Journal of Urgent Care Medicine

CityMD Pays $12 Million in False Claims Settlement

CityMD, which operates more than 175 urgent care centers in New York and New Jersey, has agreed to pay $12 million to settle allegations of violating the False Claims Act. The allegations state that for 2 years, CityMD knowingly submitted false claims to a federal health program for uninsured patients for COVID-19 testing. The Justice Department says CityMD failed to adequately verify patients’ insurance status, submitting claims for those who already had insurance. Additionally, CityMD …

What is a False Claim?

Benjamin Barlow, MD; Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC The False Claims Act (FCA) is a federal statute enacted in 1863, inspired by defense-contractor fraud during the Civil War. Today it is used to prosecute inappropriate billing in the healthcare setting. Any person who knowingly submits false claims to the government (ie, Medicare, Medicaid, and Tricare) is liable for 3 times the government’s damages plus a penalty that is linked to inflation. Penalties are per …