A chain of addiction treatment clinics, a clinical laboratory, and two doctors have agreed to pay $15.75 million to resolve allegations they violated the federal False Claims Act. SelfRefind, which operates 12 clinics in Kentucky, PremierTox, which performs urine testing for the clinics, and Drs. Bryan Wood and Robin Peavler, owners of the clinics and laboratory, entered into the settlement. It was claimed the defendants fraudulently submitted claims to Medicare and Kentucky’s Medicaid program for tests that were medically unnecessary, overly expensive, and referred in violation of the Stark Law.
After the doctors acquired an ownership interest in PremierTox, they allegedly referred urine tests to PremierTox that were unnecessary and many times more expensive than other suitable alternative tests. PremierTox then submitted inflated claims for reimbursement from Medicare and Medicaid. Finally, SelfRefind’s referrals to PremierTox were said to have violated the Stark Law, which prohibits a laboratory from billing Medicare and Medicaid for certain services referred by physicians who have a financial interest in the laboratory.
The case was handled in partnership between the federal and state government. Stuart F. Delery, Assistant Attorney General for the Justice Department’s Civil Division, stated:
Billing Medicare and Medicaid for lab tests that are not necessary contributes to the soaring costs of health care. Providers will be investigated aggressively and held accountable for falsely billing federal health care programs.
Lawyers at Beasley Allen continue to investigate, file, and litigate whistleblower cases under the False Claims Act, especially in the area of health care fraud. Our lawyers have successfully handled cases against addiction clinics in the past. For further information, call 800-898-2034 and ask for either Archie Grubb (Archie.Grubb@BeasleyAllen.com) or Andrew Brashier (Andrew.Brashier@BeasleyAllen.com), lawyers in our firm’s Consumer Fraud Section.
Source: DOJ press release
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