Florida lawmakers delayed a vote on a Medicaid reimbursement bill after state Attorney General Pam Bondi argued the legislation would disrupt the state's case against two medical labs and would have broad implications for fraud litigation in other states, according to WCGU Public Media.
In a rare committee hearing appearance, Bondi called a bill submitted by Republican state Rep. Jay Trumbull "an end run desperate attempt in a potentially multimillion dollar case that impacts Florida and other states around the country." According to Trumbull, the bill would provide clarification for "usual and customary" Medicaid payments charged by laboratories.
Bondi argued that other states are watching Florida to see how it handles a fraud investigation involving Quest Diagnostics and Laboratory Corporation of America that allegedly overbilled Florida's Medicaid program for laboratory services. Although she declined to give any details about the case, she indicated that "tens of millions of dollars" hang in the balance, according to WCGU.
In 2011, several U.S. senators called for an investigation of a potential billion-dollar fraud scheme they claimed was orchestrated by Quest, LabCorp, Aetna, Cigna and United Healthcare following an overbilling settlement in which the two laboratories paid $300 million collectively to California. More recently, Quest Diagnostics agreed to pay the federal government $1.79 million to settle claims it submitted duplicate bills to Medicare.
Since 2014, clinical laboratory services have drawn the ire of the Office of Inspector General after spending for lab services jumped 29 percent in five years. Since then, drug testing labs like Millennium Health have settled FCA allegations for $250 million, while Health Diagnostics Laboratory paid $50 million to settle FCA violations.
To learn more:
- here's the WCGU article
Senate to probe Aetna, Cigna, United Healthcare, Quest, LabCorp for alleged billion-dollar fraud
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Lab services, pay arrangements draw OIG's eye
Health Diagnostics Laboratory to pay nearly $50 million to settle kickback allegations