Laboratory and IDTF
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May 19, 2022
Healthcare testing company VirtuOx, Inc. agreed to pay $3.15 million to resolve claims brought in an action initiated by a whistleblower alleging that falsely billed Medicare for pulse oximetry testing. VirtuOx allegedly reported San Francisco as the location for overnight pulse oximetry testing when, in fact, no services were performed at that location, but that location resulted in a higher Medicare reimbursement. In addition, VirtuOx allegedly billed Medicare for both oxygen “spot checks” and overnight pulse oximetry testing, when only the overnight testing was performed. The whistleblower, Amber Watt, will receive an award of $630,000. USAO SD FLMarch 31, 2022
Clinical laboratory Radeas LLC has agreed to pay $11.6 million to resolve claims that it submitted false claims to Medicare for medically-unnecessary urine drug tests. As part of the settlement agreement, Radeas admitted that it regularly performed and billed Medicare for essentially simultaneous presumptive qualitative drug testing and confirmatory quantitative drug testing. Without physician review of a presumptive test result, the separate, simultaneous confirmatory test was often not necessary. Radeas also admitted that it paid third-party sales organizations based on the volume of UDT referrals in violation of the Anti-Kickback Statute. USAO MAMarch 22, 2022
Ten doctors in Texas and a healthcare executive have agreed to pay nearly $1.7 million to resolve allegations of violating the False Claims Act, Anti-Kickback Statute, and Stark Law. In exchange for ordering laboratory tests from Rockdale Hospital d/b/a A little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation, the doctors allegedly received thousands of dollars in kickbacks disguised as investment returns. USAO EDTXMarch 8, 2022
Eugene Sisco, III of Kentucky, the owner and operator of several medication assisted treatment (MAT) clinics for opioid addiction, has been sentenced to over 10 years in prison and ordered to pay $5.7 million in restitution, after being convicted of healthcare fraud. Sisco was found to have tricked Medicaid patients into paying hundreds of dollars in cash each month for MAT services which he later billed and was reimbursed by Medicaid for. Sisco’s laboratory, Toxperts, LLC, was also found to have billed Medicare for medically unnecessary urine drug tests, causing a loss of over $2 million to CMS. USAO EDKYMarch 7, 2022
Redwood Toxicology Laboratory has agreed to pay nearly $4.8 million to settle allegations that the California-based urine drug testing service overcharged the Connecticut Medicaid program for certain laboratory services, in violation of Connecticut’s “Most Favored Nation” regulation, which provides that the state should not be charged more than the lowest price charged to third parties. The settlement covered claims submitted between January 2015 through February 2018. USAO CTFebruary 10, 2022
Bradley Jason Kantor, 49, will spend 10 years in federal prison after being found guilty of paying kickbacks for referrals to his immunotherapy and antigen business, Mobile Diagnostic Imaging, Inc. (MDI). MDI received more than $12 million from the scheme in which MDI submitted approximately $42 million in false claims to United Healthcare, for which services were never rendered. USAO SDFLJanuary 20, 2022
A three-year-long kickback scheme effectuated by a hospital executive and seven doctors will net the DOJ a $1.1 million settlement and their continued cooperation in the investigation of and litigation against other parties. The Stark Law and Anti-Kickback Statute violations occurred over a three-year period, wherein management service organizations (MSOs) paid volume-based commissions kickbacks for ordering laboratory tests from Rockdale Hospital d/b/a Little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation. Jaspaul Bhangoo, M.D., Robert Megna, D.O., Baxter Montgomery, M.D., Murtaza Mussaji, D.O., David Sneed, D.O., Kevin Lewis, D.O., and Angela Mosley-Nunnery, M.D. will all contribute to the settlement. Additionally, Richard Defoore, former CEO of Jones County Regional Healthcare d/b/a Stamford Memorial Hospital, also agreed to pay into the settlement fund for his contribution to the scheme. USAO EDTXTop Ten Healthcare Fraud Recoveries of 2021
Posted 01/11/22
