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HCA Agrees to Pay $2 Million to Settle Claims of Unnecessary Lab Tests

By Kelly A. Briganti, Editorial Director, G2 Intelligence HCA Holdings, Inc. (formerly called Hospital Corporation of America) has settled health care fraud allegations relating to diagnostic testing for $2 million—including payment of damages and penalties. The claims stem from a whistleblower or qui tam lawsuit brought by an HCA employee under the False Claims Act against HCA and affiliated entities. The United States Attorney’s Office for the District of South Carolina with the State of Florida asserted that HCA hospitals submitted claims for unnecessary tests and double billed for other tests. Specifically, the government alleged HCA claims were improperly submitted: For “direct count low density lipids (LDL) when the tests were not ordered and/or not medically necessary.” For standalone non-stress testing when claims were submitted for fetal biophysical profiles with non-stress tests. The U.S Attorney’s Office reports that the whistleblower in the case will receive $400,000—20 percent of the settlement as provided under the False Claims Act.

By Kelly A. Briganti, Editorial Director, G2 Intelligence

HCA Holdings, Inc. (formerly called Hospital Corporation of America) has settled health care fraud allegations relating to diagnostic testing for $2 million—including payment of damages and penalties. The claims stem from a whistleblower or qui tam lawsuit brought by an HCA employee under the False Claims Act against HCA and affiliated entities. The United States Attorney’s Office for the District of South Carolina with the State of Florida asserted that HCA hospitals submitted claims for unnecessary tests and double billed for other tests. Specifically, the government alleged HCA claims were improperly submitted:

  • For “direct count low density lipids (LDL) when the tests were not ordered and/or not medically necessary.”
  • For standalone non-stress testing when claims were submitted for fetal biophysical profiles with non-stress tests.

The U.S Attorney’s Office reports that the whistleblower in the case will receive $400,000—20 percent of the settlement as provided under the False Claims Act.