Labs in Court

Michigan Reference Lab Settles False Billing Charges for $1.2 Million

Case: The OIG claimed that Michigan reference lab Great Lakes Medical Laboratory, Inc. ripped off Medicare and United Mine Workers Association (UMWA) health plans by billing for routine urine and blood tests that were already reimbursed for other lab services over a roughly 18-month period. In some cases, the lab billed tests for West Virginia workers that weren’t ordered by a physician or even actually performed. Rather than risk a trial, the lab agreed to settle the charges for $1,200,737.64, exactly twice the actual $600,368.82 that Medicare and the UMWA paid for the false claims. In addition to the double penalty, the lab in this case had to enter into a three-year Integrity Agreement requiring it to, among other things, implement a compliance program under the OIG’s review and hire an Independent Review Organization to review its Medicare and UMWA claims.

 

Significant: Reference labs hired by Medicare providers to perform contracted tests have become a popular target for federal false billing enforcement activity, particularly in drug testing. Earlier this year, a reference lab and pain clinic in Tampa and the executive that ran them had to pay $41 million to settle charges of billing Medicare for unnecessary urine drug tests.

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