Laboratory and IDTF Archives - Page 9 of 15

August 27, 2019

Three doctors and a cardiac center have agreed to pay a combined $1.1 million to resolve allegations of receiving kickbacks from the now defunct Northwest Medical Testing Company (NMTC) in exchange for ordering genetic tests from NMTC that were then billed to Medicare. Dr. Gregory Sampognaro will pay $519,750, Dr. Isabella Strickland will pay $107,900, Dr. Warren Strickland will pay $95,053, and Cardiology P.C. will pay $411,300. USAO WDWA

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Laboratory and IDTF, Medicare,

August 16, 2019

2d Chance PLLC, a Kentucky-based substance abuse center, will pay $200,494 to resolve allegations under the False Claims Act that it entered into an arrangement with Compliance Advantage, LLC, a toxicology lab, whereby 2d Chance referred patients to Compliance Advantage for complex drug testing, and Compliance Advantage provided a no-cost chemistry analyzer to 2d Chance, allowing 2d Chance to perform some urine testing at its site and bill Medicaid for those services. The financial arrangement violated the Anti-Kickback Statute. EDKY

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Provider Fraud,

Catch of the Week — Comprehensive Pain Specialists Targeted for Urine Drug Testing Fraud

Posted 07/26/19

Laboratory sample vial lying on procedure coding form

Our Catch of the Week goes to Comprehensive Pain Specialists (CPS), a now-shuttered pain-management chain that was once one of the largest in the nation, treating as many as 48,000 pain patients a month at about 60 clinics across 11 states. CPS shut down in 2018 with little warning to patients and employees. On Monday, July 22, the United States and the State of Tennessee announced their partial intervention in...

Tagged in: Anti-Kickback and Stark, Bundling and Unbundling, Catch of the Week, FCA Federal, Healthcare Fraud, Improper Medical Personnel, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case,

July 8, 2019

Anthony Camillo, the owner of Illinois-based Allegiance Medical Laboratory and AMS Medical Laboratory, has been sentenced to 2.5 years in prison and ordered to pay $3.5 million in restitution for defrauding Medicare and Medicaid. According to the DOJ, Camillo paid Missouri-based marketers between $150-$200 for urine and saliva samples sent to his labs. His conduct incentivized other fraudulent conduct, including medically unnecessary testing of disabled and elderly patients living in residential care facilities, and the use of doctors’ names on test orders without the doctors’ knowledge. USAO EDMO

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicaid, Medicare,

June 27, 2019

Massachusetts-based Clinical Science Laboratory, Inc. (CSL), and its owners, Stanley Elfbaum and Louis Amoruso, have agreed to pay $1.5 million to settle allegations under the False Claims Act that it charged Connecticut Medicaid 19 times what it charged other customers for urine drug screens. According to the DOJ, from 2016 to 2017, CSL charged Connecticut $38 per test while charging substance abuse treatment centers only $2 per test. USAO CT

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

June 18, 2019

Nevada Heart & Vascular Center has agreed to pay $2.5 million to settle allegations that it accepted kickbacks from genetic testing companies, Natural Molecular Testing Corp. and Iverson Genetic Diagnostics, Inc., in exchange for referrals of Medicare patients. The alleged violations of the Anti-Kickback Statute and False Claims Act occurred for nearly a year in 2012. USAO NV

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Provider Fraud,

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

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

May 3, 2019

Texas-based Decatur Hospital Authority, d/b/a Wise Health System, has agreed to pay $431,182.96 to the United States for billing Medicare for medically unnecessary genetic testing panels. The alleged False Claims Act violations had occurred between 2016 and 2018 and involved patient samples from Tennessee-based Total Diagnostic II, LLC. DOJ

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

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

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

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

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

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