LABORATORY, PATHOLOGY, RADIOLOGY AND DIAGNOSTICS
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
Ambulatory electroencephalography (EEG) testing company and private investment company agreed to pay more than $15 million to resolve FCA allegations that Alliance: (1) paid kickbacks to referring physicians in the form of free EEG test-interpretation reports, thereby enabling primary care physicians who were not neurologists to bill the government as if they had interpreted the tests; (2) used an inaccurate billing code for certain EEG testing to generate higher reimbursements; and (3) billed for a specialized digital analysis that it did not actually perform. The settlement also resolves allegations that Ancor Holdings caused false claims because it learned of the kickback scheme during diligence, but allowed the conduct to continue once it entered into a management agreement with Alliance. As part of the resolution, Alliance entered into a five-year CIA with HHS-OIG. 66 Clinical laboratory agreed to pay more than $1.25 million to resolve self-disclosed FCA allegations that it improperly billed federal healthcare programs for claims that misrepresented the number of drug classes tested or lacked the required supporting physician documentation, and for specimen validity testing, despite Medicare guidelines stating that such testing should not be billed separately. 67 Physician management services organization and an affiliate physician group agreed to pay $5.1 million to resolve FCA and AKS allegations that NSPC and PMA employees solicited and received kickbacks in the guise of clinical research payments from a defunct genetic testing company in exchange for referrals. Nine individuals face pending criminal charges in connection with the alleged scheme. 68 Genetics testing laboratory agreed to pay no less than $35,000 and a percentage of its future gross annual revenues up to $200,000 to resolve FCA allegations that it paid kickbacks to a now-defunct counseling group to induce genetic testing referrals. Specifically, the government alleged that the lab paid the salary of an individual who primarily worked for the counseling group. The counseling group’s owner was sentenced to three years of probation and ordered to pay restitution after pleading guilty to related healthcare fraud and drug offenses in February 2020. 69
Alliance Family of Companies LLC; Ancor Holdings LP
7/21/2021
$15.345 million
Bluewater Toxicology, LLC
7/22/2021
$1.252 million
National Spine & Pain Centers, LLC (NSPC); Physical Medicine Associates, Ltd. (PMA)
$5.1 million
8/6/2021
Alpha Genomix Laboratories, Inc.
$35,000
9/16/2021
66 https://www.justice.gov/opa/pr/eeg-testing-and-private-investment-companies-pay-153-million-resolve-kickback-and-false. 67 https://www.justice.gov/usao-edky/pr/mount-washington-laboratory-agrees-pay-12-million-resolve-allegations-false-claims. 68 https://www.justice.gov/usao-sdca/pr/pain-management-organization-pays-51-million-settle-criminal-medicare-kickback. 69 https://www.justice.gov/usao-sc/pr/georgia-genetic-testing-laboratory-pay-200000-resolve-anti-kickback-statute-claims.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 58
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