Home 5 Lab Industry Advisor 5 National Lab Reporter 5 Compliance-nir 5 Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

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

by | Aug 17, 2017 | Compliance-nir, Enforcement-nir, Essential, Labs in Court-nir, Legislation-nir, National Lab Reporter

Anthem Settles Data Breach Lawsuit for Record $115 Million Case: Anthem, the nation’s second largest health insurer, has agreed to shell out $115 million to settle a class action lawsuit over a massive 2015 cyberattack in which hackers stole the names, addresses, birthdates, Social Security numbers and other personal information of roughly 78.8 million plan members and employees. Under the deal, the biggest settlement ever for a data breach, Anthem will furnish 2 additional years of credit protection monitoring to the individuals affected and set aside a $15 million fund to cover victims’ out of pocket costs. Significance: The takeaway from the settlement isn’t just the money but the specific improvements it requires Anthem to make to its data security systems over three years, including implementation of: Strict access requirements; Data retention periods; Mandatory information security training for associates; and Annual IT security risk assessments. Five More Doctors Convicted in BLS Bribery Scheme Case: The biggest medical bribery scandal of all time continues to grow with 5 more doctors pleading guilty to taking bribes from now defunct Biodiagnostic Laboratory Services LLC (BLS) in Parsippany, New Jersey. Here’s the Scorecard for the latest defendants: Name Practice Allegations Jorge J. Figueroa Internal […]

Anthem Settles Data Breach Lawsuit for Record $115 Million
Case: Anthem, the nation's second largest health insurer, has agreed to shell out $115 million to settle a class action lawsuit over a massive 2015 cyberattack in which hackers stole the names, addresses, birthdates, Social Security numbers and other personal information of roughly 78.8 million plan members and employees. Under the deal, the biggest settlement ever for a data breach, Anthem will furnish 2 additional years of credit protection monitoring to the individuals affected and set aside a $15 million fund to cover victims' out of pocket costs.

Significance: The takeaway from the settlement isn't just the money but the specific improvements it requires Anthem to make to its data security systems over three years, including implementation of:

  • Strict access requirements;
  • Data retention periods;
  • Mandatory information security training for associates; and
  • Annual IT security risk assessments.

Five More Doctors Convicted in BLS Bribery Scheme
Case: The biggest medical bribery scandal of all time continues to grow with 5 more doctors pleading guilty to taking bribes from now defunct Biodiagnostic Laboratory Services LLC (BLS) in Parsippany, New Jersey. Here's the Scorecard for the latest defendants:

NamePracticeAllegations
Jorge J. FigueroaInternal medicine, Fair Lawn, NJAccepted $200K from BLS employees for roughly $1.4 million in illegal lab business between May 2007 and April 2013
George & Nicholas Roussis (brothers)Pediatrician and OBGYN (respectively) Staten Island, NYAccepted $175K in BLS cash payments for roughly $1.7 million in lab referrals from Oct. 2010-April 2013; BLS also paid for strip club trips, lap dances and sexual favors
Basel BatarsehInternal medicine, Wayne, NJAccepted monthly bribe checks of $3.2K ($104K in total) for generating roughly $1.3 million in lab business from Nov. 2007 to Aug. 2010
Yousef ZibdieInternal medicine, Woodland, NJAccepted $80K worth of monthly bribe checks for generating roughly $930K in illegal lab business for BLS

Significance: In a sneak preview of what the future may hold for these five when sentence is handed down in December, the very same day the above convictions were announced, a 79-year-old Bergen County (NJ) family physician was sentenced to 41 months in prison for taking $200,000 in bribes for approximately $3 million's worth of illegal lab business to BLS. The latest BLS "body count" is 50 convictions, 36 of them doctors.

LabCorp Pays $45.4K for Self-Disclosed Excluded Individual Offense
Case: Laboratory Corporation of America agreed to pay $45,466 in Civil Monetary Penalties for allegedly hiring an employee that it knew or should have known had been excluded from participating in federal health care programs. The alleged offense, which LabCorp self-disclosed, took place at one of its Florida labs.

Significance: This is the third fine against a major lab in 2017 for a self-disclosed violation to the OIG:

  • In Feb., Quest Diagnostics agreed to pay $315,093 for alleged kickbacks to a referral source in the form of above fair market rent payments by one of its New Jersey labs to a medical practice; and
  • In March, Quest settled a trio of CMP offenses, two of which were Electronic Health Records-related for $1.151 million.

Subscribe to view Essential

Start a Free Trial for immediate access to this article