The Department of Justice, Western District of North Carolina released a statement detailing a settlement made with Piedmont Pathology of Hickory, NC in the amount of $610,000. The allegations included the use of medically unnecessary stains brought to the attention of the government by a whistleblower previously employed by Piedmont. The key points of the case include the following:
“According to court documents, pathology practices apply stains to specimens to allow pathologists to identify abnormalities in the tissue. These stains include a routine hemotoxylin and eosin (H&E) stain and other special stains for various purposes. Among other things, the complaint alleges that a pathologist should review the specimen with the routine H&E stain before any special stain is used on the specimen. Special stains are billed separately to government healthcare programs. The government considers the use of special stains before the analysis of the routine H&E stained specimen to be medically unnecessary. In November 2016, the United States intervened in the case, pursuing claims that Piedmont Pathology lacked medical necessity for the special stains conducted on certain gastric biopsies before a pathologist reviewed the routine H&E stained specimen.”