Millennium Health Pays $256 Million in Settlement with DOJ Involving False Claims Act Allegations: Omni Healthcare of Melbourne, Florida, Receives Millions as One of Eight Whistleblowers
Wednesday, November 4, 2015
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health LawMillennium Health (Millennium), formerly Millennium Laboratories, Inc., entered into a settlement with the Department of Justice (DOJ) on Monday, October 19, 2015, agreeing to pay $256 million to resolve allegations of False Claims Act (FCA) violations. The allegations include billing Medicare, Medicaid and other federal health care programs for medically unnecessary urine tests and for providing kickbacks to physicians in exchange for referrals in violation of the Anti-Kickback Statute (AKS). Omni Healthcare (Omni), a Melbourne-based medical group, was one among the eight whistleblowers who filed qui tam actions against Millennium. Omni, along with the seven other whistleblowers, will receive its share of $30.35 million from the FCA recovery in the suit for the urine drug testing claims. Omni is expected to receive an additional $1.48 million for the genetic testing claims which account for $10 million of the full settlement amount. To read the settlement agreement dated October 16, 2015, as to pharmacogenetic testing, click here.
An Alleged Scheme to "Over-test" and Provide Physician Kickbacks.Millennium, a California-based lab specializing in drug and pharmacogenetic testing, is alleged to have violated the FCA, Stark Law and AKS by: (1) creating "custom profiles" for urine tests; (2) pressuring physicians to increase the number of tests per specimen by offering inducements such as free urine cups and other kickback schemes; (3) encouraging physicians to code multi-class qualitative urine drug screens using single specimens; and (4) "over-testing" by performing medically unnecessary genetic testing on pain management patients. Millennium reportedly billed federal health care programs for excessive and unnecessary urine drug testing for a lengthy period of time between January 1, 2008 to May 20, 2015. By allegedly creating and promoting "custom profiles" for drug testing, Millennium was discouraging physicians from individualizing testing to fit each patient's assessed needs. Furthermore, Millennium allegedly submitted false claims to federal health care programs from January 1, 2012 through May 20, 2015, for routine genetic testing that once again did not take into consideration the actual needs of the patients. To read the full press release issued by the DOJ, click here.
Whistleblowers Are Getting Rich!In just the last few weeks, we have seen several whistleblowers achieve big success right alongside the DOJ in the ongoing fight against health care fraud. The recent Tuomey settlement resulted in an $18.1 million payout to whistleblower, Dr. Michael K. Drakeford. To read our previous blog post on the Tuomey settlement, click here. The Millennium settlement parallels the Warner Chilcott and Novartis settlements of $125 million and $390 million, respectively. To read our previous blog post on the Novartis settlement, click here. This trio of settlements is also coincidentally on the coattails of a memorandum issued by Deputy Attorney General, Sally Quillian Yates, ("Yates memo"), calling for more accountability of individuals possessing criminal culpability in corporate health care fraud schemes. To read the "Yates memo," click here. Section 3730(b), 31 United States Code, provides for private parties, known as qui tam relators, to bring an action under the FCA on behalf of the United States. Qui tam relators are offered incentive to report these incidences of health care fraud with the promise of a quite significant percentage share of the proceeds obtained in an FCA action or settlement. This share is between no less than 15% and no more than 25% of the proceeds recovered by the government. This often results in millions for a qui tam relator (a.k.a. whistleblower). To read more about FCA actions brought by private parties, click here. To learn more about whistleblower/qui tam cases brought under the FCA, read our two-part blog. Click here for part one and click here for part two.
Comments?Do you suspect health care fraud or abuse in your workplace? Are you currently facing allegations of violations of the False Claims Act? Do you have questions or concerns about whether your current professional practices may constitute violations of the False Claims Act?
Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.Attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistleblower cases both in defending such claims and in bringing such claims. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
Sources:Department of Justice, Office of Public Affairs. "Millennium Health Agrees to Pay $256 Million to Resolve Allegations of Unnecessary Drug and Genetic Testing and Illegal Remuneration to Physicians." Press release. Justice News: 19 Oct. 2015. Web. 2 Nov. 2015.Price, Wayne T. "Omni Wins Millions in Fraud Deal: Omni Healthcare Whistleblower in Major Justice Department Settlement." Florida Today: 20 Oct. 2015. Web. 2 Nov. 2015.Trostorff, Danielle. "Millennium Health Settles Eight FCA Case Involving Urine and Pharmacogenetic Testing." American Health Lawyers Association: 26 Oct. 2015. Web. 27 Oct. 2015.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
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“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. Copyright © 1996-2015 The Health Law Firm. All rights reserved.
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