Strata settles charges of false Medicaid, Medicare claims

Strata settles charges of false Medicaid, Medicare claims

http://www.bostonglobe.com/business/2015/10/01/lexington-lab-settles-charges-false-medicaid-medicare-claims/JFbHiY1jXrtgoqGVqiphiM/story.html

and

http://www.justice.gov/usao-ma/pr/strata-pathology-resolve-allegations-regarding-kickback-payments




By Jack Newsham Globe Correspondent October 01, 2015

A Lexington medical lab will pay $559,000 over claims it paid kickback fees to doctors for patient referrals.
Strata Pathology Laboratory, Inc. of Lexington, known as StrataDx, settled with federal and state authorities who accused it of striking deals with doctors that resulted in overcharges for private insurers and extra expenses for Medicare and Medicaid.
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“When a company prioritizes profit, it disregards laws that are intended to protect patient health and the integrity of the healthcare system,” said Carmen Ortiz, the US Attorney for Massachusetts. “Settlements like this serve to deter illicit kickback schemes.”
Federal authorities claimed Strata paid sham “consulting fees” to two physician practices and struck bill-splitting agreements with seven others. The government said the doctors would bill insurance companies the full price for lab work, but subcontract that work out to Strata to do it at a discount. Whenever a Medicare or Medicaid patient needed lab tests, which pay less for such services than private insurance companies, the government alleged the doctors would refer that patient to Strata.
The settlement stemmed from a complaint by a whistleblower and former Strata employee who sued under the False Claims Act, the Department of Justice said. The settlement will be split among the whistleblower, the state, and the federal government.
The company didn’t immediately reply to a request for comment.