SelfRefind, a chain of addiction treatment clinics; PremierTox LLC, a clinical laboratory that performs urine testing; and the two doctors who own SelfRefind and PremierTox, have agreed to pay $15.75 million to resolve allegations that they violated the False Claims Act by submitting claims to Medicare and Kentucky’s Medicaid program for tests that were medically unnecessary, or were more expensive than those performed or billed in violation of the Stark Law. SelfRefind provides addiction services to Medicare and Medicaid beneficiaries in 12 locations across Kentucky.
In December 2010, the doctors each purchased a 20 percent ownership stake in PremierTox, a new, independent clinical laboratory created to perform urine drug testing. The government alleged that, after they became owners of PremierTox, SelfRefind began referring comprehensive urine drug screening tests to PremierTox that were unnecessary and many times more expensive than other suitable alternative tests. The government also alleged that PremierTox submitted to Medicare and Medicaid inflated claims that misidentified the class of drug being tested and billed for tests that were referred by SelfRefind in violation of the Stark law. The Stark Law forbids a laboratory from billing Medicare and Medicaid for certain services referred by physicians that have a financial relationship with the laboratory.
This settlement is the result of a coordinated effort among the Justice Department’s Civil Division, the U.S. Attorney’s Office for the Eastern District of Kentucky, the Kentucky Attorney General’s Office and the U.S. Department of Health and Human Services Office of Inspector General. Of the total $15.75 million settlement amount, the federal share is $13.01 million, and the remaining $2.74 million will be paid to the Commonwealth of Kentucky.
See the DOJ Announcement