Taurus West began overcharging the Department of Health Care Services in 1995, according to the lawsuit. A former sales representative confirmed that Taurus West’s usual billing policy was to negotiate and charge independent physicians discounted prices while billing Medi-Cal, Medicare, insurance companies and patients up to twice the rates on Medi-Cal’s maximum reimbursement schedule, according to the suit.
“In the face of declining state revenues, these medical laboratories have siphoned off hundreds of millions of dollars from programs intended for the most vulnerable California families,” Atty. Gen. Jerry Brown said at a news conference last week revealing the civil suit filed in San Mateo County. “Such a pattern of massive Medi-Cal fraud and kickbacks cannot be tolerated.”
In one instance, Taurus West fleeced the state by as much as 605% on a DNA probe, billing Medi-Cal $77.60 per test where it regularly charged $11, according to the suit. The lab also charged Medi-Cal $31.83 for a $15.75 lipid panel, and $38.80 for a $20 human papilloma virus screening, according to the suit.
The defendants, in exchange for the deep discounts to independent physicians, expected clients to refer their Medi-Cal and Medicare patients to the laboratories, according to the suit. Under state law, the suit alleges, the actions amounted to illegal kickbacks.
As of press time Tuesday, representatives of the company failed to return repeated calls seeking comment. However, Brown indicated that if the state were to offer a $100-million settlement deal to the defendants, attorneys for the medical laboratories would be interested.