United States Attorney Mike Stuart, along with Special Agent in Charge Maureen R. 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. (Great Lakes). 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. The settlement sum is twice the actual loss resulting from the scheme. 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. From in or about January 4, 2016 continuing 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. 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.
