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The Health Law Offices of Anthony C. Vitale
A Missouri laboratory and its three owners have been ordered to pay more than $13.6 million to settle charges they violated the False Claims Act – the federal government’s primary tool for civil enforcement.
Jerry, Jerrod and Joel W. Murphy, owners of Gamma Healthcare Inc., were accused of submitting false claims to Medicare for lab tests that were not ordered by healthcare providers and were not medically necessary.
In addition to the monetary penalty, Jerry (CEO) and Jerrod (President) are excluded from participating in Medicare, Medicaid, and all other federal healthcare programs for 15 years.
The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) is required by law to exclude from participation in all federal healthcare programs individuals and entities convicted of various offenses outlined here.
The settlement resolves False Claims Act allegations that from Jan. 1, 2020, to Oct. 31, 2020, the lab and Murphys submitted claims to Medicare for polymerase chain reaction (PCR) urinalysis tests that were not ordered by treating physicians. When a physician ordered a urinalysis with culture and sensitivity (C&S) or just a C&S, Gamma automatically performed and submitted claims for payment to Medicare for a urinary tract infection (UTI) panel of tests by PCR.
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