Source: Office of United States Attorneys
Urgent Care Operator Bloom Care LLC and its owners have paid $3,000,000 to resolve allegations that they billed for unnecessary testing and inflated the extent of services performed.
BOISE – Bloom Care LLC and its owners have paid $3,000,000 to resolve allegations that they violated the False Claims Act by submitting false claims to Federal healthcare programs for medically unnecessary testing and for inflating the extent of services performed. Bloom operated Urgent Care centers in Idaho and New Mexico throughout the COVID-19 pandemic.
The United States alleged that Bloom knowingly used the COVID-19 pandemic as an excuse for billing for medically unnecessary streptococcus and influenza tests for asymptomatic patients. Additionally, the United States contends that Bloom submitted claims for high-level evaluation and management services for COVID-19 patients when Bloom knew that the services should have been billed at a lower level of service that would have been reimbursed at a lower rate. To justify these high reimbursement claims, the United States contends that Bloom exaggerated the time spent with COVID-19 patients and/or the complexity of the evaluation required to care for these patients.
“The Department of Justice is committed to identifying waste, fraud, and abuse in federal programs,” said Acting U.S. Attorney Justin Whatcott. “I commend the federal and state agencies that investigated this case, as their important efforts protect taxpayer dollars.”
“Healthcare providers participating in federal health care programs must follow all relevant laws and rules when submitting claims – and certainly not order medically unnecessary services to boost their profits,” said Acting Special Agent in Charge Jeffrey McIntosh of the U.S. Dept. of Health and Human Services Office of Inspector General (HHS-OIG). “This settlement shows HHS-OIG’s enduring commitment to protecting the integrity of federal health care programs and the people who rely on them. We will continue to collaborate with our law enforcement partners to investigate allegations brought under the False Claims Act.”
“Companies that provide services to veterans will be held to the highest standards of integrity, professionalism, and accountability,” said Special Agent in Charge Dimitriana Nikolov with the Department of Veterans Affairs Office of Inspector General’s Northwest Field Office. “Submitting claims for medically unnecessary services will not be tolerated, and the VA OIG will continue to work with our law enforcement partners to hold wrongdoers accountable and ensure veterans receive the quality healthcare they deserve.”
This matter was investigated jointly by the U.S. Attorney’s Office for the District of Idaho, the U.S. Department of Health and Human Services Office of the Inspector General, and the United States Department of Veterans Affairs Office of the Inspector General. Additional assistance was provided by the Idaho Department of Health and Welfare. Assistant United States Attorney Elliot Wertheim handled this case.
The claims resolved by the settlement against Bloom Care LLC are allegations only and there has been no admission or determination of liability.
On May 17, 2021, the Attorney General established the COVID-19 Fraud Enforcement Task Force to marshal the resources of the Justice Department in partnership with agencies across government to enhance efforts to combat and prevent pandemic-related fraud. The task force bolsters efforts to investigate and prosecute the most culpable domestic and international criminal actors and assists agencies tasked with administering relief programs to prevent fraud by augmenting and incorporating existing coordination mechanisms, identifying resources and techniques to uncover fraudulent actors and their schemes, and sharing and harnessing information and insights gained from prior enforcement efforts. For more information on the department’s response to the pandemic, please visit www.justice.gov/coronavirus.
Anyone with information about allegations of attempted fraud involving COVID-19 can report it by calling the Justice Department’s National Center for Disaster Fraud (NCDF) Hotline at 866‑720‑5721 or via the NCDF Web Complaint Form at www.justice.gov/disaster-fraud/ncdf-disaster-complaint-form.
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