By Kevin Deutsch
A Coral Springs company has agreed to pay $3.15 million in settlement money to resolve allegations it submitted false Medicare claims to the government after a whistleblower revealed the alleged lawbreaking, prosecutors said.
VirtuOx, Inc, which operates Medicare-approved diagnostic testing facilities, allegedly violated the U.S. False Claims Act by falsely identifying the location for “certain services it performed to obtain a higher rate of reimbursement from Medicare” between January 2016 and December 2020, according to a May 19 announcement from the Department of Justice.
With headquarters at 5850 Coral Ridge Dr., the company knowingly submitted false claims to Medicare identifying its diagnostic facilities located in San Francisco as the site where it performed overnight pulse oximetry tests when, in fact, no such services were performed at that location, the government’s lawyers said.
VirtuOx did administer overnight pulse oximetry tests as part of its business but, at times, also billed Medicare for single determination pulse oximetry tests—commonly referred to as an oxygen “spot check”—for the same patient, even though the only test performed was the overnight test, according to DOJ.
Along with the civil settlement, VirtuOx entered into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services’ Office of Inspector General. The five-year agreement requires VirtuOx to retain an outside expert to perform annual claims reviews that address the place of service identified on Medicare claims, prosecutors said.
According to its website, VirtuOx is a healthcare information technology company that provides diagnostic tools and services that enable various healthcare organizations and professionals to diagnose and treat diseases.
“The fraudulent billing of Medicare results in systemically higher medical care costs for all,” said Juan Antonio Gonzalez, United States Attorney for the Southern District of Florida. “My Office will continue to hold accountable those health care providers who manipulate the system to benefit their own bottom line.”
The company’s allegedly illegal activities were revealed following a lawsuit filed by whistleblower Amber Watt in federal court in Miami.
The lawsuit was filed under the whistleblower provisions of the False Claims Act, which permits private individuals to sue on behalf of the government for false claims and to share in any monetary recovery.
The whistleblower share to be awarded in connection with the settlement is $630,000, according to DOJ.
“By submitting false claims to Medicare, providers waste valuable taxpayer dollars and undermine the integrity of federal health care programs,” said Special Agent in Charge Omar Pérez Aybar of the Department of Health and Human Services’ Office of Inspector General.
- Kevin Deutsch is an award-winning crime journalist and author. A graduate of Florida International University, Kevin has worked on staff at The Miami Herald, New York Daily News, and The Palm Beach Post.
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