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One U.S.-based urgent care operator is paying a heavy price after pleading guilty to healthcare fraud and engaging in monetary transactions derived from unlawful activity. The company, which was first accused of inflating reimbursement rates by ordering unnecessary tests and systematically exaggerating the complexity of procedures several years ago, has now copped to the charges and has to pay a $12.5 million fine. That’s the amount the prosecution says equates to the bogus charges between 2012 and 2016. The judgment is a cautionary tale to operators who may seek an illicit shortcut to profitability, but also a warning to ensure that billing and coding procedures are free from even the appearance of impropriety.
Years After Being Accused, an Admission of Guilt—and a $12.5 Million Fine