(Boise) – Idaho joined 48 other states and the District of Columbia this week in a multistate settlement against San Diego-based Millennium Health, Attorney General Lawrence Wasden said today.
Idaho will receive $41,019 as part of the $256 million settlement.
The settlement resolves alleged violations of the False Claims Act for billing Medicare, Medicaid and other federal health care programs for medically unnecessary urine drug and genetic testing and for providing free items to physicians, who in turn agreed to refer expensive laboratory testing business back to Millennium. Millennium is one of the largest urine drug testing laboratories in the United States and conducts business nationwide.
As part of the settlement, Millennium, formerly Millennium Laboratories, has agreed to pay $227 million to resolve False Claims Act allegations that the company systematically billed federal health care programs for excessive and unnecessary urine drug testing from January 1, 2008, through May 20, 2015.
The states alleged that Millennium caused physicians to order excessive numbers of urine drug tests, in part through the promotion of “custom profiles.” Instead of being tailored to individual patients, they were in effect standing orders that caused physicians to order a large number of tests, without an individualized assessment of each patient’s needs. This practice violated federal healthcare program rules limiting payment to services that are reasonable and medically necessary for the treatment and diagnosis of an individual patient’s illness or injury.
The states also alleged that Millennium’s provision of free point-of-care urine drug test cups to physicians—expressly conditioned on the physicians’ agreement to return the urine specimens to Millennium for hundreds of dollars worth of additional testing—violated the Stark Law and the Anti-Kickback Statute. The Stark Law and the Anti-Kickback Statute generally prohibit laboratories from giving physicians anything of value in exchange for referrals of tests.
Millennium has also agreed to pay $10 million to resolve False Claims Act allegations that it submitted false claims to federal health care programs from January 1, 2012, through May 20, 2015, for genetic testing that was performed routinely and without an individualized assessment of need.
In connection with the False Claims Act settlements, Millennium has also entered into a corporate integrity agreement (CIA) with the Department of Health and Human Services-Office of Inspector General (HHS-OIG). In addition, Millennium will pay $19.2 million to the Centers for Medicare and Medicaid Services (CMS) to resolve certain administrative actions related to Millennium’s urine drug test billing practices.
The False Claims Act allegations resolved were originally brought in lawsuits filed by whistleblowers under the provisions of the False Claims Act, which allow private parties to bring suit on behalf of the government and to share in any recovery.
A team representing the National Association of Medicaid Fraud Control Units conducted settlement negotiations with Millennium Health on behalf of the states.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
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