US Senators Probe Insurers, Labs on Medicaid Fraud

| November 15, 2011

WASHINGTON – Two U.S. senators are asking several major health insurers and clinical laboratory testing companies for information on whether they exchanged referrals for cheaper prices on lab services, including for patients on Medicaid. Senators Max Baucus, Democratic chairman of the powerful Senate Finance Committee, and Charles Grassley, the ranking Republican on the Judiciary Committee, on Tuesday sent letters asking for information on the matter to Cigna Corp, Aetna Inc, UnitedHealth Group Inc, Laboratory Corp of America and Quest Diagnostics Inc. The letters referred to a practice commonly referred to as "pull-through." The term refers to an arrangement in which the lab offers discounted pricing to an insurance company in exchange for the insurer facilitating referrals to the lab for testing. The Office of Inspector General with the Health and Human Services Department has previously raised concerns that such arrangements could be breaking the federal "anti-kickback" law, which protects federal insurance programs and patients from influence of financial arrangements on healthcare decisions. Baucus and Grassley asked the companies by Dec. 1 to provide them with copies of various documents such as lab service agreements, correspondence related to contract negotiations, presentations to boards of directors and financial records. To read the letters, see http://r.reuters.com/jer84s.


Category: Pathology News

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