The Austin Emergency Center and its affiliates have agreed to pay out a hefty sum in a settlement over false claims allegations. After being accused of overbilling a healthcare program for federal employees, the medical service provider will fork over $429,231 to the United States. This payout aims to resolve allegations that involved heightened charges to the Federal Employees Health Benefit Program (FEHBP), as Austin Emergency Center submitted claims for COVID-19 tests at rates exceeding those for cash-paying patients from June 18, 2020, through April 2, 2021.
Also caught in the crosshairs of their questionable billing practices was drive-through COVID-19 screening services, where it's alleged the center engaged in up-coding the evaluation and management services from April 13, 2020, through April 2, 2021. While facing the financial strains of the pandemic, this company seemed to have found a lucrative, if not ethically compromised, avenue. According to U.S. Attorney Justin R. Simmons for the Western District of Texas in a statement obtained by the Department of Justice, “Financially capitalizing on crisis and the fear and misfortune of others is at the heart of every unlawful act committed by the worst elements of our society."
The investigation, which was spearheaded by the Office of Personnel Management (OPM) Office of the Inspector General (OIG), places the Austin Emergency Center and its affiliates firmly in the spotlight. Special Agent in Charge Derek M. Holt of the OPM OIG stated in the business of healthcare, exploiting federal employees' health benefits for profit, which the taxpayers ultimately foot the bill for, should never be part of their bottom line. He noted, "During a public health emergency, providers exploited federal employees’ health benefits for profit at the taxpayers’ expense."
The settlement was negotiated on behalf of the government by Assistant U.S. Attorney Thomas Parnham, marking yet another instance where the Department of Justice has had to step in to correct actions taken by healthcare providers in the tumultuous times of a pandemic. The Department of Justice continues its pursuit to recover "stolen pandemic-era funds on behalf of the American people," reflecting this ongoing commitment by holding those exploiting the system accountable.
