New laboratories trigger old fraud concerns

lab

A new company born out of Health Diagnostics Laboratory (HDL), which paid $47 million to settle fraud claims last year, has raised questions about ongoing billing practices, the government’s oversight of laboratories and potential kickback schemes.

After purchasing HDL for $37 million last year, True Health Diagnostics (THD) has tried to distance itself from the business practices used by the former laboratory, according to MedPage Today. The company has allegedly paid physicians to process blood samples.

Although THD has denied any association with HDL, a closer look at the company’s corporate structure raises significant questions. For example, THD’s public relations consultant, Paul Spicer, also served as vice president of marketing and public relations for HDL for five years, according to the news outlet. The former co-founder and a salesperson at BlueWave Healthcare Consultants Inc.--which served as the marketing and sales contractor for HDL until the laboratory severed ties in 2015--both have some involvement with the new company.

On a broader scale, laboratory providers have taken note of the federal government’s tepid enforcement of laboratory kickback schemes. MedPage Today highlighted several potential fraud schemes involving phlebotomy providers and physician-owned laboratories that have sprung up in the aftermath of HDL’s investigation.

An advisory opinion released by Office of Inspector General last year advised laboratories against entering exclusive agreements with physician practices that would cover patient fees. Both Aetna and Cigna have sued HDL and BlueWave for paying $20 blood test processing fees to physicians. HDL has counter-sued Cigna, arguing the insurer owes the company $66 million.

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