Well, we just caught this gem that could ultimately put $100 million of Medicare business at risk for drug testing giant Ameritox.
Four years ago, in a federal kickback case in Tampa, Ameritox agreed to pay more than $16 million to settle charges. The Baltimore-based company signed a five-year “corporate integrity agreement” with the Inspector General of the U.S. Department of Health and Human Services.
“It’s kind of like being on probation,” Wolfson said.
And on April 30, Preet Bharara, the U.S. attorney for the Southern District of New York State, issued a “civil investigative demand” for information on Ameritox’s own incentives for doctors, as well as a host of billing records, lease arrangements and more.
Questions about the lease arrangements may be related to a practice that Health News Florida reported on in 2011. Drug-testing labs were paying “rent” to Florida pain-management doctors for part of their offices so they could station a collector for urine samples. The Agency for Health Care Administration told Ameritox and others that the leases were not permitted.
While the New York prosecutor’s broad demand for records doesn’t necessarily mean Ameritox has done anything wrong, it’s ominous because of the 2010 settlement. At stake are Ameritox’s federal billings, estimated at almost $100 million a year.
Also, in mid-April, U.S. District Judge Sharon Gleason issued an order slamming Ameritox in a wrongful termination case against Millennium filed in Arizona by a former employee, Kelly Nelson.
Gleason says that all parties to the Arizona case, including Ameritox – since it was involved in the related case in Tampa, agreed to a “protective order” that would keep certain documents from becoming part of the public record.
But the judge says that Nelson gave Ameritox some depositions from Millennium employees, and Ameritox filed them as exhibits in the Tampa suit. Gleason said that since Ameritox is paying Nelson’s legal bills, the two were working in concert.
In Alaska at the time of her order, Gleason said she will return to Phoenix in July to hear Nelson v. Millennium. One of her tasks, she said, will be a hearing on whether Nelson and Ameritox “should be found in contempt.”
While the intertwined cases can be dauntingly complex, Wolfson said the concept is simple: If a laboratory gives a physician something free that the doctor can use to make money, that’s wrong.
“It’s not wrong if you’re in the supermarket business, but it’s wrong in health care,” he said. That’s because the gift-giver creates a financial incentive for a physician to perform a service that may not be needed. In some cases, he said, the extra services aren’t just unnecessary but downright harmful to patients.
Besides, “it costs us all money,” Wolfson said. “That’s what the fraud laws in Medicare are all about.”