BILLING AND COLLECTIONS

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 bill from Texas lab BestCare complained to the government. The subsequent investigation found evidence that BestCare billed Medicare for over $10 million in false mileage for miles not traveled by a technician. After refusing to toss the case without a trial, the court found the lab guilty of False Claims Act violations and fined it $30.5 million. And on Aug. 17, an Administrative Law Judge upheld the OIG’s decision to exclude BestCare and its owner from all federal health programs for 15 years.

Significance: Under Medicare rules, labs can charge $1 per mile for transporting a specimen as long as a technician travels along. The lab committed two offenses:

  • Billing travel mileage for specimens shipped on commercial airlines during flights in which no technician was present;
  • Imposing a separate $1 per mile travel fee for each specimen transported collectively rather than prorating mileage among the individual specimens.
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