Dive Brief:
- Detroit US Attorney Barbara McQuade says evidence of healthcare fraud involving laboratories and hospices is mounting.
- According to McQuade, molecular diagnostic testing by labs and end-of-life care for the terminally ill are "emerging and current threats" to Medicare and Medicaid in Eastern Michigan, which has been dealing with healthcare fraud for a number of years.
- At the same time, Detroit prosecutors have also been struggling with fraud related to adult foster care.
Dive Insight:
Attorneys in McQuade's office say the laboratories are committing fraud by unbundling and billing separately for samples that were submitted for analysis as a panel. “It's difficult for the physicians to keep track of what the labs are billing for," Joan E. Hartman, the health fraud case coordinator for the US attorney's office in Michigan told Law 360. "It's kind of an easy fraud to get away with if the physician doesn't know what's going on."
As for the hospices, doctors have been accused of accepting kickbacks from for-profit hospices to falsify certifications of patient eligibility in order to allow patients to be admitted sooner.