SCOTUS Agrees to Step in and Resolve Obamacare Constitutionality Case: Before COVID-19, the health care issue that kept millions of Americans up at night was the future of the Affordable Care … [Read more...]
Labs In Court
A roundup of recent cases and enforcement actions involving the diagnostics industry
March 30, 2020
SCORECARD
Scorecard: SVT False Billing Settlements Near the $3 Million Mark
March 9, 2020
Urine drug testing for purposes of medical treatment is deemed medically necessary under Medicare billing and payment rules. The same is not true for specimen validity tests (SVT), a quality control … [Read more...]
Labs in Court
Drug Abuse Treatment Owner Guilty of $57 Million Drug Test Pass-Thru Billing Conspiracy
February 6, 2020
Case: The owner of a northern Florida substance abuse treatment center pleaded guilty for his role in a $57 million pass-through lab testing billing and money laundering scheme. The way it worked: The … [Read more...]
Labs In Court
A roundup of recent cases and enforcement actions involving the diagnostics industry
January 27, 2020
Reference Lab Pays $26.7 Million to Settle False Claim Charges Case: The feds claim that Laboratory Boston Heart Diagnostics contracted to provide lab testing services to Texas hospitals in … [Read more...]
Whistleblowers: Hospitals, Labs Dodge a Major Stark/False Claims Act Bullet
January 27, 2020
It’s the moment of truth in a whistleblower case. The defendant claims the whistleblower’s claims aren’t legally valid and asks the court to dismiss the case without a trial. If the motion is … [Read more...]
ENFORCEMENT
Enforcement Trends: False Claims Act Recoveries Increase as Labs Remain in Firing Line
January 24, 2020
The dollars paid by healthcare providers in federal False Claims Act settlements and judgments increased for the second year in row in 2019. After a surprising decline in 2017, total recoveries … [Read more...]
ENFORCEMENT
Enforcement Trends: The Top 5 Lab False Claims Act Settlements of 2019
January 24, 2020
Labs were on the paying end of at least eight million-dollar False Claims Act (FCA) settlements or judgments in the 2019 fiscal year. Here’s a review of the top 5 reported FCA recoveries against a lab … [Read more...]
LABS IN COURT
Texas Health System Fined $431K for Falsely Billing Genetic Tests
January 10, 2020
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
January 2, 2020
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...]
Labs In Court A roundup of recent cases and enforcement actions involving the diagnostics industry
January 2, 2020
Court Refuses to Let M.D./Executives Out of Their Non-Competes Case: After leaving the national reference lab in which they owned equity and served as executives, a pair of Georgia pathologists … [Read more...]
