Branford Lab to Pay $1.2M for False Billing Practices

Branford Lab to Pay $1.2M for False Billing Practices

Introduction

A Branford-based laboratory and its owners have agreed to pay $1,255,825 to resolve allegations that they submitted false claims and facilitated unnecessary medical tests, according to the U.S. Attorney for the District of Connecticut and the Connecticut Attorney General. The alleged misconduct occurred between September 2021 and December 2023.

Allegations of Unnecessary and Duplicate Testing

Authorities claim Genco Lab billed Medicare and Medicaid for urine drug tests conducted on residents of sober homes for “residential monitoring.” These tests were deemed medically unnecessary and explicitly prohibited. Additionally, Genco allegedly performed duplicate tests by conducting both a “presumptive” screening test and a more expensive “definitive” test on the same day, without a practitioner’s review. Government health care programs were billed for both types of tests each time a patient on Medicaid or Medicare was tested.

Attorney General’s Statement on Medicaid Fraud

Connecticut Attorney General William Tong condemned the actions, stating that for two years, Genco repeatedly billed Medicaid for medically unnecessary urine tests. He emphasized that his office, in partnership with federal and state agencies, will take strong action against entities that misuse Medicaid funds at the expense of taxpayers and patients.

Compliance Agreement and Future Audits

As part of the settlement, Genco and its owners entered into a Compliance Agreement with the Connecticut Department of Social Services. The lab must establish a new compliance program and return any overpayments identified in a series of audits scheduled over the next 18 months.