WATERTOWN, N.Y. -- An Albany based U.S. attorney says a Watertown medical group asked its billing company to submit more than 60,000 false claims to a military health insurer, and that company did.
TRICARE is the health care program for service members and their families. It gives a 10 percent bonus on reimbursements to physcians who provide care in understaffed areas or are in certain geographical areas.
Despite Watertown not qualifying in either scenario, North Country Emergency Medical Consultants -- which runs emergency care at Samaritan Medical Center -- had Logix Health of Massachusetts, known then as Medical Reimbursment Systems, submit 62,700 claims as if it did.
That happened over a five-year period from 2009 to 2014, despite a Logix employee warning the practice that it couldn't find any proof it was eligible. Logix went ahead anyway. North County Emergency received the bonus and paid a portion of that to Logix.
As part of one settlement announced by the U.S. attorney, Richard Hartunian, Logix has agreed to pay a $500,000 fine and provide extra employee training. North County Emergency Medical Consultants signed a separate settlement ordering the group to pay $991,338.23.