Laboratory Fraud

Clinical laboratories and independent diagnostic testing facilities – referred to as IDTFs – have often been defendants in False Claims Act cases brought by whistleblowers.

Types of Lab and Independent Diagnostic Testing Facility Fraud

Common types of fraud by laboratories and IDTFs include:

• Billing Medicare or Medicaid for medically unnecessary tests.
• Billing Medicare or Medicaid for testing performed without the treating physician’s consent or order.  A physician may order one simple test, but the laboratory may then bill for a complex “bundle” of tests, or may bill for a complex invasive exam, rather than the physcian-order screening exam.
• Unbundling tests normally billed as a single expense, and billing each test individually.
• Incentivizing physicians and other medical providers to obtain Medicare and/or Medicaid business in violation of the Stark Law and Anti-Kickback Statute
• Performing tests at an unlicensed facility, or misrepresenting where the tests were performed.
• Billing tests that were performed by unlicensed personnel, or misrepresenting who performed the test.

Contact a Whistleblower Lawyer for Help

Do you think you have a lab fraud whistleblower claim? Contact our experienced legal team today to discuss your options.