Whistleblowers: Hospitals, Labs Dodge a Major Stark/False Claims Act Bullet

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...]

LABS IN COURT

Texas Health System Fined $431K for Falsely Billing Genetic Tests  

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...]

WHISTLEBLOWERS

Billing & Coding: Myriad Genetics Pays $9.1 Million to Settle Claims of Falsely Billing Medicare for Hereditary Cancer Tests

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...]

WHISTLEBLOWERS

Case of the Month: U.S. Supreme Court Gives Whistleblowers Four More Years to Sue

Just as the tide seemed to be turning against whistleblower lawsuits (see "New DOJ Policy Targeting Whistleblowers with Weak Cases May Make Life Easier for Labs," (Lab Compliance Advisor,  March 4, … [Read more...]

BILLING & COLLECTIONS

$1.99 Million Settlement for False Billing of Genetic Tests

Case: In a case that began as a whistleblower suit filed by two ex-employees, GenomeDx Biosciences has agreed to shell out $1.99 million to settle charges of improperly billing Medicare for its … [Read more...]

WHISTLEBLOWERS

Case of the Month: Facing 3 against 1, Texas Lab Settles EHR Consulting Kickback Charges

Question: What happens when multiple whistleblowers bring separate qui tam lawsuits against a lab for the same offense? Answer: Under the False Claims Act (FCA), only the first whistleblower to … [Read more...]

DOJ

Enforcement Trends: New DOJ Policy Targeting Whistleblowers with Weak Cases May Make Life Easier for Labs

It's not just new laws, regulations or even court cases. Trends in health care fraud enforcement are sometimes driven by changes in prosecution policies, including those that aren't made public. Such … [Read more...]

COURT CASES

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

Abbott Pays $25 Million to Settle TriCor Kickback & Off-Label Marketing Claims Case: The case began when a sales rep accused Abbott Laboratories and AbbVie Inc. of paying kickbacks to induce or … [Read more...]

COURT CASES

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

Alabama Hospital and Lab Subsidiary Agree to $4.25 Million Kickback Settlement Case: Aperian Laboratory Solutions and its parent East Alabama Medical Center will fork over $4.25 million + legal costs … [Read more...]

WHISTLEBLOWERS

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

Texas Lab and Owner Get 15-Year Exclusion for Medicare Mileage Swindle Case: What would you do if your bill for a $43 blood test included a $1,500 travel fee? The patient who actually received such a … [Read more...]


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