Tag: stark law

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 failed to bring enough violators to justice to effectively

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Allegations of Lab Test Fraud Involve Multiple Defendants

CEO SUMMARY: UnitedHealth made national news when it filed a $100 million lawsuit against Next Health and other defendants in Dallas in January 2017. The insurer alleged fraud involving clinical laboratory tests. That lawsuit is just the latest chapter in an almost decade-long string of legal proceedings involving the healthcare businesses some of the defendants have

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Pulling Aside the Curtain on Alleged Lab Fraud

IN RECENT YEARS, MANY CLINICAL LAB ADMINISTRATORS AND PATHOLOGISTS have looked with dismay at the increased fraud associated with the laboratory test referrals of office-based physicians. High-profile federal cases involving lab companies accused of fraud garner national headlines.

Small companies sending sales reps into physicians’ offices, however, have changed the landscape in 2018 versus that of

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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 department (HOPD) billing model” to describe these arrangements. The scammers want the hospitals, as in-network

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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 petition for a pre-packaged Chapter 11 bankruptcy on November 10.

In papers submitted to

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