Compliance News Roundup: Kentucky Faces Numerous False Claims Act Violations

Compliance News Roundup: Kentucky Faces Numerous False Claims Act Violations

Posted by Healthicity
Nov 27, 2019 9:30:30 AM

1. Kentucky Lab Agrees to Pay $2.1 Million for False Urine Drug Testing Claims - LabTox, LLC, a clinical laboratory in Lexington, KY agreed to pay $2,101,335 to resolve civil allegations that it violated the False Claims Act. The allegations relate to urine drug testing services LabTox provided to Medicare and Kentucky Medicaid beneficiaries. According to the settlement, LabTox billed for qualitative urine drug screens completed by a high complexity method, which resulted in higher reimbursement rates, while the actual complexity of the testing method was the opposite, the US Attorneys argued. In addition to agreeing to pay the $2.1 million settlement, LabTox also entered into an Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General.

Read more about LabTox’s Settlement here >>

2. Kentucky Hospital to Pay over $10 Million to Resolve False Claims Act Allegations - Meanwhile, Pharmacy Plus and Pharmacy Plus Specialty, of Louisville, KY, agreed to pay $10,101,132 to resolve False Claims Act allegations that it knowingly submitted false claims to the Medicare program. The settlement resolved allegations that they knowingly submitted claims to Medicare for prescription drugs that did not meet Medicare coverage requirements, including the need to obtain the treating physician’s signature on the order establishing medical necessity, to confirm that refills were reasonable and necessary.

Read more about Kentucky’s Fraud Problem >>

3. Deeper Than the Headlines: The Results of a Skilled Nursing Facility Audit - The OIG recently conducted an audit of a Skilled Nursing Facility to determine the accuracy of its Resource Utilization Groups. According to findings, the SNF in question did not properly support all therapy minutes because it inappropriately included unskilled time for electrical stimulation therapy. The errors occurred because staff did not understand that unskilled time should not be included in the MDS minutes. As a result, the SNF received some unearned funds…

Go Deeper Than the Headlines here >>

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