LabCorp (Laboratory Corporation of America Holdings) has been hit with a whistle-blower federal lawsuit alleging the laboratory services company defrauded Virginia’s Medicaid program by billing it at much higher rates than other customers, according to a recently unsealed complaint filed in federal court on September 9th.
Relators Hunter Laboratories LLC and its founder Chris Riedel contend that LabCorp made false claims for payment of Medicaid-covered laboratory tests by claiming that the fees they charged to Medicaid were no higher that the maximum allowed under Virginia regulations.
As a participating Medicaid provider, LabCorp is required to provide services to Medicaid patients at their most favorable rates, but they repeatedly defrauded Medicaid by billing the program for fees well in excess of their lowest costs, according to the complaint.
For example, LabCorp, the Relators say, provided volume-based discounts to members of the Premier Inc. purchasing collective, resulting in discounted fees that are way below what LabCorp has billed to Medicaid.
“This suit calls defendants to answer for defrauding Virginia’s taxpayers and compromising the welfare of Medicaid beneficiaries,” the Relators said.
Additionally, for some tests, rates for private customers have been discounted well below costs, but LabCorp nevertheless has an interest in keeping those rates low in order to prevent any other laboratories from gaining a piece of the market, according to the complaint.
“In other words, by using the publicly funded Medicaid program to subsidize private discounts, the larger and better established laboratories have cornered much of the market for themselves,” the complaint said.
The suit alleges violations of the Virginia Fraud Against Taxpayers Act. The Relators are seeking civil penalties and treble damages.
Representatives for LabCorp did not immediately respond to requests for comment on Wednesday.
Riedel and Hunter have won big in cases against LabCorp before. In 2011, LabCorp agreed to pay $49.5 million to settle a California lawsuit alleging it illegally overcharged Medi-Cal for laboratory tests and gave kickbacks in exchange for Medi-Cal referrals.
The suit originated with a qui tam complaint also filed in 2005 Riedel and Hunter alleging that LabCorp and others had systematically overcharged Medi-Cal over a 15-year period. In March 2009, then-California Attorney General Jerry Brown announced that the state had intervened in the suit.
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Andrew Baker, the former CEO of Unilab and current CEO of Huntington Life Sciences, has written an article for The Huffington Post in which he asks the federal government to stop LabCorp and another lab company from continuing to scam the Medicare and Medicaid programs of billions of dollars.
Mr. Baker had previously filed a whistleblower lawsuit against LabCorp in 2007 alleging that LabCorp violated the federal False Claims Act and Anti-Kickback Statutes. Those case is still in court.
In the article he estimates that LabCorp and the other lab have cost taxpayers $15 billion since 1996 in the form of false claims stemming from illegal kickbacks to Aetna, Cigna, United Healthcare and Blue Cross.
The claims are that Labcorp is breaking federal laws by deeply discounting lab fees to private insurance companies, sometimes charging them for laboratory tests even below their costs. In exchange, the insurance companies pressure doctors in their networks to send all of their patients’ lab work, including Medicare and Medicaid patients, to LabCorp.
He claims that Labcorp funds the kickbacks, in the form of lower lab fees for private insurance companies, by charging Medicare and Medicaid patients the highest possible fee instead of offering them the lowest charged price, and by pressuring doctors to send all of their lab work exclusively to Labcorp. Other categories in Medicaid and Medicare require that the government be charged the lowest charged fees by a provider.
Mr. Baker also mentions LabCorp’s $50 million settlement with the state of California for overcharging California’s Medicaid program and for providing kickbacks to physicians for referrals.
As a result of his article, pressure is increasing for government intervention in laboratory pricing for government programs. He advocates for clarification of the intent of current federal law that would require laboratories to charge Medicare and Medicaid their “best price”, just as California has already done. This would require that Laboratory Corporation of America can only charge Medicare and Medicaid the lowest price they charge private insurance companies or HMOs. Which in turn means a massive hit to Labcorp’s bottom line. It would also open up the market to smaller labs which don’t have the multi-tier, lower than cost pricing intended to put them out of business. Such a hit to Labcorp’s financials would tumble their stock (NYSE: LH).
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LabCorp has been sued and is under Federal investigation for Medicaid and Medicare fraud. In addition, it’s under scrutiny by the U.S. Senate Finance Committee who is investigating Medicare and Medicaid fraud. Laboratory Corporation of America was ordered to hand over its financial records to the U.S. Senate.
A lawsuit was filed on behalf of the Federal government that claims LabCorp operated a “pull-through” scheme to force doctors covered by insurers to use LabCorp for all medical testing viagra uk buy. The suit claims LabCorp (NYSE: LH) offered illegal discounts to doctors in exchange for referring all their patients who need laboratory testing to the company. According to federal anti-kickback laws, it’s illegal for health care companies to directly or indirectly compensate other parties to encourage them to order any service paid for by the federal health care programs.
Under federal law, companies can’t charge or participate in the Medicare or Medicaid program if they violate federal laws. The suit claims LabCorp charged Medicaid and Medicare more than $1 billion, which is about 20% of the companies total income. If LabCorp is found guilty they will not be allowed to conduct lab tests on anyone covered by Medicaid and Medicare, which is a large portion of LabCorps testing income.
On other news, LabCorp secured a new credit line of $1 billion. What a coincidence.
Tags: billing, federal investigation, Government Investigations, health care, kickback, labcorp, Labcorp Criminal, labcorp unethical, Labcorp Wrongdoings, laboratory Corporation of America, medicaid, medicaid fraud, medicare
Just last month, LabCorp reported that they made $131.4 Million dollars in profit for the latest quarter, on revenue of $1.19 Billion. That was a 17% increase in profits as compared to the same quarter last year. Obviously LabCorp stock (NYSE: LH) went up to a new yearly high and all the senior executives high-fived each other.
Well that was last month. Just a few days ago Labcorp went to the state and local governments in North Carolina for a handout of taxpayer money. LabCorp wants to consolidate its billing operations and if it selects Greensboro as the location of the new facility, it would receive nearly $900,000 in taxpayer money. That’s free money from the taxpayers that will never be repaid.
The Burlington-based company is reportedly considering moving its billing operations from 24 sites across the country to one location in Greensboro or in Danville, Virgina. On Thursday, Guilford County commissioners approved giving the company $248,791 of tax payers money. The city of Greensboro also is offering $373,000. North Carolina would grant Labcorp $275,000 of taxpayer money. That’s a total payoff of $896,791 of taxpayer’s money. The excuse the elected officials are using is North Carolina’s unemployment rate, which is up to 11% and above the national average. This is the ninth straight month the state’s unemployment rate has reached double digits. So what is the government doing handing out free money to a company that just made over $131 Million in the last three months?
So as I see it, a cash strapped state, county and city have decided to payoff LabCorp, a company that made over $131 Million in profits over the last three months, to move their billing operations to their region. It is obvious that LabCorp threatened to move the operation to Virginia in order to get the cash from the taxpayers of North Carolina. I would like to know how many of the elected officials involved in the decision have, or will receive political contributions from LabCorp? Who knows what LabCorp will ask for next? How about adding the following motto to the state’s seal “Property of LabCorp.”
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Making a lab error on a blood test can have a serious impact on a life. I don’t know if LabCorp employees don’t care, or if they are simply numb to the impact of their lab errors because they rapidly run through so many blood tests. This is part of their “quantity is more important than quality” problem.
I received this email from Natasha today. I don’t know what I would do if this LabCorp lab error occurred during a blood test on my child. It is devastating news that no one should have to endure as a result of a lab error.
LabCorp diagnosed my son with a rare genetic disorder called Angelman Syndrome by a Methylation blood work test. This syndrome is characterized with mental retardation, lack of speech, and seizures just to name a few symptoms. Our family was devastated, and we grieved for months.
When he got in to see a neurologist, he ordered another test to get more information about which type of the syndrome he may have. This test came back negative. We were shocked, but tried not to get our hopes up too high because we did not know which test was accurate. When we finally got in to see the geneticist, he ordered another round of genetic testing, this time a more detailed test called a cgh, as well as the original test. All negative.
LabCorp told the genetic counselor that they think they switched his blood. For privacy reasons they wont tell us anything, but assured her that they would try and find the child who really has this condition. As relieved as we were to have the good news, we are so angry for this mix up happening in the first place. Months and months of our lives were taken from us, and I still have not received one phone call from Lab Corp. We are unsure how to proceed from here. Anyway, this is an EXTREMELY abbreviated version of the story. Please let me know if you would like more information, I will do anything to help, no family should go through what we experienced.
My recommendation to Natasha is that she find a lawyer and sue LabCorp for punitive damages. A blood test lab error of this magnitude should be sufficient grounds for a lawsuit. One that I am sure LabCorp would settle quickly before the news quickly spreads and their testing service loses even more credibility.
The days between getting LabCorp’s lab results and finding out about LabCorp’s error were probably Natasha’s worst days of her life. No health services provider has the right to do this to anyone. It’s obvious that Laboratory Corporation of America understands money, so they should pay for their mistake. In addition, government regulators should step in so that this never happens again.
The United States Food and Drug Administration issued a letter to LabCorp warning them that they are in violation of the law. LabCorp doing illegal things brings up their checkered past, when they were charged with fraud in the LabScam investigation.
The FDA warning letter and possible criminal and civil action against LabCorp could be the beginning of the end for Laboratory Corporation of America. I say this because as one government agency moves against them, there are possibly other government agencies that might step up to further investigate other allegations against the company. It’s about time that this regulatory oversight process start. For too long LabCorp has focused on the buck as opposed to the law and the required quality standards. In my own opinion, it is a company that is out of control.
Here’s the FDA story:
WASHINGTON, Oct 8 (Reuters) – Laboratory Corp of America (LH.N: Quote, Profile, Research, Stock Buzz) is violating the law by selling an ovarian cancer screening test without regulatory approval, U.S. health officials said on Wednesday.
The OvaSure test does not fall in a category that can be sold without prior clearance from the agency, the Food and Drug Administration said.
“Because you do not have marketing clearance or approval from the FDA, marketing OvaSure is in violation of the law,” the agency said in a letter dated Sept. 29.
The agency told the company to “take prompt action to correct these violations.”
LabCorp spokesman Eric Lindblom said the company was “disappointed” by the letter.
“We are currently in discussions with the FDA over the next steps and of course we share the FDA’s determination to assure patients are protected,” he said.
The company started selling the blood test in June, saying it could detect early-stage ovarian cancer in high-risk women.
The FDA letter was posted on the FDA website. You can read the full letter by clicking here.
LabCorp shares (NYSE: LH) fell nearly 1.8 percent today to close at $60.63 on the New York Stock Exchange.