NextCare Inc. To Pay $10 Million To Resolve False Claims Act Allegations

An Arizona-based company, NextCare Inc., has agreed to pay the United States $10 million to settle federal and state allegations that it submitted false claims.  NextCare is an owner of a chain of urgent care facilities with locations in Arizona, Colorado, Texas, North Carolina, Ohio, and Virginia.

NextCare Inc. submitted false claims to Medicare, TRICARE, and the Federal Employees Health Benefits Program, as well as the Medicaid programs of Colorado, Virginia, Texas, North Carolina, and Arizona, by billing for unnecessary allergy, H1N1 virus, and respiratory panel testing.  It was also alleged that the company inflated billings for urgent care medical services in the years under review, a practice known as upcoding.

Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina, noted that, “Today’s $10 million settlement with NextCare demonstrates our commitment to putting a stop to improper billings practices that exploit Medicare and drain vital resources from our health care system.  NextCare’s upcoding and unnecessary medical testing wasted taxpayers’ dollars.  This is a strong message to companies and individuals who engage in such conduct.  We are here, we are watching, and we will use all of our resources to safeguard the integrity of important public programs and protect consumers across the nation.”

The allegations resolved by the settlement were initially raised in a lawsuit filed against NextCare by former NextCare employee Lorin Cohen.  Ms. Cohen will receive $1.614 million as her share of the recovery.

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