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Health fraud settlement totals $1.2 million

CHARLESTON, W.Va. — A Michigan lab company will pay $1.2 million to settle claims of fraud involving Medicare, the United Mine Workers of America 1992 Benefit Plan, the 1993 Benefit Plan and the Combined Benefit Fund.

The case against Great Lakes Medical Laboratory involved the U.S. Attorney’s Office in the Southern District of West Virginia, the U.S. Department of Health and Human Services, Office of Inspector General and the U.S. Department of Labor, Office of Inspector General.

The allegations centered on alleged billing fraud between Jan. 2016 and May 2017.

Great Lakes Medical Laboratory was a routine testing site for urine and blood samples from West Virginia.

Federal investigators said they determined that at least 21,732 testing claims submitted for reimbursement had already been included in bills submitted for other lab services.

In some cases, reimbursements were sought for services that had not been ordered through or were not performed by referring physicians.

The settlement amount was double what officials said was the actual loss of more than $600,000.

Under the terms of the settlement, Great Lakes Medical Laboratory has signed onto a three-year Integrity Agreement with the U.S. Department of Health and Human Services, Office of the Inspector General.

As part of it, the company is required to maintain compliance and risk assessment programs and hire an Independent Review Organization to monitor Medicare and UMWA Funds claims.

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