SOUTH CAROLINA
Quest Diagnostics Inc. agreed to pay $6 million to settle a lawsuit alleging that the laboratory paid kickbacks to doctors and did unnecessary testing, according to officials.
Quest, which is headquartered in Madison, New Jersey, acquired Berkeley Heartlab Inc. in 2011, which paid the kickbacks and did the unnecessary testing.
Quest ended the illegal conduct that sparked the lawsuit and subsequent settlement.
“We rely on doctors to provide honest, independent recommendations regarding clinical testing,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “Companies that pay kickbacks to referring doctors corrupt those doctors’ independence, leaving patients vulnerable to expensive and unnecessary testing.”
According to the complaint, Berkeley paid kickbacks to referring physicians disguised as “process and handling” fees.
The government’s complaint further alleged that these illegal practices resulted in medically unnecessary cardiovascular tests being charged to federal healthcare programs.
The statute is intended to ensure that a physician’s medical judgment is not compromised by improper financial incentives and is instead based on the best interests of the patient.
The statute also prohibits routinely waiving patient copayments to ensure that patients are appropriately incentivized to refuse unnecessary tests.
“We will not allow laboratories to provide financial incentives to induce physicians to steer patients their way,” said Special Agent in Charge Derrick L. Jackson of the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta. “The Office of Inspector General will continue to work aggressively to eliminate this type of behavior which ultimately drives up healthcare costs and eliminates fair competition.”
The lawsuit was initially filed by Dr. Michael Mayes under the qui tam, or whistleblower, provisions of the False Claims Act.
Under the act, private citizens can bring suit on behalf of the government for false claims and share in any recovery.
The act permits the federal government to intervene in and take over a whistleblower suit, which it did in this case in 2015.
On April 9, 2015, the federal government announced settlements with two other laboratories – Health Diagnostics Laboratory Inc. of Richmond, Virginia, and Singulex Inc., of Alameda, California – for engaging in conduct similar to that resolved in the settlement with Quest.