The government alleged Calloway Labs submitted fraudulent claims to Medicare and Medicaid for pathology services that were never provided from 2009 to 2013. The government further alleged Calloway Labs was performing a medical review of each urine sample it tested, which is not covered by Medicare or Medicaid, and improperly coded the reviews as pathology services before submitting the claim for reimbursement.
"Medicare is the largest payer for clinical laboratory services and, therefore, is vulnerable to fraud, waste and abuse," said Gloria Jarmon, deputy inspector general for audit services, in the news release. "In addressing that vulnerability, HHS' Office of the Inspector General uses a multidisciplinary approach, including data-mining, audits, and, as appropriate, enforcement actions, to protect the integrity of HHS programs and recover taxpayer dollars."
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