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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:

Page 5 of 15

Catch of the Week: Classic Medicare Fraud

Posted  11/5/21
medicare dollars
For those like your correspondents who spend their days deep in the weeds of complex Medicare fraud, it’s a delight when something refreshingly simple comes along.  Thanks to Billy Joe Taylor of Arkansas, we can relax this Friday with a cool glass of straightforward Medicare fraud.  For allegedly making $100 million in claims to CMS for tests that were not ordered or ever performed, he is our Catch of the...

Tagged in: Catch of the Week, COVID-19, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Provider Fraud,

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Catch of the Week: Fraudulent Sleep Tests in Fresno

Posted  10/29/21
bed with pillow and sheets scattered
Fraud permeates through all aspects of America’s healthcare system- from hospitals to big pharma to chiropractors. This week’s catch of the week focuses on another part of the system, sleep clinics. As increasing numbers of troubled sleepers are seeking diagnosis and treatment of chronic sleep disorders, the significant growth in sleep medicine over recent years brings increasing opportunities for the unscrupulous...

Tagged in: Catch of the Week, Healthcare Fraud, Improper Medical Facility, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Medical Devices and DME, Medicare, Provider Fraud,

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October 22, 2021

Texas doctors Robert Wills and Brannon Frank, who previously operated Austin Pain Associates, will pay $3.9 million to resolve allegations that they billed federal and state healthcare programs for medically unnecessary urine drug tests that were performed at Austin Pain Associates’ in-house lab.  The investigation was initiated after a whistleblower complaint was filed by former Austin Pain Associates employees Jennifer Nuessner and Robert Hoffman; they will receive approximately $618,000 from the federal share of the settlements. DOJ

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

Catch of the Week: Laboratory and Two Founders Will Pay up to $16M Over Fraudulent Billing for Urine Drug Testing

Posted  10/22/21
Person wearing lab coat in laboratory
Clinical laboratory MD Labs Inc., and co-founders and owners, Denis Grizelj and Matthew Rutledge, settled charges the lab falsely billed Medicare, Medicaid, and other federal payors for pricey and unnecessary urine drug tests. Over a four-year period, the lab regularly ran two different drug tests at once and then sent results from both tests to the ordering healthcare physician simultaneously, according to the...

Tagged in: Catch of the Week, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Medicare, Provider Fraud, Whistleblower Case,

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October 8, 2021

U.S. Medical Management, LLC (USMM) and VPA, P.C. (VPA) have agreed to pay $8.5 million to resolve claims raised in five separate qui tam lawsuits that USMM and VPA billed Medicare for medically unnecessary laboratory and diagnostic testing services between 2010 and 2015.  Although the government did not join any of the lawsuits, the whistleblower who filed first will receive $1.53 million under the alternate remedy provision of the False Claims Act.  USAO EDMI

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare, Multiple Whistleblowers and First-to-File, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

August 19, 2021

Nevada Advanced Pain Specialists agreed to pay $1 million to resolve allegations that it submitted false claims for confirmatory urine drug testing performed without regard to the results of presumptive tests that had been performed. The allegations were first brought in a qui tam lawsuit filed by an whistleblower Omni Healthcare, Inc., which will receive a relator’s share of $150,000 of the settlement.  USAO MA

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

July 22, 2021

Medical laboratory Bluewater Toxicology, LLC, agreed to pay $1.2 million following its self-report of overbilling for urine drug testing services.  In billing Medicare, Kentucky Medicaid, Indiana Medicaid, TRICARE, and CHAMPVA, Bluewater was alleged to have submitted false claims that misrepresented the number of drugs tested in definitive urine drug tests, that lacked sufficient documentation, or that were for specimen validity testing that is not separately billable to Medicare.  USAO ED KY

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

July 9, 2021

Genetworx Laboratories, a diagnostic laboratory in Virginia, has agreed to pay $1.4 million to resolve allegations of submitting false claims to Medicare in violation of the False Claims Act.  Over the course of a year, Genetworx allegedly billed for genetic tests that were performed on groups of senior citizens in senior homes without valid physician oversight.  USAO NJ

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

June 25, 2021

Connecticut Addiction Medicine, LLC (CAM) and its owners, Dr. Jay Benson and Dr. Mahboob Aslam, have agreed to pay over $1 million to resolve their liability under the False Claims Act in connection with overcharges for urine drug tests that they caused to Medicare and Medicaid.  As part of their standard practice, CAM ran presumptive tests in-house but also sent the same sample out to an independent reference laboratory for definitive tests.  CAM then billed federal healthcare programs for the medically unnecessary presumptive tests.  USAO CT

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

DOJ Lowers The Boom On COVID-19 Healthcare Scams, Again

Posted  05/28/21
COVID Virus Zoomed In
Hey, fraudsters, did you hear?  There was a global pandemic, so the government pumped trillions of dollars into the economy.  Probably a good time to get a piece of the cut, you ask?  They’ll never find out, right?  So many ways to grift! Well, not so much.  From the start, the cops on the beat, led by the United States Department of Justice, have screamed from the rooftops:  “Don’t do it.  We WILL...

Tagged in: COVID-19, Criminal Proceedings, FCA Federal, Financial and Investment Fraud, Government Programs Fraud, Healthcare Fraud, Importance of Whistleblowers, Laboratory and IDTF, Lack of Medical Necessity, Market Manipulation and Trading Violations, Medical Billing Fraud, Misrepresentations, Pharma Fraud, Securities Fraud,

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