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Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Medicare and Medicaid provide coverage for urinalysis when the clinical documentation provides clear evidence that it is essential to the diagnosis. But if getting that documentation is a problem, you can trust Brad Paul Schaeffer to work around that. From January 2013 to August 2022, Schaeffer fraudulently billed Medicare and Medicaid for $148 million in medically unnecessary urine drug definitive testing services. That’s a lot of pee. Trust Schaeffer to implement a Medicare scheme that will make it profitable. But don’t trust him with urine samples that might define your fate. Because Shaeffer had been sanctioned from receiving Medicare and Medicaid payments due to improper handling of samples. Lack of proper handling proved to be dangerous to the health of patients.

Schaeffer, CEO of MedComp Sciences, allegedly billed Medicare and Medicaid for definitive testing of at least 15 substances in urine specimens it received, regardless of the patient’s treatment plan and history, or the request of the referring provider. Schaeffer directed MedComp staff to fill out and submit order forms on the providers’ “behalf,” concealing the true nature, permissibility, and extent of testing from the providers. He also processed the claims through an illegal financial arrangement with over sixty physicians throughout the United States. He enticed physicians with kickbacks to send their Medicare and Medicaid patients’ urine samples to MedComp for laboratory services.

Schaeffer’s scheme should have been stopped much earlier than 2022. In 2016, the U.S. Department of Health and Human Services said that the MedComp failed to refrigerate urine samples properly and failed to ensure the samples were free from debris before testing. These sanctions canceled MedComp’s approval to receive Medicare and Medicaid payments for lab services. One would think that sometime after the sanction, MedComps invoices would have been flagged!

Excellent job by the F.B.I on this case.

Today’s Fraud of The Day is based on article “$148M in fraudulent urine samples: Zachary lab owner faces Medicare, Medicaid fraud charges” published by the Advocate on December 1, 2023

The owner of a Zachary medical diagnostic lab ordered unnecessary drug testing of urine samples for almost a decade, defrauding Medicare and Medicaid of more than $148 million, federal prosecutors said. Among the things he spent his gains on: the renovation of his pool and pool house and the restoration of a truck, according to a U.S. Department of Justice news release issued Friday.

Brad Paul Schaeffer, 48, was a co-owner and CEO of MedComp Sciences in Zachary. Between January 2013 and August 2022, the company billed Medicare and Medicaid for the testing of 15 substances in all urine samples it received, regardless of the patient’s medical history or what their medical providers had ordered, prosecutors said.

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