UCSD Health to Pay Nearly $3M Over Medicare False Claims Allegations

According to a press release issued Tuesday by the U.S. Department of Justice (DOJ), University of California San Diego Health, the academic health arm of the higher education institution, has paid $2.98 million to resolve contentions that it violated the federal False Claims Act by ordering medically unnecessary genetic tests reimbursed by Medicare. 

The civil suit was filed by the DOJ on behalf of the Office of Inspector General of the Department of Health and Human Services (HHS).

The parties’ agreement ends the dispute, wherein HHS contended that from December 2015 to October 2019, UCSD Health ordered and submitted referrals for the tests performed by CQuentia Arkansas Labs, CQuentia NGS and Total Diagnostic II (collectively, CQuentia labs). The federal government argued that the hospital’s conduct caused false claims to be presented by CQuentia labs to Medicare for payment, ultimately misusing taxpayer dollars.

“Ordering unnecessary genetic tests creates a drain on vital government-funded health care programs like Medicare,” U.S. Attorney Randy Grossman for the Southern District of California said in a statement. “This settlement is another example of this office’s commitment to work with our law enforcement partners to hold medical providers accountable when their conduct leads to taxpayers bearing the cost of improper billing practices.”

The press release notes that resolution was obtained as a result of coordinated effort between the DOJ Civil Division’s Commercial Litigation Branch, the Fraud Section and the U.S. Attorney’s Office for the Southern District of California, and with assistance from the HHS Office of Inspector General and the FBI. Under the terms of the agreement, the federal government releases its claims while UCSD neither admits nor denies fault.