Billing Agent for Healthcare Provider Settles for $500,000 to Resolve TRICARE False Claims Act Case

Today, the Department of Justice U.S. Attorney’s Office for the Northern District of New York announced a settlement with Medical Reimbursement Systems, Inc. (“MRSI”) to resolve allegations that it violated the false claims act.  The press release can be found here. Medical Reimbursement Systems, Inc. provided billing, coding and full revenue cycle services for health care providers.  The settlement resolves allegations that MRSI submitted false claims on behalf of a client in Watertown, NY to the TRICARE program, the military health insurer.  The government contended that MRSI, who provided coding, billing physician education and data entry services for the practice, submitted false claims for the practice to TRICARE to receive bonuses intended for providers in a qualifying  Health Professional Shortage Area even though the practice was ineligible to receive these payments.

Danielle Holley, Esq. assisted in writing this blog post.  For more information about False Claims Act matters, contact David Ross who served as Acting New York State Medicaid Inspector General under Governors Pataki and Spitzer, as well as General Counsel, Deputy Medicaid Inspector General, and Director of Audits and Investigations for the Office of the Medicaid Inspector General.  He can be reached at (518) 462-5601 or via e-mail at dross@oalaw.com.


David Ross

About David Ross

David is Partner and concentrates his practice on Medicaid, Medicare and private insurance audits & investigations, Health Law including fraud and abuse, governmental investigations of all kinds, Medicaid compliance plans and Article 78 cases. He is head of our Government Investigations practice and also works in Healthcare Fraud & Abuse.