Texas Pathology Lab Settles EHR Consulting Kickback Claims for $63.5 Million Case: In 2006, HHS implemented an AKS safe harbor and Stark exception letting non-physician providers pay up to 85% … [Read more...]
COURT CASES
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
February 19, 2019
ANTI-KICKBACK
Despite Vigorous Denial, Molecular Lab Pays $1.8 Million to Settle Fraud Charges
February 8, 2019
Case: The feds claim that Molecular Testing Labs, a toxicology and genetics lab in Washington State, paid local labs in exchange for Medicare and Tricare referrals; it then turned what had been an … [Read more...]
FALSE CLAIMS
Chicago Doctor Indicted for Approving Medically Unnecessary In-Home Tests
February 1, 2019
Case: Working out of a Chicago-based clinic, a doctor allegedly prescribed and authorized ultrasounds, percutaneous allergen and nerve transmission for Medicare patients even though he knew the … [Read more...]
REIMBURSEMENT
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
January 23, 2019
Tennessee Pain Doctor Faces Jail for Opioid Abuses, Medicare Fraud Case: The doctor is facing 45 charges, including 22 counts of illegal distribution of a controlled substance for routinely … [Read more...]
COMPLIANCE
Enforcement Trends: After 2017 Decline, False Claims Act Healthcare Recoveries Bounce Back
January 21, 2019
Although the False Claims Act (FCA) remains a federal enforcement cash cow, the growth rate has fallen off in recent years, at least in the healthcare sector. But that short-term trend could be in … [Read more...]
ENFORCEMENT
New Law: EKRA Makes Drug Addiction & Rehab Labs Potential Targets for Federal Prosecution
January 15, 2019
Recent federal legislation addressing the opioid crisis may have unintended consequences on the lab industry. The idea was to allow the feds to prosecute a certain kind of abuse banned by the … [Read more...]
COURT CASES
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
January 15, 2019
Wisconsin Health System Settles Stark Claims for $12 Million Case: In a case that began as a whistleblower suit, a company affiliated with Advocate Aurora Health, Inc. has agreed to pay $12 … [Read more...]
FALSE CLAIMS
Florida Lab Owners Convicted for Role in Notorious Drug Distribution Scheme
January 4, 2019
Case: The two brothers who own a Palm Beach lab pleaded guilty to health care fraud for their role in the illegal drug distribution conspiracy carried out by notorious sober home operator Kenny … [Read more...]
ENFORCEMENT
By the Numbers: DOJ Recovers Billions in FY 2018
December 31, 2018
Year after year, the False Claims Act (FCA) remains the federal government's most valuable fraud enforcement tool. Although recovery amounts have declined slightly in the past two years, FCA … [Read more...]
CONSUMER FRAUD
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
December 31, 2018
Molecular Lab Vigorously Denies But Pays $1.8 Million to Settle Fraud Charges Case: The feds claim that Molecular Testing Labs, a toxicology and genetics lab in Washington State, paid local labs … [Read more...]
