Corporate Compliance

Lab agrees to refund improperly billed patients

Compliance Monitor, July 6, 2005

MDS Inc, a Canadian-based company that performs medical laboratory services, has agreed to pay refunds to scores of New York customers who received improper medical bills, according to the New York attorney general's Office.

Additionally, the company agreed to reform billing practices, so that when it submits a claim to a health plan, it will not bill patients until the plan notifies MDS that the consumer may be liable. As many as 2 million claims could be subject to the agreement with MDS, according to the attorney general's Office.

"My office is committed to protecting consumers from unwittingly paying out-of-pocket for services and care that actually is covered by their health plans," said New York Attorney General Eliot Spitzer

The state attorney general's office found that MDS improperly "balance billed" some consumers by charging them for the entire balance of the bill when MDS had submitted a claim to the consumer's health plan but received no response from the health plan. In certain instances, both the health plan and the consumer paid the billed amount in full, resulting in MDS improperly receiving double payment on a single bill, according to Spitzer's office.

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