Medicus Laboratories, LLC (Medicus) has agreed to pay $5 million and enter into a 5-year Corporate Integrity Agreement with the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS). The settlement reflects OIG’s ongoing efforts to combat fraud in the urine drug testing industry through a unique combination of audits, investigations, and legal remedies.
The settlement resolves OIG’s allegations that Dallas-based Medicus violated the Civil Monetary Penalties Law by submitting false or fraudulent claims to Medicare. Specifically, OIG contended that Medicus knowingly presented multiple, prohibited claims to Medicare for a single patient encounter and submitted claims for other laboratory tests not covered by Medicare.
“OIG uses a multidisciplinary approach to protect HHS programs,” said Gregory E. Demske, Chief Counsel to the Inspector General. “This matter, begun through OIG data-mining by OIG auditors, shows that once we uncover fraudulent billing, OIG will quickly shift gears and impose civil money penalties to recover taxpayer dollars and ensure that Medicare providers abide by the rules.”
“As the largest payer of clinical laboratory services, Medicare is vulnerable to fraud, waste, and abuse. This case serves as an example of our continued efforts to protect the integrity of Medicare payments for clinical lab services,” said Brian P. Ritchie, Assistant Inspector General for OIG’s Centers for Medicare & Medicaid audits.
In resolving this matter through settlement Medicus has denied any liability. No judgment or finding of liability has been made against Medicus.
Link to article: http://oig.hhs.gov/newsroom/news-releases/2014/drug-cmp.asp