January 18, 2022. Testing, testing, the DOJ is on top of unnecessary genetic testing schemes. The United States Department of Justice recently settled cases against UC San Diego Health and Boca Toxicology Lab LLC (dba Lab Dynamics) for submitting claims for unnecessary tests to Medicare. Under the terms of the settlement, the academic health system of the University of California, San Diego paid $2.98 million. The owner of Florida-based Boca Toxicology Lab LLC pled guilty to one count of conspiring to commit healthcare fraud in a $6.9 million conspiracy. Given the multiple points of contact involved in healthcare testing, individuals working at providers’ offices and/or lab facilities have the opportunity to blow the whistle on suspected fraudulent activity. Whistleblowers who report healthcare fraud may be entitled to receive 15-25% of the government’s recovery.
Over a period of four years, providers with the academic health system allegedly “ordered and submitted referrals for medically unnecessary genetic testing,” according to court documents. The lab then submitted claims to Medicare for these unnecessary tests, conduct which violates the False Claims Act. As the Acting Assistant Attorney General for the Justice Department’s Civil Division noted, “Hospitals are the gatekeepers for medical care and are expected to ensure that all services performed at their direction, including genetic tests, are medically appropriate.” Such misconduct has the side effect of eroding...
IDAHO — A woman previously ordered to pay $10 million in damages for making false claims about a professor’s role in the 2022 killings of four students at the University of Idaho has filed an appe...