(855) 337-6836

If you own or operate a toxicology laboratory then you likely are aware of the increased scrutiny by the Federal government on your industry. You even may recently have been notified that your company is under investigation by the government for violating federal laws. Some of these laws include:

  • False Claims Act
  • Anti-Kickback Statute
  • Stark Law
  • Several other concerns

In addition to increased scrutiny throughout the industry, the Federal government in particular is looking at labs which test urine samples for drug use. One such example comes from an October 2017 press release by the Department of Justice about a settlement with a Florida laboratory regarding possible violations of the Anti-Kickback Statue and the False Claims Act. The press release indicates that the lab sought reimbursements for urine toxicology samples referred by a specific doctor:

According to the press release, “Illegal arrangements in order to boost profits at the expense of the taxpayers will not be tolerated,” said Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services, Office of Inspector General. “This settlement reflects the resolve of the OIG and our partners to ensure accountability in every corner of the health care industry.”

The fraud occurs when laboratories bill healthcare providers for unncessary or excessive tests. The government may be concerned when it believes it sees a pattern or history of multiple tests ordered for a single person in a short window of time, billing providers for tests which never took place, or noticing some indication that labs are compensating providers for directing the patients’ tests to that particular laboratory.

The laboratory even can be investigated for fraud in additional ways beyond the typical compensating doctors and other healthcare providers for directing the drug tests to be performed at the specific laboratory. One such way is compensating drug treatment centers to direct the drug tests to be performed at the specific toxicology lab. DNA cancer screening tests are being watched by the government as emphasized in this July 2017 press release from the Department of Justice (DOJ):

In the release the accused, “caused false and fraudulent claims to be submitted for health care benefits. The false and fraudulent claims were for toxicology and DNA cancer screening tests that were not legitimately prescribed, not needed, not provided as billed, and which were the product of kickbacks.”

The release further goes into detail saying, “According to the information filed in the case, {THE ACCUSED} would give Wal-Mart gift cards in exchange for urine and saliva specimens. These specimens were then mailed to {NAMED LABORATORIES} for unnecessary toxicology and DNA cancer screening tests and billed to TRICARE by {ANOTHER LAB}, a laboratory specializing in the evaluation of dermatologic disorders and located in Dallas, Texas. {THE ACCUSED} disguised the gift cards as a food assistance program for low-income beneficiaries. {COMPANY} collected urine and saliva samples from as many as 200 beneficiaries per day.

“{THE ACCUSED”} paid doctors a flat fee per month to sign orders for toxicology and DNA cancer screening tests. The doctors never saw the patients and had no doctor-patient relationship with the patients. Beneficiaries did not receive the results of their tests. {COMPANY} employees obtained signature stamps from the doctors and stamped the doctors’ signatures on testing orders before sending the forms to {LABS}. {COMPANY} employees also placed false diagnosis codes on TRICARE claim submissions to make it appear that the beneficiary needed the testing. This was done to ensure that TRICARE would accept, and pay, the claim.”

As mentioned in the name release, penalties for toxicology fraud can be both civil and criminal. Criminal convictions can result in 10 years in federal prison for each count plus fines and probation. Civil convictions can lead to fines, repayment, denial from continued participation in federal programs and other impact to the business.

The attorneys at James S. Bell have a long track record of helping their clients in these situations including case dismissals. On our team we have a former Federal prosecutor and trial attorneys with years of experience specifically in federal healthcare fraud cases.

Contact us today to schedule an appointment with a lawyer who is experienced in handling toxicology laboratory fraud and other federal healthcare fraud cases. You also may call us at (855) 337-6836.

 

Summary
Laboratory Investigations Defense Attorney
Service Type
Laboratory Investigations Defense Attorney
Provider Name
James S. Bell, PC,
2808 Cole Avenue, Suite 1000,Dallas,TX-US,
Telephone No.(855) 337-6836
Area
US
Description
Defense attorney for owners and operators of toxicology, blood, urine and other laboratories accused or being investigated with federal healthcare fraud.