ENFORCEMENT

Provider Fined for Not Taking Compliance Measures Required by Its CIA

Case: Nearly 10 years ago, a new Affordable Care Act rule requiring labs and other providers to investigate their credit balances for potential Medicare overpayments took effect. In 2015, Pediatric … [Read more...]

BILLING AND COLLECTIONS

Texas Lab and Owner Get 15-Year Exclusion for Medicare Mileage Swindle

Case: What would you do if your bill for a $43 blood test included a $1,500 travel fee? The patient who actually received such a bill from Texas lab BestCare complained to the government. The … [Read more...]

FALSE CLAIMS

Florida Lab Owners Convicted for Role in Notorious Drug Distribution Scheme

Case: The two brothers who own a Palm Beach lab pleaded guilty to health care fraud for their role in the illegal drug distribution conspiracy carried out by notorious sober home operator Kenny … [Read more...]

CONSUMER FRAUD

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

Molecular Lab Vigorously Denies But Pays $1.8 Million to Settle Fraud Charges Case: The feds claim that Molecular Testing Labs, a toxicology and genetics lab in Washington State, paid local labs … [Read more...]

BILLING AND COLLECTIONS

Aetna Sues Manager of Oklahoma Rural Hospital for Lab Test Ripoff

Case: People's Choice, a management firm specializing in turning around financially strapped hospitals, is being sued by Aetna for using an Oklahoma rural hospital client to carry out an elaborate lab … [Read more...]

ANTI-KICKBACK

Massachusetts Lab Fined $1.374 Million for Free Test Supplies Kickback Scam

Case: A federal court ordered Calloway Laboratories, Inc. to pay $1,374,058 to settle claims of falsely billing Medicare and TRICARE for urine drug tests over a six-month period in 2014. As part of … [Read more...]

COMPLIANCE GUIDANCE

Compliance Perspectives: Avoid Kickback Liability by Steering Clear of MD Processing Fees

Editor's Note: Two months ago, we talked about paying referring physicians a fee for collecting and processing blood, urine, tissue and other specimens. (G2 Compliance Advisor, Oct. 9, 2018, p. 1). … [Read more...]

ANTI-KICKBACK

Jail for Urine Drug Testing Kickback Co-Conspirators

Case: Urine samples produced by patients of a Maryland-based pain clinic were a billables gold mine for a Jersey City testing lab, well worth the $1.37 million in kickbacks it ultimately paid to … [Read more...]

FALSE CLAIMS

Free Testing Supplies to Physicians Costs Massachusetts Lab $1.374 Million

Case: A federal court ordered Calloway Laboratories, Inc. to pay $1,374,058 to settle claims of falsely billing Medicare and TRICARE for urine drug tests over a six-month period in 2014. As part of … [Read more...]

CONSUMER FRAUD

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

New York Doctor Busted for Falsely Billing Medicaid for Lab Drug Tests Case: The State claims that the physician billed for $939,000 worth of drug testing services that his lab didn't and … [Read more...]


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