CODING

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...]

ANTI-KICKBACK

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...]

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...]

ANTI-KICKBACK

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

LabCorp Must Go to Trial to Defend against Deceptive Trade Practices Charges Case: Fourteen patients sued LabCorp for allegedly overcharging them for lab tests. In March 2018, a North Carolina … [Read more...]

FALSE CLAIMS

Pennsylvania M.D. Used Addiction Clinics as Front for Opioid Scheme

Case: A 57-year-old doctor pleaded guilty to running an elaborate opioid distribution and insurance fraud scheme out of the Liberation Way addiction treatment center for whom he served as medical … [Read more...]

NEWS

New York Breaks Up $28 Million Medicaid Diagnostics Mill

Case: One of the biggest Medicaid diagnostics fraud schemes in recent memory has resulted in multiple convictions, including two doctors and two corporate presidents. According to New York … [Read more...]

ANTI-KICKBACK

Maryland Hospital Fined $457.2K for Free Support Services Kickbacks

Case: Union Hospital of Cecil County, Inc. has agreed to pay $457,213 for a pair of self-disclosed kickback violations, namely, paying remuneration to: Physicians in the form of free support … [Read more...]

FALSE CLAIMS

Kentucky Lab Pays $125K to Settle Self-Disclosed SVT False Billing Charges

Case: VerraLab JA, LLC, has agreed to pay $125,983 after self-disclosing that it billed Medicare for specimen validity tests (SVT) performed to authenticate urine samples for drug testing. Unlike the … [Read more...]

COURT CASES

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

Drug Abuse Treatment Owner Guilty of $57 Million Drug Test Pass-Thru Billing Conspiracy Case: The owner of a northern Florida substance abuse treatment center pleaded guilty for his role in a … [Read more...]

NEWS

Healthcare ‘Trial of the Century’ Ends in Guilty Verdict against Esformes

Case: After a seven-week trial, a federal court convicted Florida healthcare executive Philip Esformes of 20 charges in carrying out a $1.3 billion Medicare fraud scheme, the biggest in history. In … [Read more...]


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