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New Jersey Office of the State Comptroller: Medicaid Fraud Division · March 5, 2001 · Primary source

Sunrise Clinical Lab Billed Medicaid Without Required Signatures in Nearly a Quarter of the Instances Reviewed, OSC Audit Finds

Score 85PRIMARYregulatoryState MFCUNJ

Summary

The New Jersey Office of the State Comptroller released an audit finding that Sunrise Clinical Lab, LLC, an independent clinical laboratory in Irvington, violated New Jersey Medicaid regulations by billing for drug tests without required physician signatures in 24 percent of the 183 episodes reviewed, covering the period July 1, 2017 through March 31, 2021. The audit also found that Sunrise failed to perform ordered drug tests in 44 separate instances. Sunrise is ordered to repay $3,437,006 to New Jersey Medicaid, and OSC issued eight corrective recommendations including staff training and a corrective action plan.

What this may mean

Sunrise Clinical Lab must repay $3,437,006 to the New Jersey Medicaid program and submit a corrective action plan addressing physician signature documentation and test performance failures. The audit reveals a pattern of specimen collection irregularities, including a Sunrise employee affixing physician stamps without authorization, creating potential fraud, waste, and abuse exposure for clinical labs billing drug testing under state Medicaid. OSC has now ordered repayment totaling more than $43 million across seven New Jersey clinical laboratory audits.

Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.

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