CareWell Urgent Care reaches $2.8 million deal over alleged false billing

By Marian Johns | Apr 2, 2019

BOSTON (Legal Newsline) — CareWell Urgent Care Centers has reached a $2.8 million combined settlement with the federal government and the states of Massachusetts and Rhode Island over alleged false claims for medical billing. 

According to a March 29 Massachusetts Attorney General's Office news release, CareWell "routinely overbilled" MassHealth as well as the state's Group Insurance Commission (GIC) plans for unnecessary patient exams. 

The allegations, which stem from a whistleblower lawsuit, include MassHealth medical staff being instructed to perform the exams in an effort for CareWell to get higher reimbursements from the government. The Attorney General's Office also alleges the company altered electronic billing and "falsely billed" services as being done by doctors but they were actually done by nurse practitioners in order to get more reimbursement. 

“Urgent care centers provide necessary, time-sensitive care to families across Massachusetts,” state Attorney General Maura Healey said in a statement. “CareWell took advantage of patients in Massachusetts by giving them exams they did not need, while at the same time overbilling the State and wasting critical health care resources.”

The settlement includes CareWell paying $857,800 to the state of Massachusetts and $2 million to be split by the state of Rhode Island and the federal government.

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