Department of Labor, Office of Inspector General. We will continue to work with our law enforcement partners to protect the financial integrity of labor unions and safeguard the assets of union members,” said Derek Pickle, Acting Special Agent-in-Charge, Philadelphia Region, U.S. “One of the primary missions of the Office of Inspector General is to investigate allegations of fraud relating to union affiliated benefit plans. Attorney’s Office, DOL-OIG and all our law enforcement partners to evaluate and pursue allegations of inaccurate Medicare billings.” “HHS-OIG will continue to work with the U.S. Department of Health and Human Services, Office of the Inspector General. Dixon, Special Agent in Charge for the U.S. “Accurately billing for services provided to Medicare beneficiaries is required of all health care providers,” said Maureen R. The IA requires Great Lakes to maintain a compliance program, implement a risk assessment program, and hire an Independent Review Organization to review Medicare and UMWA Funds claims. As a result of the $1,200,737.64 settlement, which represents twice the actual loss suffered by Medicare and the UMWA Funds, both federal programs will be made whole.Īs part of this settlement, Great Lakes entered into a three-year Integrity Agreement (IA) with HHS-OIG. These false claims resulted in a loss to Medicare and the UMWA Funds in the amount of $600,368.82. Moreover, investigators learned that the fraudulent claims were for services that were not specifically ordered by the referring physicians, and determined that there was no indication that the services billed were actually performed. From in or about Janucontinuing into or about May 12, 2017, Great Lakes presented at least 21,732 claims to Medicare and the UMWA Funds which included separate claims for reimbursement for services which were already included in bills submitted for other laboratory services. Great Lakes operated a medical reference laboratory in Michigan and routinely tested urine and blood samples referred by medical providers located in West Virginia and elsewhere. “We will continue to work with HHS-OIG, DOL-OIG and others to eradicate fraud from taxpayer funded federal programs.” This settlement demonstrates my office’s commitment to protect critical Medicare dollars and union affiliated benefit plans from fraud and abuse,” said United States Attorney Mike Stuart. The settlement sum is twice the actual loss resulting from the scheme. Pursuant to the settlement agreement, Great Lakes will pay $1,200,737.64 to resolve allegations that the Michigan laboratory engaged in a billing scheme that defrauded Medicare and the United Mine Workers of America 1992 Benefit Plan, the 1993 Benefit Plan, and the Combined Benefit Fund (UMWA Funds) of $600,368.82. Dixon, United States Department of Health and Human Services, Office of Inspector General (HHS-OIG) and Special Agent in Charge Derek Pickle, United States Department of Labor, Office of Inspector General (DOL-OIG), announced that his office has settled healthcare fraud claims against Great Lakes Medical Laboratory, Inc. – United States Attorney Mike Stuart, along with Special Agent in Charge Maureen R.
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