Medicare Compliance & Reimbursement
Blood Test Panels Now Under The OIG's Microscope
Labs could find that every commonly ordered blood test panel or profile they submit is rejected as fraudulent if any of their components are medically unnecessary.
That nightmare scenario became a reality for Health Line Clinical Laboratories and its owners after two former employees blew the whistle and called into question seven years' worth of blood tests billed to Medicare and Medicaid. The U.S. Attorney's office in northern California revealed April 21 that it had resolved the charges after the Los Angeles-based lab agreed to a $10 million civil settlement.
Former HLCL salespersons Kim Jenkins and Timothy Mills brought the qui tam suit after allegedly discovering that from 1996 to 2003, lab owners Dr. Aramais Paronyan and Natella Lalabekyan had routinely altered comprehensive blood test panels and profiles ordered by physicians by adding and then billing for five medically unnecessary tests.
Under the whistleblower provisions of the False Claims act, Jenkins and Mills could be eligible to a portion of the financial recovery.
Lesson Learned: Failure to monitor blood test panel claims could put your lab in jeopardy.
Medicare Compliance & Reimbursement
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