Compliance News Roundup: Unnecessary Tests

1. Florida pain clinic to pay $7.4M for Medicare fraud - “A company that runs pain clinics in northeast Florida will pay the federal government $7.4 millionafter an investigation found that it was fraudulently billing Medicare for unneeded patient drug tests:” http://www.nbc-2.com/story/32945626/florida-pain-clinic-to-pay-74m-for-medicare-fraud

2. United States Settles False Claims Act Allegations Against Coastal Spine and Pain For $7.4 Million - “The United States Attorney’s Office is committed to taking the steps necessary to protect Medicare, TRICARE, and other federal healthcare programs from fraud,” said U.S. Attorney Bentley. “When health care practitioners conduct medical tests, they must only bill for them when it is appropriate and medically necessary. We will vigorously pursue providers that perform tests indiscriminately, regardless of need:” https://www.justice.gov/usao-mdfl/pr/united-states-settles-false-claims-act-allegations-against-coastal-spine-and-pain-74

3. Deeper Than the Headlines: Unnecessary Tests - Compliance officer CJ Wolf takes the Florida Pain Clinic settlement and analyzes what happened from a compliance standpoint and how it could be prevented.“In the case of Coastal Spine and Pain, the government alleged that even though the clinic’s use of qualitative drug screening was appropriate, the clinic always performed the additional, and more expensive, quantitative drug tests. The government stated the clinic did this 100% of the time, regardless of the result of the initial qualitative screening test. The government contended this was medically unnecessary, as there was no reason to question or further confirm previous qualitative urine drug testing screens:” Deeper Than the Headlines: Unnecessary Tests