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Whistleblower News From The Inside -- April 26, 2018

Posted  April 26, 2018

By the C|C Whistleblower Lawyer Team

Alaskan non-profit settles FCA suit for $2.3M — Arc of Anchorage, a non-profit organization that provides services to those with developmental disabilities or mental health issues, has resolved allegations that it submitted false claims to the Alaska Medicaid Program by billing for services that were never provided and “unbundling” services in order to bill at higher rates. Alaska Department of Law

San Diego lab settles FCA suit for $2M  Biotheranostics, Inc. has settled allegations that it submitted claims to Medicare for medically unnecessary Breast Cancer Index tests. By law, Medicare can only pay for tests that are reasonable and necessary for diagnosis or treatment of a patient’s disease or injury. According to the allegations, the company knowingly promoted the tests to patients who did not need them. DOJ

Long Island pediatrics practice settles FCA suit for $750k — Pediatrics and Adolescent Medicine has resolved allegations that it billed the Medicaid program for services performed by physicians who were not enrolled in the program. It is illegal for healthcare providers to seek Medicaid reimbursement for services performed by physicians who are not enrolled in the Medicaid program. Here, the practice allegedly billed for the services performed by the unenrolled physicians under the credentials of enrolled physicians.  The fraud was brought to light by a whistleblower, whose award is not yet announced. USAO Eastern District of New York