NEW YORK – Boston Heart Diagnostics will pay nearly $26.7 million to resolve False Claims Act allegations, the US Department of Justice announced this week.
The DOJ had charged the Framingham, Massachusetts-based lab company with conspiring to pay doctors kickbacks that were disguised as investment returns. Between 2015 and 2017, Boston Heart agreed to provide laboratory testing services to small Texas hospitals in return for payments per test. The company coordinated with independent marketers of the hospitals to generate more referrals to the hospitals and itself, the DOJ alleged, adding the marketers created companies known as management service organizations to pay referring doctors. The payments were disguised as investment returns, when in truth, according to the agency, they were based on and in exchange for physician referrals.
The patients were referred to the Texas hospital and Boston Heart for lab tests, which were then billed to Medicare, Medicaid, and Tricare.
The settlement resolves charges that Boston Heart conspired with the Texas hospitals and others to submit claims for outpatient lab tests for patients who weren't outpatients in order to get higher reimbursements from federal health programs.
The allegations were originally made in two whistleblower cases, and the whistleblowers will receive about $4.4 million of the settlement, the DOJ said.