We represent victims of reverse discrimination and anti-DEI whistleblowers

Medical labs conduct a high volume of tests and then bill health insurers or government programs such as Medicare, Medicaid and Tricare for their work. Each sample they take and each test they run is supposed to be medically justified and ordered by a qualified healthcare professional. There are situations where lab owners succumb to greed and seek payment for tests that were unnecessary or overly complex. 

The Department of Justice (DOJ) announced that BioReference Health LLC and its parent company, OPKO Health Inc. agreed to pay $704,349 in response to an investigation concerning fraudulent billing practices. For more than a decade, BioReference routinely performed and billed for more expensive complete blood count (CBC) tests with automated white blood cell (WBC) differential, even when medical providers had ordered less expensive CBC tests without the WBC differential.

Like many instances of medical billing fraud, the BioReference case stemmed from a case filed by a whistleblower under the federal False Claims Act. This law authorizes private individuals, known as relators, to bring lawsuits on behalf of the government. As qui tam plaintiffs, the relators are eligible to share in any payment obtained by the government. Here, the whistleblower will receive $112,694, approximately 16 percent of the total settlement. This is in line with the normal share awarded to relators, which usually falls between 15 and 30 percent. 

The False Claims Act, specifically the provision authorizing qui tam litigation, is a powerful tool for combating fraud in federal healthcare programs, including Medicare and Medicaid. It prohibits the submission of false or fraudulent claims for payment to the government. This case underscores the importance of whistleblowers in pointing out illegal behavior and making sure it stops.

Whether you work for a medical lab, a doctor’s office or some other employer in the healthcare industry, don’t hesitate to speak up if you believe that your employer is overbilling the government.  Kardell Law Group fights for whistleblowers in qui tam cases so that they can safely report misconduct and collect the payment they’ve earned through their diligence and honesty.