January 24, 2022
Carson
City, NV – Today,
Nevada Attorney General Aaron D. Ford announced that, on Jan. 21, Nevada joined
with the federal government to settle allegations of fraud against the Nevada
corporation Lipshutz & Wills Medical Group, LLP d/b/a Monos Health (“Monos
Health”) in relation to its involvement in the billing of urine drug testing to
Medicaid, Medicare and Tricare. The approximately $2 million settlement, which resolves
allegations from Jan. 1, 2016, through Oct. 11, 2019, involves claims of improper
billing of Urine Drug Testing (“UDT”).
“Monos Health
improperly and knowingly defrauded Medicaid, Medicare and Tricare for over 3
1/2 years,” said AG Ford. “This settlement will help redress the harms
that this company has caused. I’d like to thank the United States Attorney’s
Office for helping us with this important investigation.”
The federal government
alleges that during the referenced time period, Monos Health performed
definitive UDT on the same day as presumptive UDT without first reviewing the
results of the presumptive test and assessing the individualized need for a
definitive test. Additionally, Monos Health unnecessarily performed testing at
higher rates when testing at a lower rate using a different billing code would
have been sufficient. Finally, Monos Health used standing orders for definitive
UDT in violation of Medicaid and Medicare guidelines. The federal government
alleges that Monos Health’s conduct resulted in the submission of false
reimbursement claims to government health care programs, including the Nevada
Medicaid Program and Medicare, thereby violating federal law and the Nevada
False Claims Statute.
This settlement stems
from a whistleblower lawsuit originally filed in the United States District
Court for the District of Nevada (United States ex rel. Stacie Oliver, M.D.
v. Jeremy Lipshutz, et al., No. 2:19-cv-1839). The case was a joint
investigation between the United States Attorney’s Office, District of Nevada,
as well as the Nevada Attorney General’s Office, Medicaid Fraud Control Unit.
Senior Deputy
Attorney General Amy Steelman worked with the United States Attorney’s Office,
District of Nevada in attaining the settlement’s result for the state.
The Nevada MFCU
receives 75% of its funding from the U.S. Department of Health and Human
Services under a grant award. The remaining 25% is funded by the State of Nevada.
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