Labs In Court

Lab Uses Billing Info of Another Lab to Get Around Payment Restrictions

Case: In 2015, Kentucky Medicaid and private payors began having doubts about the legitimacy of urine drug test claims submitted by CAL Laboratory Services and restricted payments to the toxicology … [Read more...]

LABS IN COURT

Massachusetts Practice Busted for Taking Free POCT Cups from Millennium

Case: A northern Massachusetts medical practice and Detroit pain clinic became the latest downstream providers to pay the OIG a five-figure fine to settle kickback claims in the form of accepting free … [Read more...]

LABS IN COURT

Texas Health System Fined $431K for Falsely Billing Genetic Tests  

Case: The feds contend that between 2016 and 2018, Decatur Hospital Authority (d/b/a Wise Health System) sent samples from surgical patients to Tennessee labs for medically unnecessary genetic tests. … [Read more...]

FALSE CLAIMS

Federal Court Dismisses Whistleblowers’ Urine Drug Test False Billing Claim

Case: Whistleblowers accused a national lab company of falsely billing Medicare and Medicaid for high complexity quantitative urine drug tests under CPT code G0431 at up to $476 per test. According to … [Read more...]

ANTI-KICKBACK

Alabama Doctors, Cardio Practice, Settle Genetic Testing Kickback Claims for $1.1 Million 

Case: Three doctors and a cardiology practice, all based in Alabama, have agreed to shell out $1.1 million for allegedly taking bribes from a now-bankrupt genetic testing company in the Seattle area. … [Read more...]

LABS IN COURT

Texas Scammer Gets 20 Years for Role in $50 Million Lab Test Ripoff

Case: The plot unfolded 10 years ago when a then 26-year-old woman and three co-conspirators set up 24 phony diagnostic testing centers in Houston. Offices were rented in 28 locations even though none … [Read more...]

LABS IN COURT

Feds Take Down Florida Substance Abuse Clinic Principles for Drug Test Fraud

Case: A trio of individuals associated with a Miami substance abuse facility were charged with taking part in a scheme to bill private insurers for tests that weren’t medically necessary or, in some … [Read more...]

LABS IN COURT

Urgent Care Centers Settle E/M Upcoding Charges for $2 Million

Case: The owners/operators of CareWell urgent care centers in Massachusetts and Rhode Island have agreed to shell out $2 million for improper coding of Evaluation and Management services. CPT code … [Read more...]

Labs In Court

A roundup of recent cases and enforcement actions involving the diagnostics industry   Lab’s ‘False Positive’ Drug Test Report ≠ Defamation of Employee  Case: An Arkansas nurse got fired … [Read more...]

CMS

ACLA Goes for Knockout Punch in PAMA Lawsuit

Case: Having survived a first-round setback, the American Clinical Laboratory Association (ACLA) went back on the offensive asking a federal court to strike down CMS’ scheme for implementing PAMA’s … [Read more...]


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