Quest Diagnostics yesterday agreed to pay $1.8 million to settle a qui tam (whistleblower) lawsuit that was filed in July 2012 by a former Quest phlebotomist who alleged both Quest and LabCorp performed, and billed Medicare for, duplicate laboratory testing.
I first wrote about this suit in October 2014, right after the judge unsealed it. Briefly, Ms. Elisa Martinez used to work as a phlebotomist at Quest’s patient service center (PSC) in Red Bluff California, and during her time at the PSC, she noticed:
…Quest received orders from different physicians to perform the same tests on the same patient and instead of merely sending the results of one set of tests to the ordering physicians, allegedly performed duplicate blood and urine testing and billed Medicare twice.
Ms. Martinez stated she watched a phlebotomist at her PSC pour urine from one specimen cup into a second cup in order to facilitate the duplicate testing, and an employee in the business office confirmed each duplicate test was billed separately. When she asked one of her supervisors about the matter, she was allegedly told to “listen more and back up everybody”.
Only a few allegations are made in the complaint, and it is important to note Ms. Martinez was not required to present an exhaustive list of all fraudulent acts she witnessed; she only had to present enough to move the case forward.
According to the press release announcing the settlement, the “U.S. Department of Justice investigated and substantiated the allegations” in the suit, but Quest “denied any liability or wrongdoing.” An article over at Taxpayers Against Fraud says Ms. Martinez will receive $358,000 of the settlement.
I reached out to Mr. Michael Hirst, one of the attorneys representing Ms. Martinez, and he was kind enough to provide me with the following comment about the case:
Ms. Martinez has performed a significant public service by coming forward and blowing the whistle. Without her courage, none of this would have been exposed.
The performance of medically unnecessary and duplicate tests can put patients at risk and undermine the integrity of the Medicare program. Government programs like Medicare and Medicaid, which are vital to so many, need to be protected by all.
The amended complaint that was filed on January 30, 2015 does not list LabCorp as a defendant, so at some point LabCorp was dropped from the suit, although I do not know precisely when or why.