NEW YORK – Federal prosecutors recently announced that Florida-based Physicians Toxicology Laboratory has agreed to pay $4.425 million to resolve allegations that it encouraged physicians to order unnecessary drug and hormone tests and sought Medicare reimbursement for those tests.
Officials with the US Attorney for the Western District of Michigan said Friday that, from January 2017 through December 2019, the lab in Tampa had encouraged medical practices in Michigan to order simultaneous presumptive and definitive drug tests for all patients without determining the medical necessity. The lab also had created requisition forms that included orders for the two simultaneous tests and hired its own employees to collect urine samples and fill out those forms within the medical practices.
Physicians Toxicology Laboratory also billed Medicare for urine-based hormone level tests that had been ordered by one of the Michigan healthcare facilities with almost all drug tests. Prosecutors said that the practice ordered those tests to determine specimen validity, which was already included in the reimbursed cost of drug testing.
Prosecutors noted that two of the Michigan healthcare practices, Family Health Partners and Advanced Pain Solutions, d/b/a Vitruvian Health of Ionia, previously agreed to pay $189,000 to settle allegations related to the scheme.
Lund Capital Group, former Physicians Toxicology Laboratory president Matthew Lund, and Thomas Lund have also entered into three-year agreements with the US Department of Health and Human Services Office of Inspector General (HHS-OIG) to establish and maintain a compliance program and employ a clinical director who will review and approve lab policies, practices, and sales and marketing statements. The lab also needs to engage with an independent review organization to review claims for medical necessity and appropriate documentation.