Press Release
United States Obtains More Than $370 Million In Judgments Against Kentucky Businessman And His Companies For Laboratory Testing Scheme That Targeted Medicare
For Immediate Release
U.S. Attorney's Office, Middle District of Florida
Tampa, FL – United States Attorney Roger B. Handberg announces today that the United States has obtained more than $370 million in judgments against a Kentucky businessman and his companies for a laboratory testing scheme that targeted the Medicare program.
In August 2022, the United States filed a complaint-in-intervention against Rajen Shah and his companies United Diagnostics Lab, Tomoka Medical Lab, Tennessee Valley Regional Laboratory, Luminus Diagnostics, and Golden Rule Management for violations of the False Claims Act. The complaint alleged that Shah caused his laboratories to bill Medicare for expensive molecular tests that were not ordered by a licensed healthcare provider.
On September 21, 2023, the district court granted the United States’ motion for default judgment and awarded judgment in favor of the United States and against the defendants in the amount of $105,634,097.50 for Shah, $6,159,118 for Tomoka Medical Lab, Inc., $23,996,305.50 for Tennessee Valley Regional Laboratories, LLC, $75,478,674.00 for Luminus Diagnostics, LLC, $105,634,097.50 for Golden Rule Management, LLC, and $54,587,325.00 for United Diagnostics Lab, LLC.
“The integrity of our healthcare system depends on the government being able to rely on accurate and truthful information submitted by laboratories, and that labs only bill for services ordered by a beneficiary’s doctor or nurse practitioner,” said U.S. Attorney Handberg. “We will continue to hold people accountable when they disregard Medicare’s regulations.”
“Providers who seek to boost their own profits by submitting inaccurate billing information to federal health care programs like Medicare undermine the integrity of these programs, which beneficiaries rely on for safe and effective health care services,” stated Acting Special Agent in Charge Julie Rivera of the U.S. Department of Health and Human Services Office of Inspector General. “Our agency, working with our law enforcement partners, will continue to investigate health care fraud schemes, including those involving providers allegedly submitting fraudulent claims in violation of the False Claims Act.”
In 2021, Shah received a jail sentence for a criminal contempt charge stemming from his violation of court orders related to the United States’ fraud investigation.
This case was investigated by the U.S. Attorney’s Office and the U.S. Department of Health and Human Services – Office of Inspector General. The case was handled by Assistant U.S. Attorney Sean Keefe.
The False Claims Act is a federal statute originally enacted in 1863 in response to defense contractor fraud during the American Civil War. It allows the United States to recover damages and penalties for the false or fraudulent submission of claims seeking reimbursement from the government. The United States intervened in a lawsuit originally brought by Jacqueline Cushing, a former Tomoka employee, under the whistleblower provisions of the False Claims Act. The Act permits private citizens with knowledge of fraud against the government to bring a lawsuit on behalf of the United States and to share in any recovery.
The case is captioned United States of America ex rel. Jacqueline Cushing v. Rajen Shah, et al, Case No. 19-cv-2997-T-33TGW.
Updated September 26, 2023
Topic
False Claims Act
Component