NextCare, Arizona-Based Urgent Care Center Company, to Pay $10 Million to Feds for Filing False Claims

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Image: www.asu.edu
John Shufeldt, former CEO for NextCare urgent care clinics, threatened to fire managers who didn't meet a quota for giving allergy tests to patients who didn't need them, a lawsuit states. Today, the Justice Department announced that the company agreed to pay a $10 million penalty for billing Medicare and Medicaid for the unnecessary tests.

NextCare, a nationwide urgent-care-center company based in Phoenix, has agreed to pay the feds $10 million for submitting false claims to Medicare, Medicaid and other federal health-care programs.

We had no idea turning in corrupt corporations could be so lucrative: The informant in this case, former NextCare employee Lorin Cohen, will be paid $1.6 million "for her share of the recovery," according to a U.S. Justice Department news release.

That's even better than a lottery jackpot, because Cohen knows her willingness to step up means the company may put a halt to its taxpayer-fleecing ways.

NextCare routinely billed federal health-care agencies for "unnecessary allergy, H1N1 virus and respiratory panel testing."

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A call to the company's corporate office in Mesa was not returned.

Health-care providers are allowed to be reimbursed by federal programs only for medically necessary procedures.

We're not sure why Cohen got all the money, because a 2011 civil case against NextCare also alleging the company filed false claims was instigated by a Surprise man named Antonio Saidiani. A spokesman with the DOJ said he'd check on our question and get back tous.

In the 2011 lawsuit, Saidiani, who worked as a manager overseeing operations in eight Arizona NextCare urgent care centers, alleges that the company was tight on cash in 2008 and early 2009, so it embarked on a series of "testing initiatives" that lasted until at least April of 2010, when Saidiani left the company.

The initiatives instructed employees at NextCare facilities to conduct allergy tests on "all patients regardless of the condition that brought them in." Patients getting allergy tests would also receive a routine spirometry test that measures lung function. And if a patient exhibited cold or flu symptoms, they were always tested for H1N1 "swine flu," the lawsuit states.

Those medically unnecessary tests allegedly defrauded the government of tens of millions of dollars.

Staff members were told to recommend an allergy test for every man, woman and child to come into the clinic with the slightest sniffle, the lawsuit alleges. For those who agreed, the test involved pricking the skin with 62 different allergens and examining the body's response. Patients were notified that their insurance would pick up the tab for the test.

The lawsuit quotes from a 2009 e-mail sent to senior managers by former NextCare CEO John Shufeldt, who told employees the "dew is off the rose" as far as stockholders in the private company are concerned, and that revenue-enhancing, universal allergy tests could save the company.

"I cannot stress how important this program is [to] our financial well-being," Shufeldt wrote.

The CEO threatened that managers who failed to meet a monthly quota for the allergy tests would be fired, the lawsuit states.

NextCare replaced Shufeldt as CEO in June 2010 with Phoenix native John Julian.

From the sound of it, even with the $10 million penalty, NextCare still came out ahead on this one.

Click here to read the NextCare lawsuit alleging false claims.

UPDATE: Charles Miller with the DOJ got back to us later, saying that Cohen had filed a similar lawsuit before Saidiani. The reward for whistleblowers is on a first-come, first-serve basis, Miller explains, so only Cohen gets the jackpot.

Scroll down for statement by NextCare:


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4 comments
Sharonhall
Sharonhall

 Yes baby you hit the spot.. And while they are getting a new staff get some employees that look like something not from around the way down the dirt road because googling the company whew baby they look like who done it and why my goodness they look like they dont even wash their hands .

William7980890
William7980890

Yes Thank God for Victory. Nextcare has been robbing people for years. I feel bad for the employees working there because it is a recession. No advancement for you all. You will be stuck and stuck I would not work for a company who is robbing my tax dollars duh! Doesnt make since. No one likes you guys and the ratings are horrible. You will not go further than where you are at. And the employees that work for you all are dum as hell. John Julian think with your head and not your ass get some new employees . They have laid off hundreds of employees and force employees to work the front and the back as well for 12$ an hour. And if you are dum you will do it. Maybe a year down the line all the clinics will close. I live in Virginia and it is everywhere. People are talking about it in the streets. Also how BCBS sued you all for doing that too. Just close down its over. Also there is 1 manager to 5 clinics now how do you do that bloodsuckers go fuck yourself its a whole lot cheaper because thats all you all are worth. Also Scott cover your Gray Nextcare is getting to you.. Haha.How about putting Nextcare on your resume it will get you nowhere. you messed with the feds you have messed with it all its over and they will be on your ass like white on  rice.. Stay on the train tracks muthafuckers!!!! 

ExpertShot
ExpertShot

What we need is a co-operatively owned health care system.  It's a privately owned corporation but it is owned equally by all shareholders - no one can control it to their own ends.

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