United States Intervenes in False Claims Act Lawsuit Against Colorado Medical Companies

The United States Attorney’s Office for the District of Colorado announces that the United States has intervened in a whistleblower lawsuit in the United States District Court for the District of Colorado. The United States alleges in its complaint that three Colorado healthcare companies—Front Range Urgent Care, Inc., Comfort Care Family Practice, Inc., and QwikCareMD, LLC (together, QwikCare)—and two individuals, Anita Weiscamp, and Steven L. Wenrich, M.D., engaged in a scheme for nearly a decade to submit fraudulent claims for payment under federal health insurance programs. Specifically, the complaint alleges that the defendants submitted inflated claims for payments using Dr. Wenrich’s provider number even when Dr. Wenrich did not provide nor supervise any services for which the claims were submitted. The complaint names Front Range Urgent Care, an urgent care medical practice, Comfort Care Family Practice, a family care medical practice, both of which have their primary places of business in Colorado Springs, Colorado. Both entities were established by a doctor, Dr. Steven Wenrich, who later passed away. The complaint also names QwikCareMD, a company that provided medical management services to Front Range Urgent Care and Comfort Care Family Practice. QwikCareMD was established by Dr. Wenrich’s spouse, Anita Wiescamp. The case involves payments by Medicare and TRICARE, which are federal healthcare programs. Medicare provides health benefits to individuals ages 65 and older as well as to certain other individuals with qualifying conditions. Medicare has several parts, including Part B, which provides benefits to Medicare participants to cover the costs of services provided by physicians and other practitioners, among other things . TRICARE provides health benefits to U.S. Armed Forces civilian personnel, military retirees, and their dependents. Under Medicare Part B and TRICARE, the federal government pays healthcare providers for covered services on a fee-for-service basis. In particular, the federal government pays more for physicians to provide services than for nurse practitioners or physician assistants to provide those same services. The complaint alleges that defendants violated the False Claims Act by knowingly submitting false claims under Dr. Wenrich’s physician provider number when Dr. Wenrich did not provide or supervise services for which the claims were submitted. Instead, the services were actually provided by nurse practitioners or physician assistants. The complaint alleges that the defendants fraudulently submitted tens of thousands of these inflated requests for payments. These false claims caused the federal government to pay significantly more for the services that were provided by defendants than Medicare and TRICARE otherwise should have paid. “Our federal healthcare system relies on honest billing,” said U.S. Attorney Peter McNeilly for the District of Colorado. “When companies overbill Medicare and TRICARE by fraudulently submitting inflated requests for payments, they jeopardize important benefits for others under those programs. We will not tolerate such conduct.” “Fraudulent billing that exploits Medicare is not an error, but deliberate misconduct that steals from a program that millions of Americans depend on,” said Special Agent in Charge Linda T. Hanley with the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Schemes that knowingly misrepresent who provided care in order to obtain higher reimbursement — as alleged in this case — are a direct attack on the integrity of federal health care programs, including Medicare. HHS‑OIG will continue to pursue allegations of fraud aggressively, working relentlessly with our law enforcement partners to ensure those who commit health care fraud are held fully accountable.” “Healthcare fraud committed against TRICARE, our military’s healthcare benefit program – including schemes in which services are billed at a higher level than what was actually provided – undermines military readiness by diverting critical resources away from beneficiaries who genuinely need medical care,” said Chad Gosch, Special Agent in Charge of the Defense Criminal Investigative Service’s (DCIS) Southwest Field Office. “As the investigative arm of the Department of Defense’s Office of Inspector General, DCIS remains steadfast in our commitment to holding accountable those who illegally compromise the integrity and effectiveness of TRICARE for personal gain.” The lawsuit was originally filed by former employees of QwikCare under the qui tam , or whistleblower, provisions of the False Claims Act. Those whistleblower provisions permit private parties to sue on behalf of the United States based on the submission of false claims to the government. The False Claims Act authorizes the United States to investigate the allegations made by such private parties and, if it elects to do so, to intervene in a whistleblower lawsuit and take over primary responsibility for litigating it, as the United States has done here. The Act permits the government to recover three times its damages, plus civil penalties. The private plaintiffs are then entitled to receive a share of any funds recovered through the United States’s lawsuit. This matter was investigated by the U.S. Attorney’s Office for the District of Colorado, the Department of Health and Human Services’ Office of Inspector General, and the Defense Criminal Investigative Service. The claims asserted against defendants are allegations only, and there has been no determination of liability. The lawsuit is captioned United States ex rels. Young, M.D. and Perez v. Anita Weiscamp., et al ., No. 20-cv-02514-DDD-MDB (D. Colo.).