Atlanta Lab Fraud Attorney
Elite Advocacy for Whistleblowers
Do you know about a laboratory that is overcharging Medicare and Medicaid? Stop the fraud by filing suit under the False Claims Act. Whistleblowers who file an FCA lawsuit can help U.S. taxpayers recover millions of dollars and also be paid 15% to 30% of what the Government gets as a result of the lawsuit.
Do you know about a lab that is overcharging Medicare or Medicaid? See whether your case has merit under the False Claims Act lawsuit. Attorney Lee Wallace is a veteran Atlanta lab fraud lawyer who has tackled numerous whistleblower cases. She is someone you can trust with your case.
Learn more about lab fraud:
Begin with your FREE consultation to discuss your lab fraud suspicions.
Types of Laboratory Fraud
Laboratory fraud and overcharges are draining Medicare coffers by billions each year.
The kind of fraud varies, but the government has lost money to:
- Fraud caused by labs that are bundling (and then unbundling) tests
- Paying kickbacks
- Running unnecessary tests
- Upcoding the types of tests run
- Violating the stark act
Learn how to be a whistleblower who stops fraud committed by labs that are over charging the Government.
Examples of Lab Fraud Cases
- A Kentucky addiction clinic and a clinical laboratory, plus their doctor-owners, agreed to pay the Government a whopping $15.75 million to settle False Claims Act allegations. According to the DOJ, the owners of the addiction clinic, SelfRefind, each bought a 20% share of the lab, PremierTox. After the purchase, the doctors began referring unnecessary urine drug screening tests to the lab. The defendants were charged with inflating claims as well, by claiming to have run more expensive tests than they actually performed. DOJ also levied accusations that the group violated the Stark Law, which is aimed at stopping the cozy financial relationships among medical providers that can cause self-dealing and fraud.
- SmithKline Beecham Clinical Laboratories settled a False Claims Act case with a payment of $334 million to the Government and U.S. taxpayers. The lab was accused of bundling lab tests together when doctors ordered them, and then unbundling the tests when it charged Medicare and Medicaid. Doctors who only wanted to order a particular blood test were offered a bundle that also included several other lab tests. The additional tests were not medically necessary, but Doctors understood that the tests came as a group, so the additional tests cost no additional amount. However, when the laboratory billed the Government, it unbundled the tests and billed separately for each one. Thus, the lab billed for tests that were not medically necessary and that doctors had not intended that their patients have. The whistleblower, who had worked for SmithKline’s billings department, was paid $52 million for his work in bringing the case.
- A number of False Claims Act suits have claimed that a lab gave cut rates to an insurance company in exchange for an agreement that the insurance company would steer Medicare-reimbursable business to the lab. The lab knew it would more than cover its losses on the tests run for the insurance company by charging the Government inflated rates on its many, many Medicare patients.
- OIG has released a special fraud alert stated that it is particularly concerned about cozy relationships emerging between laboratories and referring physicians and their physician group practices. OIG noted that clinical laboratories had been paying doctors for information about patients. The labs pay the doctors to send in information to be included in a “Registry” or “Registry Arrangement” maintained by the lab. The Registry is a database of patients who might undergo specialized, expensive tests that the lab provides. OIG says that some Registry Arrangements violate the Anti-Kickback Statute (AKS). For example, OIG says that it is particularly leery of these sorts of arrangements: the doctor must perform tests a certain number of times each year to be eligible to be paid by the lab; the physician is paid per-patient or in a way that takes into account the volume or cost of the lab tests the doctor or his physicians’ group is sending to the lab; the doctor is being paid more than market value, etc.
To find out more about lawsuits to stop labs from charging Medicare and Medicaid too much, do not hesitate to get in touch with our team. Lee Wallace at The Wallace Law Firm, LLC has over 25 years of experience and she has won millions of dollars for our clients.
Get personalized guidance for your whistleblower claim involving lab fraud by calling (404) 814 0465.