TAG:

false claims act

UTC Labs to Pay $41.6 Million in a Civil Settlement With DOJ

ONE MORE LAB COMPANY has settled allegations of fraud and abuse. Last month, UTC Laboratories agreed to pay a fine of $41.6 million and will be excluded from all federal healthcare programs for 25 years. Announced Oct. 9, the settlement resolves allegations that UTC violated the F…

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Quest Subsidiary Acquires True Health Assets for $8.5M

BANKRUPT LAB COMPANY TRUEHEALTH DIAGNOSTICS AGREED TO SELL some remaining assets priced at $8.5 million to Cleveland HeartLab, a subsidiary of Quest Diagnostics. True Health, with labs in Richmond, Va., and Frisco, Texas, filed a bankruptcy action in…

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After Two-Year Battle with CMS, True Health on Verge of Collapse

CEO SUMMARY: In 2017, an auditor for CMS alleged that True Health filed fraudulent claims and the federal Medicare program cut all payments to the lab company and one month later reduced the cut to 35% of the billed amount. Two months ago, CMS ended all payments again. These facts became …

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Pathology Firm Pays $63M to Settle Qui Tam Case

CEO SUMMARY: Inform Diagnostics, formerly Miraca Life Sciences, settled the federal qui tam case while denying wrongdoing. The $63.5 million settlement will by paid by the former owner, Miraca Holdings, a Japanese company. The federal Department of Justice alleged that the company—then …

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Several Big Surprises in 2018’s Top 10 Lab Stories

CEO SUMMARY: This year’s list of the Top 10 Lab Industry Stories for 2018 is dominated by new directives from Medicare and private health insurers, as well as significant decisions by federal courts. Collectively, these developments create new compliance risks for all clinical laborator…

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Peeking at Whistleblower Claims: How Labs Induce Physicians

IN RECENT DECADES, probably no sector of the U.S. healthcare system has seen the level of fraud and abuse that seems to pervade the clinical laboratory industry. The common perception is that illegal inducements between lab companies and referring physicians are rampant and federal prosecutors have f…

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Defunct, Oft-Troubled Calloway Labs Hit with $1.4M Federal Judgement

HOW OFTEN IS A DEFUNCT LAB COMPANY IN THE NEWS? That was the odd development last week when it was announced that a U.S. District Court had entered a $1.4 million civil judgement against Calloway Laboratories, Inc., a toxicology lab company formerly based in Woburn, Mass., for busine…

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In HDL Case, Judge Imposes Damages, Penalties of $114 Million

LAST WEEK, A FEDERAL JUDGE in South Carolina issued an order imposing civil damages and penalties of more than $114 million on Tonya Mallory, the former CEO of Health Diagnostic Laboratory, in Richmond, Va., and two owners of the lab’s marketing partner, BlueWave Healthcare…

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Attorney Says Labs Face Increased Legal Liability

CEO SUMMARY: For many reasons, including cuts to lab test prices that health insurers pay, narrow networks, and more competition for lab test referrals, a significant number of lab companies are seeking ways to increase market share. These methods include the use of new laboratory test ar…

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D.C. Circuit Court Reverses Medical Necessity Ruling

MANY LAB EXECUTIVES were concerned last year after a judge in the District of Columbia Circuit Court ruled that clinical laboratories need to determine that all lab test services physicians order are medically necessary. The court also ruled that ordering physicians do not need to determine medical …

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