News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Quest Diagnostics Discloses Pending Agreement to Pay California $241 Million to Settle Medi-Cal Medical Laboratory Test Pricing Case

A final settlement between both parties may become the template state officials use to resolve Medi-Cal overcharge claims involving other clinical pathology laboratories

Authorities in California and Quest Diagnostics Incorporated (NYSE: DGX) appear to be close to resolving a major lawsuit involving allegations that the nation’s largest clinical laboratory company had overcharged Medi-Cal, the state’s Medicaid program, for a period of years beginning in 1995.

Last week, Quest Diagnostics announced it had “reached an agreement in principle to settle a previously disclosed civil lawsuit” and, as part of this agreement in principle, it will pay $241 million to settle the legal matter.
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California’s Medi-Cal Program May Be Close to a $241 Million Settlement with Nation’s Largest Clinical Pathology Laboratory Company

Quest Diagnostics Incorporated Discloses Facts About Negotiations With Medi-Cal Officials to Resolve Claims Associated with Discounted Medical Laboratory Prices

In California, Quest Diagnostics Incorporated (NYSE: DGX) and several other pathology testing laboratories, including Laboratory Corporation of America (NYSE: LH), have found themselves caught in the twin jaws of a regulatory vice. At issue is the long-standing practice in the state of clinical laboratories offering discounted prices for medical laboratory tests that are less than prices paid by California’s Medi-Cal program.

One jaw of the vice is a high-profile whistleblower lawsuit that was filed in 2005, and unsealed by then-Attorney General Jerry Brown in April 2009. The suit claims that seven clinical laboratory companies violated state law over a 15-year period by charging certain customers less for medical laboratory tests than what the seven lab companies billed Medi-Cal, the state’s Medicaid program. The suit alleges that the Medi-Cal program was overcharged by hundreds of millions of dollars from medical laboratory test claims submitted by the defendant lab companies during this time.

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