The Boston Division of the FBI announced a $558,793 settlement with Strata Pathology Laboratory, Inc. on Oct. 1, 2015, to settle allegations that the laboratory violated the federal False Claims Act.
The settlement was based upon certain consulting agreements between the laboratory and referring physicians as well as account billing arrangements with referring physicians. In the account billing arrangements, the physicians purchased the pathology services for private payors at a discount from the laboratory, marked up the price, and then re-billed the private payors, profiting from the spread in the purchase price and the reimbursement amounts. The government alleged that the discounted pricing constituted a kickback in exchange for the referral of specimens for federal health care program beneficiaries to the laboratory.
This settlement stemmed from a complaint filed by a former laboratory employee under the whistleblower provisions of the federal False Claims Act. You can get more information from the official FBI press release.
If you have questions regarding your own client billing arrangements, please contact the attorney listed below.