Covid Test DMV LLC, doing business as Rapid Health (Rapid Health), a pharmacy located in Los Angeles, has agreed to pay the United States $8,242,860 to resolve allegations that it violated the False Claims Act (FCA) by knowingly submitting or causing the submission of false claims to Medicare for over-the-counter (OTC) Covid-19 tests that were not provided to Medicare beneficiaries.
Between April 2022 and May 2023, Rapid Health distributed OTC Covid-19 tests in connection with the Centers for Medicare & Medicaid Services (CMS) OTC Covid-19 Test Demonstration Project (Demonstration Project). During the Demonstration Project, Medicare Part B beneficiaries could request OTC Covid-19 tests from participating providers, and CMS would reimburse those providers for up to eight OTC Covid-19 tests per Medicare Part B beneficiary per month at a fixed rate of $12 per test.
The settlement announced resolves allegations that Rapid Health knowingly submitted or caused the submission of claims to Medicare for OTC Covid-19 tests that Rapid Health never provided to Medicare beneficiaries. Medicare patients could order OTC Covid-19 tests from Rapid Health during the Demonstration Project through Rapid Health’s website. When Rapid Health received an order, it was supposed to process the order, generate a shipping label, and send the OTC Covid-19 test to the beneficiary. The United States alleged that issues with Rapid Health’s processing procedures caused Rapid Health to bill orders to Medicare without shipping the test to the beneficiary, and that although Rapid Health was aware of these issues it nevertheless continued to bill Medicare for tests that were not shipped.
“The Demonstration Project was designed to increase the availability of OTC Covid-19 tests to Medicare beneficiaries in an unprecedented time of need,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Providers that knowingly billed for tests that were never given to patients failed to support the goals of the project and defrauded the American taxpayers.”
“This outcome serves as a reminder of our unwavering commitment to combat health care fraud and investigate those who allegedly attempt to exploit and defraud Medicare and other federally funded health care programs,” said Special Agent in Charge Maureen Dixon of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “With our local, state and federal partners, HHS-OIG will continue to work aggressively to ensure the dependability and the integrity of the Medicare program.”
The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and HHS-OIG.
Trial Attorney Lindsay DeFrancesco of the Civil Division’s Fraud Section handled the matter.
On May 17, 2021, the Attorney General established the COVID-19 Fraud Enforcement Task Force to marshal the resources of the Justice Department in partnership with agencies across the federal government to enhance efforts to combat and prevent pandemic-related fraud. The task force bolsters efforts to investigate and prosecute the most culpable domestic and international actors committing civil and criminal fraud and assists agencies tasked with administering relief programs to prevent fraud by, among other methods, augmenting and incorporating existing coordination mechanisms, identifying resources and techniques to uncover fraudulent actors and their schemes and sharing and harnessing information and insights gained from prior enforcement efforts. For more information on the department’s response to the pandemic, please visit www.justice.gov/coronavirus.
Tips and complaints from all sources about potential fraud affecting COVID-19 government relief programs can be reported by visiting the webpage of the Civil Division’s Fraud Section, which can be found here. Anyone with information about allegations of attempted fraud involving COVID-19 can also report it by calling the Justice Department’s National Center for Disaster Fraud (NCDF) Hotline at 866-720-5721 or via the NCDF Web Complaint Form at www.justice.gov/disaster-fraud/ncdf-disaster-complaint-form.
The claims resolved by the settlement are allegations only. There has been no determination of liability.
No comments:
Post a Comment