BioReference Health LLC, formerly known as BioReference Laboratories Inc. (BioReference) and OPKO Health Inc. (OPKO), face a $704,349 government fine for medically unnecessary blood tests.
The monetary penalty has resulted from allegations that the collective healthcare testing provider conducted and billed for blood tests without the consent or agreement of a patient’s healthcare provider.
The government has now stepped into the matter, accusing BioReference of knowingly submitting false claims to federal healthcare programs.
These concerns and the complaint were raised in the District of Delaware as part of a legal whistleblower case (United States ex rel. Omni Healthcare Inc. v. OPKO Health, Inc. and BioReference Laboratories Inc., Civil Action No. 19-1670 (DDE)).
The Civil Division’s Commercial Litigation Branch, Fraud Section, and U.S. Attorney’s Office for the District of Delaware achieved the settlement with assistance from the Department of Health and Human Services Office of Inspector General (HHS-OIG).
Blood testing and laboratory providers given financial penalty
“BioReference allegedly profited by fraudulently performing and billing the federal government for unreasonable and unnecessary lab tests,” said U.S. Attorney David C. Weiss for the District of Delaware. “Schemes like these waste taxpayer money and raise healthcare costs for all Americans.
The federal healthcare programs were supposedly billed for “complete blood count (CBC) with automated white blood cell (WBC) differential laboratory tests that were not medically necessary,” said the Justice Department.
The government alleges that BioReference and OPKO consistently billed for more expensive testing in CBC with WBC differential tests. This was in light of the medical providers, who were billed by BioReference, specifically ordering less expensive CBC tests with no WBC differential tests.
Trial Attorney Claire L. Norsetter of the Justice Department’s Civil Division and Assistant U.S. Attorney Shamoor Anis for the District of Delaware announced the settlement and were responsible for the administration of the penalty.
“Health care providers are expected to provide and bill only for services that are medically necessary,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division.
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