ANTI-KICKBACK

Enforcement Trends: Feds Administer a Double Dose of Civil Monetary Penalty Increases

Potential penalties for Medicare violations will be higher if they're assessed on or after Oct. 11, 2018. That's when the newly announced Dept. of Health and Human Services' (HHS) inflation-adjusted … [Read more...]

CYBERSECURITY

Case of the Month: Anthem Settles Massive HIPAA Breach Case for Record $16 Million

Pop Quiz: What's the highest amount a health care entity ever paid to the HHS Office for Civil Rights (OCR) to settle a HIPAA violation? The answer used to be $5.5 million paid by Advocate Health … [Read more...]

ENFORCEMENT

Alabama Hospital and Lab Subsidiary Agree to $4.25 Million Kickback Settlement

Case: Aperian Laboratory Solutions and its parent East Alabama Medical Center will fork over $4.25 million + legal costs to settle charges of paying kickbacks for referrals and then falsely billing … [Read more...]

ENFORCEMENT

Ohio Hospital System Settles Kickback Claims for $14.25 Million

Case: Mercy Health has agreed to pay $14.25 million to settle charges of having improper financial relationships with six referring staff physicians. The feds accused the Cincinnati-based nonprofit … [Read more...]

COMPLIANCE

Florida Lab Pays $100K to Settle Claims of Violating Bioterrorism Law

Case: The OIG claimed that a Florida lab violated Federal Select Agent regulations by transferring a select toxin to an entity not registered to possess, use or transfer it and failing to get … [Read more...]

COMPLIANCE PLANS

OIG Work Plan Monthly Review: July 2018

None of the six new items that OIG added to its Work Plan last 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...]


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