AG Rayfield: “It is a betrayal of public trust when any business or individual exploits their position for profit.”

Oregon Attorney General Dan Rayfield today announced a significant civil settlement reached by the Oregon Department of Justice’s Medicaid Fraud Unit (MFU) with Family Choice Urgent Care, LLC. Family Choice agreed to pay $489,280 to resolve allegations that they submitted false claims to the Oregon Medicaid program for medically unnecessary and unprovided services.

The settlement addresses claims that Family Choice improperly billed Medicaid for medically unnecessary office visits. It also resolves allegations that they billed for higher levels of visits than were actually provided for asymptomatic patients.

“It is a betrayal of public trust when any business or individual exploits their position for profit,” said Attorney General Rayfield. “I commend the Medicaid Fraud Unit for standing up to these fraudulent practices and protecting our Medicaid program—ensuring critical resources go to Oregon’s most vulnerable.”

The Medicaid Fraud Unit is charged with investigating and prosecuting Medicaid billing fraud and healthcare provider abuse or neglect. Over the past decade, the unit has secured over 250 criminal convictions, 100 civil settlements, and recovered more than $90 million. MFU’s total funding for the latest federal fiscal year (FFY 2024) was $4,602,858. Of that total, 75% or $3,452,144 was awarded under a grant from the U.S. Department of Human Services. The remaining 25%, totaling $1,150,714 was funded by the State of Oregon.

Senior Assistant Attorney General John Rothermich led this case for the ODOJ. The civil claims resolved here are allegations only and Family Choice denies the state’s allegations.

Report Fraud, Abuse & Neglect:

• Medicaid provider fraudemail: Medicaid.Fraud.Referral@doj.state.or.us
• Abuse or neglect: Call Oregon’s abuse reporting hotline at 1.855.503.SAFE (7233)
• If someone is in immediate danger, call 911