NEWS

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

West Virginia Medicaid Recovers $17 Million for $8.5 Million Opioid Scam Case: A subsidiary of Acadia Healthcare Co. has agreed to pay $17 million to settle charges of falsely billing West … [Read more...]

CODING

Tennessee Pain Doctor Faces Jail for Opioid Abuses, Medicare Fraud

Case: The doctor is facing 45 charges, including 22 counts of illegal distribution of a controlled substance for routinely prescribing oxycodone and other Schedule II drugs without examining and … [Read more...]

FALSE CLAIMS

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

WV Hospital & Marketing Consultant Sued for Elaborate Kickback Scheme Case: A new DOJ lawsuit accuses a West Virginia non-profit hospital and its business consultant of seeking to dominate the … [Read more...]

ANTI-KICKBACK

Pain Management Clinic, 2 MDs Pay $99K to Settle Millennium Free POCT Cup Kickback Claims

Case: An Oklahoma pain management practice and two of its physicians are the latest to settle kickback claims for accepting free point of care test cups from now defunct Millennium Laboratories. The … [Read more...]

ANTI-KICKBACK

Texas Pathology Lab Settles EHR Consulting Kickback Claims for $63.5 Million

Case: In 2006, HHS implemented an AKS safe harbor and Stark exception letting non-physician providers pay up to 85% of physicians' costs to help them transition from paper records to EHR systems. But … [Read more...]

ENFORCEMENT

Mass. Pain Management MDs Jailed for Elaborate Drug Testing Conspiracy

Case: After pleading guilty to running "one of the most dangerous pain management practices in Massachusetts," a medical resident was sentenced to 75 months in jail, three years of supervised release … [Read more...]

ANTI-KICKBACK

Lab Settles Specimen Collection Fee Kickback Charges for $2.275 Million

Case: Cleveland HeartLab (CHL) has agreed to pay $2,275,094 after self-disclosing to the OIG that it paid remuneration in the form of payments to physicians and physician groups for collecting, … [Read more...]

REIMBURSEMENT

Kentucky Pain Clinic Pays $127K to Settle Specimen Validity Test Billing Claims

Case: The Northern Kentucky Center for Pain Relief agreed to pay the OIG $126,799.90 to settle claims of billing Medicare for specimen validity testing (SVT). Explanation: Under Medicare rules, urine … [Read more...]

HIPAA

Aetna to Pay California $935K for HIV Envelope Privacy Fiasco

Case: The price tag for the privacy snafu that occurred in July 2017 when Aetna mailed12,000 beneficiaries sensitive information about their HIV medication in envelopes with a transparent window keeps … [Read more...]

BILLING & COLLECTIONS

$1.99 Million Settlement for False Billing of Genetic Tests

Case: In a case that began as a whistleblower suit filed by two ex-employees, GenomeDx Biosciences has agreed to shell out $1.99 million to settle charges of improperly billing Medicare for its … [Read more...]


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