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VRA Enterprises to Pay $17M for Medicare COVID Test Billing Scheme

VRA Enterprises, LLC dba Precision Rx (VRA), a pharmacy located in Tampa, Florida, has agreed to pay the United States $17,069,371 to resolve allegations that it violated the False Claims Act (FCA) by knowingly submitting or causing the submission of false claims to Medicare for Over-The-Counter (OTC) Covid-19 tests that were not provided to beneficiaries, or that were sent to beneficiaries months after VRA had billed them to Medicare. Between April 2022 and May 2023, VRA distributed OTC Covid-19 tests in connection with the Centers for Medicare & Medicaid Services (CMS) OTC Covid-19 Test Demonstration Project (Demonstration Project). During the Demonstration Project, Medicare Part B beneficiaries could request OTC Covid-19 tests from participating providers, such as VRA, and CMS would reimburse those providers for up to eight OTC Covid-19 tests per beneficiary per month, at a fixed rate of $12 per test.

The settlement resolves allegations that VRA knowingly submitted or caused the submission of false claims to Medicare for OTC Covid-19 tests in connection with the Demonstration Project. The United States contends that, between August 2022 and May 2023, VRA submitted claims to Medicare for OTC COVID-19 tests that it did not provide to beneficiaries. The United States also contends that, in January 2023, VRA submitted approximately 136,491 claims to Medicare for OTC COVID-19 test it did not ship to beneficiaries until April 2023. VRA received thousands of complaints from beneficiaries during the Demonstration Project about missing OTC COVID-19 tests. VRA also repeatedly acknowledged internally that it had “billed Medicare” for tests it “failed to ship” and should “issue a refund” to Medicare “immediately” for such tests, but did not do so. As a result of this conduct, the United States contends that VRA knowingly submitted or caused to be submitted false claims to the Medicare Program in violation of the False Claims Act.