Urine drug toxicology giant Millennium Health (MH) is reportedly negotiating a settlement with the federal government for as much as $250 million according to the Wall Street Journal. In addition, another outlet has reported MH is meeting with restructuring consultants and bracing for potential additional lawsuits from its lenders and private payors.
A source told me about a month ago that MH and the federal government were working on a settlement that could reach $250 million, but I was unable to obtain independent confirmation, so I did not proceed with an article at that time.
What did Millennium allegedly do?
I was able to get ahold of a Civil Investigative Demand (CID) letter the Department of Justice (DOJ) sent to a physician back in August 2014 that required the physician to “provide documents and testimony to the Federal Government, and to answer the attached interrogatories.”
The CID stated the DOJ was investigating allegations that the physician “… and/or [MH] submitted, or caused to be submitted, false claims to federal health care payors […] for medically unnecessary urine drug testing (“UDT”)” and that MH “provided kickbacks or other forms of unlawful remuneration to health care providers […] in order to induce UDT referrals to [MH]”.
The DOJ told the physician its primary areas of inquiry were:
- Submission of claims for UDT services and reimbursement for those claims;
- Medical necessity of UDT generally and for specific patients;
- Ordering of UDT, including, but not limited to, the documents and forms used to order UDT;
- Sales practices concerning UDT directed towards you or the entities for which you work, including, but not limited to, promises or provision of free goods and services; and
- Remuneration by urine drug laboratories to you or the entities for which you work
The documents requested and interrogatories also provide additional insight into the government’s investigation. Among the documents requested were:
- All contracts and agreements including custom profiles and/or standing orders
- All documents concerning payments or other remuneration (including meals, staffing assistance, discounted equipment, assistance with CLIA certifications and electronic medical records, and speaker fees)
- All documents concerning waiver of co-pays by MH
- All documents submitted to MH including requisition forms, custom profiles, and standing orders
- All documents concerning medical necessity of UDT, including confirmatory or quantitative testing of negative UDT screen results performed at the point-of-care
- All patient records and billing files for eleven patients listed