Tri-Area Community Health has agreed on Apr. 27 to pay $513,729.90 to the United States to resolve allegations that it improperly billed Medicare for Annual Wellness Visits. The organization, located in Laurel Pike, Virginia, had already repaid $321,075.56 toward the total settlement amount.
Tri-Area Community Health is a Federally Qualified Health Center with six independent clinic locations within the Western District of Virginia. The center provides Annual Wellness Visits for Medicare beneficiaries and submits claims for these services.
According to authorities, from August 2022 through December 2025, Tri-Area Community Health allowed pharmacists to conduct Annual Wellness Visits without physician oversight or presence—either physically or virtually—and billed these visits under physicians’ names who were not involved in the appointments. Officials said Tri-Area Community Health cooperated with the investigation by conducting an internal review and helping identify claims that were reimbursed improperly.
The resolution was achieved through collaboration between the U.S. Attorney’s Office for the Western District of Virginia, the Department of Health and Human Services Office of Inspector General (HHS-OIG), and other federal agencies. First Assistant United States Attorney Robert N. Tracci and Special Agent in Charge Maureen Dixon of HHS-OIG announced the agreement.
Assistant U.S. Attorney Matthew G. Howells led the investigation with assistance from HHS-OIG staff members.
The U.S. Attorney for the Western District of Virginia promotes public safety and community well-being through crime prevention and outreach according to its official website. The office operates sites in Roanoke, Charlottesville, Abingdon, Lynchburg, Danville and Harrisonburg according to its official website, covering much of western Virginia according to its official website. It is part of the U.S. Department of Justice according to its official website and handles federal prosecutions as well as civil litigation on behalf of the government according to its official website. The office also partners with law enforcement at all levels in efforts aimed at improving public safety according to its official website.
Officials clarified that “the claims resolved by the settlement are allegations only and there has been no determination of liability.”
