Case: A new DOJ lawsuit accuses a West Virginia non-profit hospital and its business consultant of seeking to dominate the Ohio Valley market by bribing physicians for referrals. The scheme began in … [Read more...]
ANTI-KICKBACK
WV Hospital & Marketing Consultant Sued for Elaborate Kickback Scheme
September 27, 2019
ENFORCEMENT
West Virginia Medicaid Recovers $17 Million for $8.5 Million Opioid Scam
September 19, 2019
Case: A subsidiary of Acadia Healthcare Co. has agreed to pay $17 million to settle charges of falsely billing West Virginia Medicaid for opioid-related tests. The DOJ claims that over a six-year … [Read more...]
CODING
Urgent Care Centers Settle E/M Upcoding Charges for $2 Million
September 11, 2019
Case: The owners/operators of CareWell urgent care centers in Massachusetts and Rhode Island have agreed to shell out $2 million for improper coding of Evaluation and Management services. CPT code … [Read more...]
COMPLIANCE
Genetic Testing Fraud Prosecutions are on the Rise around the Country. Are Your Genetic Testing Practices Compliant?
September 10, 2019
By Robert Liles bio Over the last year, a number of genetic testing fraud investigations and prosecutions have been initiated by Medicare, Medicaid and TRICARE investigators and auditors. While … [Read more...]
ANTI-KICKBACK
Texas Scammer Gets 20 Years for Role in $50 Million Lab Test Ripoff
September 6, 2019
Case: The plot unfolded 10 years ago when a then 26-year-old woman and three co-conspirators set up 24 phony diagnostic testing centers in Houston. Offices were rented in 28 locations even though none … [Read more...]
Texas Health System Fined $431K for Falsely Billing Genetic Tests
August 30, 2019
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...]
ANTI-KICKBACK
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
August 28, 2019
LabCorp Must Go to Trial to Defend against Deceptive Trade Practices Charges Case: Fourteen patients sued LabCorp for allegedly overcharging them for lab tests. In March 2018, a North Carolina … [Read more...]
COURT CASES
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
August 26, 2019
Federal Court Dismisses Whistleblowers' Urine Drug Test False Billing Claim Case: Whistleblowers accused a national lab company of falsely billing Medicare and Medicaid for high complexity … [Read more...]
PRECISION MEDICINE
Myriad Genetics Pays $9.1 Million to Settle Hereditary Cancer Test False Billing Claims
August 26, 2019
In March 2018, Myriad Genetics got a piece of mail no lab provider ever wants to see in its inbox: an OIG subpoena asking for billing records in connection with "an investigation into possible false … [Read more...]
FALSE CLAIMS
Pennsylvania M.D. Used Addiction Clinics as Front for Opioid Scheme
August 23, 2019
Case: A 57-year-old doctor pleaded guilty to running an elaborate opioid distribution and insurance fraud scheme out of the Liberation Way addiction treatment center for whom he served as medical … [Read more...]
