Indianapolis, Indiana, November 25, 2025
Patients Choice Laboratories (PCL), a diagnostic lab in Indianapolis, has agreed to pay $9.62 million to settle allegations of improper Medicare claims and kickbacks. The U.S. Department of Justice announced the settlement, which highlights the significance of ethical practices and compliance with federal healthcare regulations. This case serves as a reminder for healthcare providers to adhere to legal standards to maintain the integrity of federal health programs.
Indianapolis, Indiana
Indianapolis Diagnostic Lab Settles $9.62 Million Medicare Claims Case
Settlement highlights compliance risks and the importance of ethical practices in healthcare
Patients Choice Laboratories (PCL), a diagnostic laboratory based in Indianapolis, has agreed to pay $9.62 million to settle allegations of submitting improper Medicare claims and engaging in kickback schemes. The U.S. Department of Justice announced the settlement on November 24, 2025.
Settlement Details
The settlement resolves claims that PCL violated the False Claims Act and the Anti-Kickback Statute by knowingly submitting Medicare claims for respiratory pathogen panels (RPPs) that were either medically unnecessary or obtained through kickbacks. Additionally, PCL paid commissions to independent sales representatives based on the volume or value of referrals, further violating federal regulations.
Allegations Against PCL
According to the U.S. Department of Justice, PCL entered into a Marketing Services Agreement (MSA) with a company purportedly providing infection prevention services in long-term care facilities. The MSA, valued at $5,000 per month, was alleged to be a pretext for paying the company for laboratory test referrals. Between December 2020 and May 2022, PCL paid approximately $1.86 million to the company in exchange for RPP referrals, resulting in over $6 million in Medicare reimbursements for tests conducted at 43 long-term care facilities nationwide.
Background on the Case
The U.S. Attorney’s Office for the Southern District of Indiana, along with the Department of Health and Human Services Office of Inspector General (HHS-OIG) and the Federal Bureau of Investigation (FBI), investigated the case. The settlement reflects the government’s commitment to holding accountable those who seek to profit at the expense of federal healthcare programs and the patients they serve.
Implications for Healthcare Providers
This case underscores the importance of compliance with federal healthcare regulations, including the False Claims Act and the Anti-Kickback Statute. Healthcare providers are reminded to ensure that their billing practices and referral arrangements adhere to legal and ethical standards to maintain the integrity of federal health programs.
Frequently Asked Questions (FAQ)
What is the False Claims Act?
The False Claims Act is a federal law that imposes liability on individuals and companies who defraud governmental programs, including Medicare and Medicaid. It allows whistleblowers to file actions on behalf of the government and share in any recovered damages.
What is the Anti-Kickback Statute?
The Anti-Kickback Statute is a federal law that prohibits the exchange of anything of value to induce or reward referrals of federal healthcare program business, including Medicare and Medicaid. Violations can result in criminal and civil penalties.
What are respiratory pathogen panels (RPPs)?
Respiratory pathogen panels are diagnostic tests used to detect a variety of respiratory pathogens, including viruses and bacteria, that can cause respiratory infections.
What are the consequences of violating the False Claims Act and the Anti-Kickback Statute?
Violations can lead to significant financial penalties, including settlements and fines, as well as potential criminal charges. Healthcare providers may also face reputational damage and loss of trust from patients and the public.
How can healthcare providers ensure compliance with federal regulations?
Healthcare providers should implement comprehensive compliance programs, conduct regular training for staff, establish clear policies and procedures, and perform routine audits to identify and address potential violations of federal healthcare regulations.
Key Features of the Case
| Feature | Details |
|---|---|
| Settlement Amount | $9.62 million |
| Allegations | Submission of improper Medicare claims and kickback schemes |
| Investigating Agencies | U.S. Department of Justice, HHS-OIG, FBI |
| Implications | Emphasis on compliance with federal healthcare regulations |
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Author: STAFF HERE INDIANAPOLIS WRITER
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