Lab pays $4.8 million for overcharging CT Medicaid patients

A file photo of Connecticut Attorney General William Tong. He and other officials announced the settlement with the Redwood Toxicology Laboratory on Monday, March 7, 2022, alleging the lab violated state “most favored nation” regulations.
Brian A. Pounds/Hearst Connecticut Media
A national lab has paid nearly $4.8 million to resolve allegations that it overbilled Connecticut’s Medicaid program for certain lab services over several years, officials said Monday.
Connecticut Attorney General William Tong and other officials announced the settlement with the Redwood Toxicology Laboratory on Monday, alleging the lab violated the state’s “most favored nation” regulations.
The policy states that clinical laboratories should not request payment from Connecticut Medicaid for services at a price higher than the lowest price charged by the laboratory for the same or similar services from other third parties.
The lab, based in Santa Rosa, Calif., offers lab testing services such as urine drug testing services for drug-addicted patients under the Connecticut Medicaid program.
Specifically, officials said, the lab routinely accepted payments from Connecticut Medicaid for specific urine drug tests at a rate of $38 per test. However, the lab was charging other third parties from $2 to $10.50 for the same or similar tests, officials said.
The lab agreed to pay $4,797,578 to cover claims submitted to Connecticut’s Medicaid program from January 1, 2015 through February 24, 2018.
Anyone who suspects healthcare fraud is encouraged to report it by calling 1-800-HHS-TIPS.