Dive Brief:
- Millennium Health, previously known as Millennium Laboratories, will pay $256 million to settle allegations it violated the False Claims Act by billing Medicare, Medicaid, and other federal healthcare programs for medically unnecessary urine and genetic tests as well as violating the Stark law and Anti-Kickback Statute by providing urine drug test cups to physicians in exchange for their return of the samples to Millennium for testing, the Department of Justice (DOJ) announced this week.
- The company will also pay $10 million to settle allegations it inappropriately billed federal healthcare programs from Jan. 1, 2012, through May 20, 2015, for genetic testing that was "performed routinely and without an individualized assessment of need."
- In addition, Millennium has accepted a corporate integrity agreement (CIA) with the Department of Health and Human Services-Office of Inspector General (HHS-OIG) and will pay a further $19.2 million to CMS to settle issues around the company's urine drug test billing practices, the DOJ says.
Dive Insight:
The DOJ highlights the case as further evidence of success in its crackdown on healthcare fraud, calling it another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative.
At the same time, the major U.S. lab testing company is arranging to file for bankruptcy protection by Nov. 10, which will allow it to turn control over to its lenders, according to an anonymous source quoted by Bloomberg News.
“The Department of Justice is committed to ensuring that laboratory tests, including drug and genetic tests, are ordered based on each patient’s medical needs and not just to increase physician and laboratory profits,” Principal Deputy Assistant Attorney General Benjamin C. Mizer of the Justice Department’s Civil Division said in a prepared statement. “We will not tolerate practices such as the ordering of excessive, non-patient specific tests and the provision of inducements to physicians that lead to unnecessary costs being imposed upon our nation’s healthcare programs.”