Healthcare Fraud & Abuse Review 2021

LABORATORY, PATHOLOGY, RADIOLOGY AND DIAGNOSTICS

DA TE

ENTITY

FCA ALLEGATIONS

AMOUNT

Clinical laboratory and two of its owners and co-founders agreed to pay no less than $11.6 million, with future contingent payments up to $16 million based on specific criteria, to resolve FCA allegations that they billed federal healthcare payors for medically unnecessary urine drug tests by performing both presumptive and confirmatory urine drug tests on the same sample simultaneously. As part of the resolution, the laboratory and the owners entered into a five-year CIA with HHS-OIG. A pain management practice entered into a separate settlement related to these allegations. 70 Pathology practice agreed to pay $2.4 million to resolve FCA allegations that it billed Medicare for procedures that require written analysis by a pathologist when the corresponding medical records did not contain the required written substantiation. As part of the resolution, the practice entered into a three-year IA with HHS-OIG. 71

MD Spine Solutions LLC d/b/a MD Labs Inc.; Denis Grizelj; Matthew Rutledge

10/20/2021

$11.6 million

Princeton Pathology Services P.A.

12/7/2021

$2.4 million

70 https://www.justice.gov/usao-ma/pr/md-labs-and-its-co-founders-agree-pay-16-million-resolve-allegations-fraudulent-billing. 71 https://www.justice.gov/usao-nj/pr/pathology-practice-agrees-pay-24-million-resolve-false-claims-act-allegations.

NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 59

Powered by