Clinical Lab Fraud

Clinical labs play a very important role in provideing modern healthcare. However, some of the most significant cases filed under the False Claims Act have been related to clinical lab fraud.

Clinical lab fraud can take a number of forms including:

Laboratories may engage in illegal kickback schemes where they provide financial incentives or other inducements to physicians or healthcare providers in exchange for patient referrals. These kickbacks can lead to unnecessary tests being ordered or patients being directed to specific labs.

This occurs when a laboratory bills for individual tests that are typically bundled together and billed as a single panel. By billing separately for each test, the lab can inflate the overall reimbursement and increase revenue.

Upcoding involves billing for a more expensive or complex test than was actually performed. Laboratories may manipulate billing codes to receive higher reimbursements for services rendered.

False Billing
False billing involves submitting claims for tests or services that were not provided at all. This can include billing for tests that were medically unnecessary or duplicative.

Improper Marketing and Sales Practices
Some labs engage in deceptive marketing practices to attract more business. This can include offering free or discounted services to patients or physicians, misrepresenting the accuracy or necessity of tests, or providing improper incentives to sales representatives.

Billing for Non-Covered Services
Laboratories may bill for tests or services that are not covered by insurance or government healthcare programs. This can include billing for experimental or investigational procedures or using improper codes to bypass coverage restrictions.

Prosecuting a claim under the False Claims Act is complex. Those who believe they are aware of pharmaceutical fraud should consult an experienced attorney to determine the steps necessary to protect themselves and file a successful claim.

This section is sponsored by:

The Whistleblower Advocates
123 S Broad St #1950-B, Philadelphia, PA 19109
(215) 402-2183

The Whistleblower Advocates is a law firm that is experienced in representing whistleblowers across the United States in Qui Tam actions. Our goal is to help our clients champion truth and integrity within the pharmaceutical industry, while protecting their interests. As legal professionals deeply committed to upholding ethical standards, we represent individuals who courageously step forward to expose fraudulent practices. Our experience extends to various forms of pharmaceutical fraud, including deceptive marketing tactics, the promotion of off-label drug use, and the manipulation of clinical trial data.

By choosing The Whistleblower Advocates team as your partner, you align yourself with a dedicated team equipped to navigate the complexities of whistleblower protection laws. From uncovering unethical sales strategies that prioritize profits over patient safety to revealing instances of kickbacks and illegal incentives within healthcare systems, we provide comprehensive legal support tailored to your unique circumstances. Together, we strive to ensure accountability and transparency, fostering an environment where honesty and compliance are paramount. Take a stand against pharmaceutical fraud with The Whistleblower Advocates and pave the way for a more ethical future in healthcare.

Case types we handle:
Pharmaceutical Fraud
Healthcare Fraud
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Construction Project Fraud
Education Industry Fraud
Financial Industry & Mortgage Fraud
Environmental Fraud
Nursing Home Fraud