare providers comply with the requirements of Medicare and Medicaid not only maintains the integrity of these programs, but it also safeguards patients and results in better healthcare outcomes. I would like to express our appreciation for our collaboration with the Washington Medicaid Fraud Control Division and the exception investigative work performed by HHS-OIG. We will continue to ensure that fraud, waste, and abuse does not permeate federal healthcare programs.”
The investigation involved cooperation between the United States Attorney’s Office, the Washington State Attorney General’s Office, and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).
Washington State Attorney General Nick Brown said, “Medicare and Medicaid exist to make sure families’ critical medical needs are met. It is vital that we protect the integrity of these programs. This settlement will help ensure these funds are put to use as intended for Washingtonians.”
Jeffrey C. McIntosh, Acting Special Agent in Charge at HHS-OIG, added: “It is critical for providers to bill Medicare, Medicaid, and other taxpayer-funded health care programs lawfully and accurately. The submission of false laboratory testing claims diverts key resources away from those who rely on them, including the elderly and low-income families. HHS-OIG remains committed to working with our law enforcement partners to safeguard federal health care programs for the benefit of the American people.”
Assistant United States Attorney Jacob E. Brooks led the federal investigation and prosecution efforts while Assistant Attorney General Rachel Sterett represented the state’s interests.
