High-priced laboratory fraud settlements continue to roll in, as Millennium Health LLC, the nation's largest drug testing laboratory, is negotiating a settlement to resolve allegations that it billed Medicare for unnecessary tests.
Two years after federal agents arrested David and Scott Nicoll, owners of Biodiagnostic Laboratory Services Inc. in New Jersey, for orchestrating a 37-person, $200 million fraud scheme, CNBC is pulling back the curtain on how that scheme evolved.
High-priced home health fraud cases in Michigan and Illinois, coupled with comments from the U.S. Attorney's Office in Detroit, offer insight into some of the high risk areas of Medicare fraud among states in the Midwest.
Call it the enforcement "flavor of the month," but laboratories have been feeling the heat from federal investigators recently, particularly those interested in their relationship with physician practices, which may run afoul of the anti-kickback statute.
Two cardiovascular testing labs have agreed to pay a combined $48.5 million to settle allegations that they paid physicians to handle blood samples, according to a release by the Department of Justice (DOJ). As previously reported, Health Lab Diagnostics Inc. (HDL) agreed to pay $47 million, while California-based Singulex Inc. agreed to pay $1.5 million.
An advisory opinion released last week by the U.S. Department of Health and Human Services Office of Inspector General advises labs not to enter exclusive agreements with physician practices that would cover patient fees for certain insurance plans. This type of agreement could violate anti-kickback laws and lead to an investigation and possibly administrative sanctions.
A New Jersey man pleaded guilty to one count of conspiring to bribe a doctor and one count of money laundering in connection with a massive fraud scam orchestrated by Biodiagnostic Laboratory Services.
The Office of Inspector General released a new report on questionable Medicare claims for clinical laboratory services, for which program spending rose 29 percent between 2005 and 2010.