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Laboratory and IDTF

This archive displays posts tagged as relevant to laboratories and independent diagnostic testing facilities. You may also be interested in our pages:

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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

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

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

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

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

Catch of the Week – Inform Diagnostics

Posted  02/1/19
Technician in laboratory safety wear using eyedropper to fill vials of blood
Texas-based pathology laboratory company Inform Diagnostics, formerly known as Miraca Life Sciences Inc., agreed on January 30th to a $63.5 million settlement to resolve allegations it violated the False Claims Act (“FCA”), the Anti-Kickback Statute (“AKS”), and the Stark Law by providing subsidies to referring physicians for electronic health record (“EHR”) technology as well as free or discounted...

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

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

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
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