TAG:
false claims act
Lab Scheme Recruits Hospitals To Bill as In-Network Providers
CEO SUMMARY: Management companies using a new generation of potentially fraudulent schemes are targeting hospitals and health systems for arrangements that use questionable means to increase lab test volume and revenue. The management companies often use the term “hospital outpatient de…
PAMA Reporting Penalties Can Be Substantial for Laboratories
STARTING JAN. 1, 2017, there are substantial penalties for labs that fail to properly meet the complex lab test price marketing reporting requirements of the Protecting Access to Medicare Act of 2014. Labs that fail to do so face the potential of stiff, multi-million dollar fines. “Under PAMA, cli…
UnitedHealthcare Warns Labs: Don’t Waive Patient Fees
This article is an excerpt from a 1,500-word article in the March 21 issue of THE DARK REPORT. Full details of UHC’s battle against out-of-network labs, as well as its plans to begin requiring pre-authorization for genetic testing, are included in the original article, available to paid members…
UnitedHealthcare Warns Labs Not to Waive Patient Fees
CEO SUMMARY: UnitedHealthcare directly tackled the issue of out-of-network labs waiving or capping copayments, coinsurance and deductibles that are to be paid by patients. In a network bulletin this month, UHC said that such arrangements may violate federal law and could lead to state ins…
Cleveland Clinic and related lab sue True Health Diagnostics
THE DARK REPORT is the only lab industry news source to recognize the significance of the lawsuit between the Cleveland Clinic Foundation and Cleveland HeartLab against a new lab company, True Health Diagnostics. It is the latest chapter in a string…
Letter to Florida Doctor Offers to Waive Lab Test Fees
CEO SUMMARY: Florida’s highly-competitive market for lab testing services is again seeing some lab companies use “Waiver of Charges to Managed Care Patients” agreements with physicians in situations where the lab is an out-of-network provider. This means the lab will do free testing…
Toxicology Lab Millennium Pays $256M to DOJ, Files For Bankruptcy
IN ANOTHER MAJOR LAB FRAUD CASE, toxicology lab company Millennium Health will pay $256 million to settle allegations in a whistleblower lawsuit that it overbilled federal healthcare programs for unnecessary lab testing. Just 22 days after this agreement, Millennium Health filed a pe…
True Health To Buy HDL Pending Court Approval
CEO SUMMARY: This will be an interesting week in the ongoing saga of Health Diagnostic Laboratory. The judge in the bankruptcy case must review the sales auction and the winning bid of $37.1 million that True Health Diagnostics submitted. At least two lawyers representing whistleblowers in …
Feds Show How Labs Took $500 Million from Medicare
CEO SUMMARY: In this second phase of the whistleblower case against three cardiology testing labs and a sales consulting company, federal prosecutors are requesting a jury trial against the individuals named in the court documents filed August 7. Federal investigators alleged t…
Will Federal Prosecutors Pursue HDL Lab Execs and Physicians?
WHERE WAS MUCH TO BE LEARNED when, on April 9, federal prosecutors announced settlements of multiple whistleblower lawsuits against Health Diagnostics Laboratory, Inc. of Richmond, Virginia, and Singulex Inc. of Alameda, California. First, the Department of Justice structured a…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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