- Millennium Health, the largest drug-testing lab in the United States, may end up paying $250 million in fines for billing the goverment for unnecessary Medicare testing.
- The allegations against the company are that they performed unnecessary tests on patients, including conducting a cheap standard test and then re-testing with a more expensive test—even when the re-test was not warranted.
- This federal investigation, which involves the Department of Justice (DOJ), the Department of Health and Human Services (DHHS), the Office of the Inspector General (OIG), as well as the Centers for Medicare and Medicaid Services (CMS), has been ongoing for three years.
According to an article in the Wall Street Journal, high-tech drug billing testing costs skyrocketed by almost 2000% over a six-year period to $612 million in 2013—and much of those costs were borne by Medicare. Testing includes everything from testing for narcotics and party-drug abuse, to standard blood testing for health screening.
It has been easy to procure higher payments for bigger bills by testing for multiple substances at once, which allows labs to bill up to $1,000 for a test. However, the federal government is cracking down with series of new regulations, including capped fees for testing. The proposed lump-sum payment is in the range of $175 to $350. While a capped fee will deter excessive testing and billing, the high-profile Millennium case should also provide an example of what not to do.