by Ben Vernia | October 26th, 2015
On October 19, the Department of Justice announced that the medical testing company Millennium Health has agreed to pay over a quarter of a billion dollars to settle allegations, first raised by whistleblowers, that the company submitted claims for medically unnecessary tests, and paid kickbacks to physicians for referrals. According to DOJ’s press release:
Millennium Health, formerly Millennium Laboratories, has agreed to pay $256 million to resolve alleged violations of the False Claims Act for billing Medicare, Medicaid and other federal health care programs for medically unnecessary urine drug and genetic testing and for providing free items to physicians who agreed to refer expensive laboratory testing business to Millennium, the Justice Department announced today. Millennium, headquartered in San Diego, is one of the largest urine drug testing laboratories in the United States and conducts business nationwide.
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As part of today’s announced settlements, Millennium has agreed to pay $227 million to resolve False Claims Act allegations, detailed in a complaint filed by the United States, that Millennium systematically billed federal health care programs for excessive and unnecessary urine drug testing from Jan. 1, 2008, through May 20, 2015. The United States alleged that Millennium caused physicians to order excessive numbers of urine drug tests, in part through the promotion of “custom profiles,” which, instead of being tailored to individual patients, were in effect standing orders that caused physicians to order large number of tests without an individualized assessment of each patient’s needs. This practice violated federal healthcare program rules limiting payment to services that are reasonable and medically necessary for the treatment and diagnosis of an individual patient’s illness or injury. The United States also alleged that Millennium’s provision of free point of care urine drug test cups to physicians—expressly conditioned on the physicians’ agreement to return the urine specimens to Millennium for hundreds of dollars’ worth of additional testing—violated the Stark Law and the Anti-Kickback Statute. The Stark Law and the Anti-Kickback Statute generally prohibit laboratories from giving physicians anything of value in exchange for referrals of tests.
Millennium has also agreed to pay $10 million to resolve False Claims Act allegations that it submitted false claims to federal health care programs from Jan. 1, 2012, through May 20, 2015, for genetic testing that was performed routinely and without an individualized assessment of need.
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$19.2 million of the settlement will resolve administrative claims by the Department of Health and Human Services, DOJ wrote. The company also executed a five-year Corporate Integrity Agreement with HHS’s Office of Inspector General.
The Department of Justice announced that eight whistleblower cases will be dismissed as part of the agreement, and that of the $237 million False Claims Act portion of the settlement, whistleblowers will receive a total of $31.83 million (a relators’ share of approximately 13.4%).
