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CityMD Will Pay $6.6M in Medicare to Settle Whistleblower Lawsuit

Federal prosecutors say CityMD, a New York based urgent care, admitted that it overcharged Medicare. They will pay millions for ordering more expensive procedures, and billing for services provided by physicians who were not properly credentialed.

The Whistleblower Lawsuit

The federal government joined a private whistleblower lawsuit. The lawsuit had been filed under seal but made severe allegations that CityMD has now admitted to committing.

Federal prosecutors say that the chain of 88 urgent cares billed Medicare for services that physicians did not perform, and billed Medicare for more expensive and complex services than were actually provided to patients. They also employed a number of physicians who were not credentialed with the Medicare program and falsely billed Medicare for services by these uncredentialed physicians.

Medicare rules prohibit medical providers from “seeking reimbursement from the Medicare program for services rendered by a physician unless that physician is enrolled with the Medicare program when the services are rendered.”

Full Cooperation

The Department of Justice says CityMD cooperated fully in the investigation. They admitted and accepted responsibility for their actions. They also agreed to pay $6,606,251.40 in damages.

CityMD issued this statement following the settlement agreement, “CityMD is pleased to have reached a satisfactory resolution to this matter, which involved past insurance billing and coding. This matter was unrelated to CityMD’s patient care, which has consistently been of the highest quality.”

To learn more about this case or report suspected fraud, contact Newman & Shapiro today!