Government sues laboratory companies, owner for billing for unordered tests

by Ben Vernia | August 22nd, 2023

On July 17, the Department of Justice announced that it had filed civil complaints targeting the owner of several laboratory companies which the government alleges submitted claims for tests that physicians had not ordered. According to DOJ’s press release:

The Justice Department has filed a complaint against Patrick Britton-Harr and multiple laboratory companies owned by him alleging False Claims Act violations for submitting claims to Medicare for laboratory tests that were not ordered by health care providers, not medically necessary, and sometimes never performed. 

According to the complaint, Britton-Harr owned and operated Provista Health LLC as well as multiple other corporate entities that allegedly sought to profit from the unfolding COVID-19 pandemic by offering COVID-19 tests to nursing homes as a way to bill Medicare for a wide array of medically unnecessary respiratory pathogen panel (RPP) tests. The complaint alleges that these RPP tests were not medically necessary because the beneficiaries had no symptoms of a respiratory illness and because the tests were for uncommon respiratory pathogens.

The complaint also alleges that Britton-Harr and Provista Health submitted claims for RPP tests that were never ordered by physicians. Multiple physicians denied ever ordering the thousands of RPP tests for which Britton-Harr and Provista Health allegedly submitted claims to Medicare listing one of these physicians as the ordering provider. The complaint further alleges that Britton-Harr and Provista Health submitted claims to Medicare for RPP tests that were never performed, including over 300 claims that stated that the nasal swab test sample was supposedly collected from the beneficiary on a date after the beneficiary had died.    

As alleged in the complaint, Britton-Harr wholly owned and operated Provista Health, AMS Onsite Inc., Britton-Harr Enterprises Inc., Coastal Laboratories Inc. and Coastal Management Group Inc., and these companies – together with Britton-Harr – conspired to carry out these schemes. 

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The cases apparently arose from a government investigation, rather than from a whistleblower lawsuit.

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