SelfRefind to Settle False Medicare Claims for $15.8M

Posted: 03/06/2014  browse the blog archive
SelfRefind to Settle False Medicare Claims for $15.8M

SelfRefind and PremierTox LLC have agreed to pay $15.75 million to resolve allegations that they violated the False Claims Act by submitting claims to Medicare and Kentucky’s Medicaid program for tests that were medically unnecessary, more expensive than those performed, or billed in violation of the Stark Law, the Department of Justice announced

Drs. Bryan Wood and Robin Peavler, owners of SelfRefind, each purchased a 20 percent ownership stake in PremierTox LLC, a new clinical laboratory created to perform urine drug testing. Allegedly, after Wood and Peavler became owners of PremierTox, SelfRefind began referring comprehensive urine drug screening tests to PremierTox that were unnecessary and more expensive than other suitable alternative tests. The government also alleged that PremierTox knowingly submitted inflated claims to Medicare and Medicaid that misidentified the class of drug being tested and billed for tests that were referred by SelfRefind in violation of the Stark law.  The Stark Law forbids a laboratory from billing Medicare and Medicaid for certain services referred by physicians that have a financial relationship with the laboratory. 

The lawsuit was filed under the whistleblower provisions of the False Claims Act. Under the False Claims Act, private parties with knowledge of fraud against the government may sue on behalf of the government and share in the recovery. Had there been a whistleblower in this case, their portion of the settlement may have been anywhere from 15 to 30 percent. Of the total $15.75 million settlement amount, the federal share is $13.01 million, and the remaining $2.74 million will be paid to the Commonwealth of Kentucky.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.