Cooley Dickinson Hospital Resolves Allegation of Billing for Unnecessary Tick-Borne Disease Tests

BOSTON – Cooley Dickinson Hospital, a Partners HealthCare affiliated hospital based in Northampton, has agreed to pay $11,332 to resolve the allegation that it submitted claims to Medicare and Medicaid for medically unnecessary testing.

Individuals can contract tick-borne diseases, such as Lyme disease, anaplasmosis, erlichiosis, and babesiosis, if bitten by specific ticks infected with bacteria, viruses, or parasites.  The type of tick-borne disease an individual may contract depends on the species of tick, which, in turn, depends upon the geographic region where the individual was bitten. 

Cooley Dickinson allegedly created tick borne disease test “panels” through which physicians and nurse practitioners could order more than one tick-borne disease test. When a physician and/or nurse practitioner selected a testing panel in the ordering system (as opposed to manually selecting each medically appropriate tick-borne disease test), an order went to Cooley Dickinson’s laboratory to test for all of the tick-borne diseases programmed into the testing panel, even though the panel included tests for diseases caused by ticks that were not likely to be present in the geographic region where the individual was bitten so that the tests were not medically indicated by the patient’s symptoms.  The government alleges that between July 1, 2014, and June 22, 2017, Cooley Dickinson submitted claims to Medicare and Medicaid for blood tests used to detect tick-borne diseases when the tests were not medically necessary.

“This settlement is another reminder of how whistleblowers can help the government identify improper billing practices among health care providers,” said United States Attorney Andrew E. Lelling.

A patient of Cooley Dickinson, Dr. Morris Leibowitz, brought these allegations through a whistleblower lawsuit. Under the qui tam provisions of the False Claims Act, private individuals, known as relators, can sue on behalf of the government for false claims and to share in any recovery.  In connection with today’s announced settlement, Dr. Leibowitz will receive 21% of the recovery. 

U.S. Attorney Lelling made the announcement today. Assistant U.S. Attorneys Steven Sharobem and Christopher Morgan of Lelling’s Office handled the matter.