Urgent Care Chain MedExpress Sued for Billing Unnecessary and Upcoded Services during the COVID Pandemic

MedExpress, a subsidiary of UnitedHealth Group, is a large urgent care chain with more than 150 locations nationwide. A former employee and physician assistant filed a qui tam complaint under the Federal False Claims Act, the Virginia Fraud Against Taxpayers Act, and the New Jersey False Claims Act, blowing the whistle on MedExpress’s policy of billing to Medicare and Medicaid unnecessary and upcoded office visits for any patient who came in to request a COVID rapid test.

Specifically, the complaint alleged that MedExpress had a policy of requiring all Medicare and Medicaid patients to be seen by a provider for an office visit, even if they had no symptoms and also tested negative on the rapid test given at the clinic. The complaint further alleged that these unnecessary provider encounters, which lasted just a few minutes and involved minimal complexity and medical decision-making, were routinely upcoded and billed at a higher level of service than what was actually provided to the patients.

The judge in the case recently denied Defendant’s motion to dismiss as to the federal and Virginia claims, but granted the motion as to the New Jersey claims. Now the case moves into the discovery phase.

Read the complaint here, and the order on the motion to dismiss here.

Individuals with information about MedExpress or the practices alleged in the complaint may contact the whistleblower attorneys of Brown, LLC by calling (877) 561-0000.

Please note that the complaint and the description of the complaint are merely allegations and have not been proven as of this writing. The Defendant has not admitted to these allegations and is vigorously defending and contesting the allegations.