BioReference Labs Shells Out $11.5 Million to Settle Kickback and False Billing Charges
Case: The feds claimed that from 2009 to 2012, BioReference Laboratories billed Medicare TRICARE for hospital inpatient tests listed on the Part B Clinical Lab Fee Schedule even though those tests were covered by the hospital’s Part A inpatient prospective bundled payment and thus should have been billed to the hospital. Consequently, the government ended up paying for those tests twice. Rather than risk a trial, BioReference agreed to settle the charges for $11.5 million. Significance: In addition to the $1.4 million covering the improper billing, the settlement includes $10.1 million covering allegations that BioReference donated the cost of electronic medical records software to physicians’ practices “based solely on the volume of business” those practices generated. The settlement agreement requires BioReference to admit to paying for EMR software to 69 practices based on whether the revenues generated by the particular office would equal three times the software’s value.
Case: The feds claimed that from 2009 to 2012, BioReference Laboratories billed Medicare TRICARE for hospital inpatient tests listed on the Part B Clinical Lab Fee Schedule even though those tests were covered by the hospital’s Part A inpatient prospective bundled payment and thus should have been billed to the hospital. Consequently, the government ended up paying for those tests twice. Rather than risk a trial, BioReference agreed to settle the charges for $11.5 million.
Significance: In addition to the $1.4 million covering the improper billing, the settlement includes $10.1 million covering allegations that BioReference donated the cost of electronic medical records software to physicians’ practices “based solely on the volume of business” those practices generated. The settlement agreement requires BioReference to admit to paying for EMR software to 69 practices based on whether the revenues generated by the particular office would equal three times the software’s value.
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