Report on Medicare Compliance Volume 30, Number 14. News Briefs: April 2021 #2

Health Care Compliance Association (HCCA)
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Health Care Compliance Association (HCCA)

Report on Medicare Compliance 30, no. 14 (April 12, 2021)

Doctors Care P.A., the largest urgent care provider network in South Carolina, and its management company, UCI Medical Affiliates of South Carolina Inc., will pay $22.5 million to settle false claims allegations, the U.S. Attorney’s Office for the District of South Carolina said April 8.[1] Doctors Care and UCI allegedly falsely certified that some urgent care visits were performed by providers who were credentialed to bill Medicare, Medicaid and TRICARE, which means the services weren’t performed by credentialed providers from 2013 to 2018, according to the complaint, the U.S. attorney’s office alleged. The case was set in motion by a whistleblower. Doctors Care and UCI didn’t admit liability in the settlement.

It’s springtime, and that means it’s time for a round of proposed Medicare payment regulations. As of press time, there are four, including the Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2022 and Updates to the IRF Quality Reporting Program[2] and the FY 2022 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2021 (FY 2022).[3] Visit the CMS newsroom at https://www.cms.gov/newsroom for more information on the other proposed payment regulations.

1 Department of Justice, U.S. Attorney’s Office for the District of South Carolina, “South Carolina’s Largest Urgent Care Provider and its Management Company to Pay $22.5 Million to Settle False Claims Act Allegations,” news release, April 8, 2021, https://bit.ly/3d4Kj7v.
2 CMS, “Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2022 and Updates to the IRF Quality Reporting Program,” proposed rule, accessed April 9, 2021, https://bit.ly/3s4FwHl.
3 CMS, “Medicare Program; FY 2022 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2021 (FY 2022),” proposed rule, accessed April 9, 2021, https://bit.ly/39VzqCW.

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