A U.S. District Court in Maryland issued a default judgment totaling $26.3 million against a COVID-19 testing lab owner and multiple lab companies, the U.S. Department of Justice (DOJ) announced on July 25.
The case was filed a year ago. Owner Patrick Britton-Harr and multiple laboratory companies were implicated for actions that violated the False Claims Act, according to the DOJ. Britton-Harr wholly owned and operated Provista Health, AMS Onsite, Britton-Harr Enterprises, Coastal Laboratories, and Coastal Management Group.
The defendants at the center of the case were offering COVID-19 tests to nursing homes as a way to bill Medicare for a wide array of medically unnecessary respiratory pathogen panel (RPP) tests. The complaint alleged that these RPP tests were not medically necessary because the beneficiaries had no symptoms of a respiratory illness and because the tests were for uncommon respiratory pathogens.
Defendants billed and received over $7 million from Medicare for a wide array of medically unnecessary respiratory pathogen tests, the record stated. These included tests for uncommon organisms such as Bordetella bronchiseptica, which causes the illness commonly known as kennel cough in dogs (and is very rare in humans), as well as Legionella pneumophila (the bacteria that causes Legionnaires’ disease).
Additionally, some tests were never ordered by physicians and sometimes for RPP tests that were never performed, including over 300 claims that stated that the nasal swab test sample was supposedly collected from the beneficiary on a date after the beneficiary had died, stated the DOJ.
Moreover, the defendants never actually had the ability to perform COVID-19 testing themselves, according to the court document, but instead relied on reference labs.
The case cited the "reference lab rule" here, as it provides that the referring lab can only be paid by Medicare for that test if “not more than 30 percent of the clinical diagnostic laboratory tests for which such referring laboratory ... receives requests for testing during the year in which the test is performed, are performed by another laboratory.” This "reference lab rule" is sometimes called the “shell lab rule” because it precludes pass-through billing arrangements where a lab bills Medicare for more than 30% of the tests that were actually performed by another lab, the document stated.
Britton-Harr has abandoned healthcare and moved into the aviation business, the 2023 court filing pointed out. Compounding his troubles, the court held him in civil contempt for violating an order that prohibited him from selling his house without approval from the court. He was ordered to deposit $575,000 with the court’s registry. The court entered these judgments after Britton-Harr and his companies failed to defend against the United States’ allegations, the DOJ said.