Archive

June 18, 2019

Nevada Heart & Vascular Center has agreed to pay $2.5 million to settle allegations that it accepted kickbacks from genetic testing companies, Natural Molecular Testing Corp. and Iverson Genetic Diagnostics, Inc., in exchange for referrals of Medicare patients. The alleged violations of the Anti-Kickback Statute and False Claims Act occurred for nearly a year in 2012. USAO NV

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Provider Fraud,

May 6, 2019

Acadia Healthcare Company, Inc., which operates outpatient drug treatment centers in West Virginia through its subsidiary CRC Health, L.L.C., will pay $17 million to resolve claims that it improperly billed the state's Medicaid program for urine and blood testing services as if they had performed the testing themselves, despite the fact that Acadia lacked the certification to perform the tests. In fact, the testing was performed by an independent outside laboratory, and that lab independently billed Medicaid for the tests, at a lower rate. Medicaid paid Acadia’s treatment centers $8,500,000 for the improperly-billed tests. As part of this settlement, defendants also entered into a five-year corporate integrity agreement to maintain specified compliance programs and procedures. USAO SDWV

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medicaid, Medical Billing Fraud,

May 3, 2019

Texas-based Decatur Hospital Authority, d/b/a Wise Health System, has agreed to pay $431,182.96 to the United States for billing Medicare for medically unnecessary genetic testing panels. The alleged False Claims Act violations had occurred between 2016 and 2018 and involved patient samples from Tennessee-based Total Diagnostic II, LLC. DOJ

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Medicare,

April 25, 2019

Two pain management clinics in Northern Virginia, National Spine and Pain Centers and Physical Medicine Associates, will pay $3.3 million to resolve a False Claims Act case first filed by a whistleblower who was a former physician assistant at one of the clinics. The clinics were alleged to have billed services provided by physician assistants and nurse practitioners as if they were provided by a physician, to have ordered medically-unnecessary urine drug tests, and to have submitted claims for urine drug testing that did not comply with the Stark Law and/or Anti-Kickback Statute. USAO EDVA

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

March 29, 2019

Acacia Mental Health Clinic and its owner, Abraham Freud, have agreed to pay $4.1 million to the United States and the State of Wisconsin for submitting false claims to Medicaid in violation of the False Claims Act. According to a qui tam complaint filed by whistleblower Rose Presser, Acacia billed for urine drug screens in simple "cup" tests as if a more sophisticated test had been performed. Acacia also billed for medically unnecessary and duplicative urine drug tests and telemedicine services performed by foreign-based psychiatrists in violation of Medicaid regulations. USAO EDWI

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Laboratory and IDTF, Medicaid, Medical Billing Fraud, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

March 15, 2019

Connecticut Behavioral Health Associates, P.C. and its principal, psychiatrist Bassam Awwa, who treat patients for substance abuse, will pay $3.3 million in a settlement with the federal government and Connecticut. Defendants allegedly billed Medicare and Medicaid for multiple drug screening tests per patient visit, instead of the single test authorized. In addition, defendants submitted bills for urine alcohol screening that were already a component of the single test, and for definitive urine drug tests that were not actually performed. USAO CT

Tagged in: Bundling and Unbundling, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medical Billing Fraud, Provider Fraud,

February 11, 2019

GenomeDx Biosciences Corp. has agreed to pay $1.99 million in connection with a whistleblower complaint by two former employees, which alleged that the genetic testing laboratory violated the False Claims Act in its submissions to Medicare. According to the unnamed whistleblowers, from 2015 to 2017, GenomeDx submitted reimbursement claims for running a post-operative genetic test on prostate cancer patients, even though that population did not have risk factors that called for the test. They will share in a $348,316.50 award as part of the settlement. USAO SDCA

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medicare, Whistleblower Case,

January 30, 2019

Inform Diagnostics, formerly known as Miraca Life Sciences Inc., will pay $63.5 million to resolve allegations that it violated the False Claims Act, Anti-Kickback Statute and Stark Law. The pathology laboratory company provided referring physicians with subsidies for electronic health records systems, as well as free or discounted technology consulting services, which were alleged to constitute improper financial relationships not subject to any safe harbor. Three separate whistleblowers had filed qui tam lawsuits against the laboratory; they will receive a share of the settlement that is yet to be determined. DOJ; USAO MDTN

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Whistleblower Case, Whistleblower Rewards,

December 19, 2018

Molecular Testing Labs, based in Vancouver, Washington, has agreed to settle claims that it violated the False Claims Act by paying local laboratories in exchange for referrals, in violation of the Anti-Kickback Statute. The amount of the settlement will be determined in ongoing litigation between Molecular Testing Labs and CMS, and could be between $180,000 and $1,777,738. USAO WDWA

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF,

November 28, 2018

Dr. Thomas Baker, Dr. Carolyn Kochert, Dr. Larry L. Zhou, and Dr. Julie Y. Chao, have agreed to settle with the United States Government for violation of the Federal False Claims Act, the Physician Self-Referral law (“Stark”), and the Anti-Kickback Statute due to their involvement in a kickback scheme with Southwest Laboratories and Medscan Laboratory, thus causing false claims to be submitted to Medicare. The four physicians will pay a total amount of over $1.5 million. The individual amounts paid are as follows: Dr. Baker, of Tennessee - $484,481.80; Dr. Kochert, of Indiana - $129,682.84; Dr. Zhou, of Kentucky - $277,758.18; Dr. Chao, of Indiana - $650,000. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medicare, Provider Fraud,

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