Zachary T. Lee Acting United States Attorney | U.S. Attorney for the Western District of Virginia
Tri-Area Community Health has agreed on Apr. 27 to pay $513,729.90 to the United States to settle allegations of improper Medicare billing for Annual Wellness Visits at its Laurel Pike, Virginia location. The organization previously repaid $321,075.56 toward this total amount.
The case is significant because Tri-Area Community Health operates as a Federally Qualified Health Center with six independent clinics in the Western District of Virginia and provides services that are billed to Medicare beneficiaries.
According to federal authorities, from August 2022 through December 2025, Tri-Area Community Health provided Annual Wellness Visits performed by pharmacists without physician oversight or supervision and billed these visits under physicians' names who were not involved in the care. The organization cooperated with investigators by conducting an internal review and helping identify claims that were improperly reimbursed.
The resolution resulted from efforts by the U.S. Attorney’s Office for the Western District of Virginia, the Department of Health and Human Services Office of Inspector General, and other federal agencies. First Assistant United States Attorney Robert N. Tracci and Special Agent in Charge Maureen Dixon announced the settlement. Assistant U.S. Attorney Matthew G. Howells led the investigation with assistance from HHS-OIG.
The claims resolved are only allegations; there has been no determination of liability.
The U.S. Attorney for the Western District of Virginia promotes public safety and community well-being through crime prevention and outreach according to its official website. The office operates locations in Roanoke, Charlottesville, Abingdon, Lynchburg, Danville and Harrisonburg according to its official website. It is part of the U.S. Department of Justice according to its official website and handles both federal prosecutions and civil litigation for the United States according to its official website. Covering western Virginia according to its official website, it partners with law enforcement at all levels according to its official website.
The office also manages crime prevention initiatives while maintaining sites across several cities in western Virginia according to its official website.
