COMPLIANCE PLANS

OIG Work Plan Monthly Review: July 2018

None of the six new items that OIG added to its Work Plan this month directly impact labs. 1. Identification of HHS Cybersecurity Vulnerabilities Questions: Where are the cybersecurity … [Read more...]

BILLING AND COLLECTIONS

Insurer Accuses Florida Lab, California Hospital of Toxicology Test Billing Fraud

Case: Anthem Blue Cross Blue Shield is suing Reliance Laboratory Testing for allegedly conspiring with California hospital Sonoma West Medical Center to create a fraudulent billing organization in a … [Read more...]

ANTI-KICKBACK

Case of the Month: Jury Socks HDL Blood Test Fraud Principles with $114.1 Million Verdict

Roughly three years ago at this time, mega-scandals were in the news featuring diagnostic giants like Millennium, Health Diagnostic Laboratory (HDL), Biodiagnostic Laboratory Service and the like. But … [Read more...]

COMPLIANCE

OIG Semiannual Report: Opioid Crackdown Is Making Labs a Prime Enforcement Target Once Again

Once the favorite whipping boy of federal enforcers, labs have been demanding less and less of the OIG's attention in recent years. But the newly published OIG Semiannual Report to Congress (covering … [Read more...]

COMPLIANCE

OIG Work Plan Monthly Review: April 2018

Four of the six new items that the OIG added to its workplan have an impact—albeit indirect—on labs: 1. CMS Recovery of Medicare Overpayments Issue: Between Oct. 1, 2014 and Dec. 31, 2016, OIG … [Read more...]

COMPLIANCE PLANS

OIG Work Plan Monthly Review: March 2018

One of the seven new items on the OIG's Work Plan this month, one deals with child support. Among the six items focusing directly on health care, none directly address clinical laboratories or … [Read more...]

FALSE CLAIMS

Enforcement Trends: Why Fending Off Whistleblowers Might Have Just Gotten Easier

Because government enforcers cannot be everywhere at once, the qui tam whistleblower lawsuit was invented. The result has been a proliferation of fraud cases against not just labs and health care … [Read more...]

LEGISLATION

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

ACLA Goes for Jugular in PAMA Challenge Case Case: Attorneys for the American Clinical Laboratory Association asked the federal court for summary judgment in its lawsuit challenging the legality of … [Read more...]

COMPLIANCE PLANS

OIG Work Plan Monthly Review: February 2018

The three new items OIG added to its Work Plan this month focus on various oversight of Medicare and Medicaid program initiatives, including State Medicaid fraud enforcement, processing of provider … [Read more...]

OPIOIDS

Enforcement Trends: Opioid Crackdown Zeroes in on Urine Drug Testing-Today the Doctors, Tomorrow the Labs

A 67-year-old Michigan M.D. is the most recent doctor taken down in what has become a crucial part of the federal government's opioid drug crusade: urine tests ordered by prescribing physicians to be … [Read more...]


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