Laboratory and IDTF

January 25, 2018

Primex Clinical Laboratories, LLC agreed to pay $3.5 million to settle claims it violated the False Claims Act and Anti-Kickbacks Statue by paying kickbacks in exchange for laboratory referrals for patient pharmacogenetic testing. The allegations originated by a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former sales reps Don Pyburn and David Choate. They will receive a whistleblower award of $754,000 from the proceeds of the government’s recovery. DOJ (NDTX)

December 21, 2017

Rhode Island-based Dominion Diagnostics, Inc. agreed to pay $815,000 to resolve claims of violating the False Claims Act by presenting claims to Medicare and Vermont Medicaid for urine specimen validity testing when referring physicians did not specifically order the testing. DOJ (DVT)

December 12, 2017

Mobile imaging companies PDQ Imaging Services, LLC, PDQ Ultrasound Services, LLC, PDQ Mobile X-Ray Services, PDQ Mobile X-Ray, LLC, along with their owners Dennis Whitsell and Jonathan Graham Lane, agreed to pay $300,000 to settle charges of violating the False Claims Act and Anti-Kickback Statute by improperly billing Medicare for transportation charges related to portable x-ray services and paying kickbacks to skilled nursing facilities in exchange for patient referrals. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Kevin P. McDonough and Boyd K. Billington. They will receive a whistleblower award of roughly $60,000 from the proceeds of the government's recovery. DOJ (EDTX)

October 20, 2017

Jacksonville-based toxicology lab Total Lab Care, LLC agreed to pay $212,500 to resolve allegations it violated the False Claims Act and Anti-Kickback Statute by improperly paying a physician for referring toxicology samples.  DOJ (MDFL)

September 11, 2017

Family Medicine Centers of South Carolina LLC agreed to pay $1.56 million, and the company's principal owner and former CEO Dr. Stephen F. Serbin and its former Laboratory Director Victoria Serbin, agreed to pay $443,000 to settle charges they violated the False Claims Act and Stark Law.  Specifically, the government alleged FMC’s incentive compensation plan improperly paid FMC’s physicians a percentage of the value of laboratory and other diagnostic tests that they personally ordered through FMC.  Dr. Serbin allegedly initiated this program and reminded FMC’s physicians that they needed to order tests and other services through FMC in order to increase FMC’s profits and to ensure that their take-home pay remained in the upper level nationwide for family practice doctors.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former FMC physician Dr. Catherine A. Schaefer.  She will receive a whistleblower award of $340,510 from the proceeds of the government's recovery. DOJ

June 20, 2017

New Jersey family doctor Bernard Greenspan was sentenced to 41 months in prison and to pay a $125,000 fine and a roughly $200,000 forfeiture for violating the Anti-Kickback Statute by accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC, its president and numerous associates. Greenspan’s referrals generated approximately $3 million in lab business for BLS. DOJ (DNJ)

May 11, 2017

Benefits management company Carecore National LLC agreed to pay $54 million to settle charges of violating the False Claims Act by submitting Medicare and Medicaid claims for medical diagnostic procedures without properly assessing whether they were necessary or reasonable.  CareCore provides utilization management services including determinations of medical necessity to New York Medicaid Managed Care Organizations (MCOs). The agreement settles allegations that CareCore instituted a scheme to auto-approve or “Process As Directed” (“PAD”) hundreds of radiology service requests on a daily basis, deeming those diagnostic services as reasonable and medically necessary, even though there had been no evaluation of those cases by the appropriate medical personnel. Of the $54 million, $18 million will go to 20 state Medicaid programs. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblower will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery. DOJ (SDNY); NY, FL

May 1, 2017

Memphis-based Poplar Healthcare PLLC and Poplar Healthcare Management, LLC agreed to pay $897,640 to resolve allegations they violated the False Claims Act by billing the government directly and through a subsidiary known as GI Pathology for diagnostic tests not medically necessary. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Poplar pathologist Gordon Wang. He will receive a whistleblower award of roughly $206,000 from the proceeds of the government's recovery. DOJ (DRI)