Peachtree Immediate Care FP, LLC

Peachtree Immediate Care FP, LLC, part of CRH Healthcare, LLC, agreed to pay $1.6 million to settle allegations under the False Claims Act (FCA). These allegations accused the Georgia-based urgent care chain of submitting improperly upcoded Evaluation and Management claims to Medicare for the testing and treatment of patients with suspected exposure to COVID-19 during the pandemic[2][3]. The settlement was the result of lawsuits filed by former employees under the whistleblower provisions of the FCA, which allows private citizens to sue on behalf of the United States for false claims and share in any recovery[1][3].

The allegations centered on the practice of “upcoding,” where healthcare providers submit codes for more severe conditions than diagnosed to receive higher reimbursement from Medicare[4]. This practice was particularly scrutinized in the context of COVID-19 testing and treatment, where the urgent care chain was accused of billing for doctor visits that allegedly never occurred, using billing codes indicating a patient was seen by a doctor when, in fact, they were seen and swabbed by lower-level staff like nurse practitioners or medical assistants[8].

Despite the settlement, CRH Healthcare and Peachtree Immediate Care did not admit to any wrongdoing. CRH Healthcare stated that settling was in the best interest of their business and the communities they serve, allowing them to put the matter behind them[4]. The whistleblowers involved in bringing the allegations forward will share in $320,000 from the settlement[1][3][5].

This case highlights the ongoing efforts by the U.S. Department of Justice, the Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation to combat fraud, waste, and abuse within federal programs, including Medicare, especially in the context of the COVID-19 pandemic[1][2][3].

Citations:

1. https://www.justice.gov/usao-ndga/pr/georgia-urgent-care-chain-agrees-pay-1600000-resolve-false-claim-act-allegations
2. https://oig.hhs.gov/fraud/enforcement/georgia-urgent-care-chain-agrees-to-pay-1600000-to-resolve-false-claim-act-allegations/
3. https://www.lawcommentary.com/articles/georgia-based-urgent-care-chain-to-pay-16m-in-whistleblower-false-claims-act-lawsuit
4. https://www.valdostadailytimes.com/news/local_news/urgent-care-chain-settles-allegations-of-false-medicare-claims/article_ba7157ae-111d-11ee-a923-a361788908c1.html
5. https://www.dallaswhistleblowerlawyer.com/blog/georgia-healthcare-whistleblowers-to-share-320000-award-for-medicare-fraud-allegations/
6. https://sky963.com/georgia-urgent-care-chain-agrees-to-pay-1600000-to-resolve-false-claim-act-allegations/
7. https://compliancy-group.com/november-healthcare-breaches/
8. https://www.ajc.com/news/health-news/peachtree-immediate-care-to-pay-16m-to-settle-overbilling-lawsuit/SUUB4Z2MTBFIJOLF6GV7KH3B54/