Dallas medical clinic to pay $7.5 million to resolve COVID-19 testing overbilling allegations

DALLAS - United States Attorney for the Northern District of Texas Ryan Raybould announced today that Aymancare PLLC, a medical clinic with offices in the Dallas area, agreed to pay $7.5 million to resolve allegations that it violated the False Claims Act by overbilling the federal government in connection with COVID-19 testing services performed for uninsured patients.

"Aggressively investigating and pursuing healthcare fraud is a top priority for my office," said U.S. Attorney Ryan Raybould. "We will use all available tools, including through civil enforcement mechanisms like the False Claims Act, to identify and recover any healthcare dollars lost to fraud, waste or abuse-the American taxpayer deserves no less."

"Ensuring that federal funds dedicated to the COVID-19 response are used appropriately remains a core oversight priority for HHS-OIG," said Jason E. Meadows, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General. "Billing for services that were never provided is a blatant abuse of the health care system and diverts critical resources away from patients who genuinely need them. We will continue working with our law enforcement partners to hold accountable those who exploit federal programs and to safeguard taxpayer dollars."

As alleged by the United States, Aymancare operated "pop-up" testing sites during the COVID-19 pandemic and advertised "free" COVID testing that was in fact paid for by the federal government through a program for uninsured patients operated by the Health Resources and Service Administration - the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program.

The United States alleged that, in addition to billing the government for the specimen collection and testing services that were provided through these testing sites, Aymancare also billed the government for separate "E&M services" (evaluation and management services, which typically represent services like office visits) as if the patients had been seen by a medical provider for some separate treatment or visit, when in fact no such separate services were performed. All that occurred during the testing encounters was that a technician or other personnel used nasal swabs to administer the COVID-19 tests.

The resolution obtained in this matter was the result of a coordinated effort between the U.S. Attorney's Office for the Northern District of Texas and the U.S. Department of Health and Human Services, Office of Inspector General.

This year, the Trump Administration launched the Task Force to Eliminate Fraud and the National Fraud Enforcement Division to enhance the Administration's war on fraud, waste, and abuse in federal programs. When unscrupulous actors exploit these programs for their own financial gain, they defraud the government, harm the people these programs are designed to aid and protect, and undermine American businesses that play by the rules. The Civil Division's False Claims Act enforcement plays a critical role in combatting such fraudulent schemes, recovering billions of dollars for the American taxpayers, and holding wrongdoers accountable. False Claims Act matters will continue to be on the forefront of the battle against fraud, and the Civil Division's False Claims work will support and advance the mission of the Task Force to Eliminate Fraud and the National Fraud Enforcement Division.

The matter was handled by Assistant U.S. Attorney Brian Stoltz.

The civil claims settled by the agreement are allegations only, and there has been no determination of civil liability.

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