US Attorney for the Western District of Michigan Mark Totten announced that Physicians Toxicology Laboratory, LLC (PTL) of Tampa, Florida, has agreed to pay $4,425,000 to resolve allegations that it violated the False Claims Act (FCA) by causing physicians to order medically unnecessary urine drug testing and hormone testing and by submitting claims for reimbursement to the Medicare Program for those tests. Lund Capital Group, LLC (PTL’s grandparent company), PTL’s former president Matthew Ryan Lund, and Thomas C. Lund joined the settlement as jointly and severally liable co-defendants. The United States alleges that PTL provided laboratory services for several medical practices in Michigan. These practices ordered urine drug tests (UDTs) for their Medicare patients, and PTL ran these tests and billed Medicare.
The United States alleges that from January 1, 2017, through December 31, 2019, PTL encouraged these medical practices in Michigan to order UDTs pursuant to blanket orders for all patients without an individualized determination of medical necessity Specifically, PTL created—and encouraged the practices to use—requisition forms that included a simultaneous order for both presumptive and definitive UDTs. PTL also employed and placed in-office urine collectors in the practices, and the collectors typically filled out the blanket orders before submitting them to PTL. As a result, the practices ordered medically unnecessary and non-covered UDTs from PTL, and PTL knowingly submitted these claims to Medicare. Additionally, the United States alleges that PTL billed Medicare for urine tests for hormone levels ordered by one of the practices with almost every UDT when the laboratory knew that the practice was ordering these tests as a form of specimen validity testing, which is already included in the reimbursed costs of UDTs.
