REIMBURSEMENT

Medicare Reimbursement: CMS Issues New Medical Review Instructions to Contractors

On Aug. 14, CMS issued new marching orders to Medicare Administrative Contractors (Contractors). The message: Tighten up the way you target suppliers and providers for medical review. The Targeted … [Read more...]

COMPLIANCE

OIG Work Plan Monthly Review: September 2017

Many of the 12 new items that the OIG added to its 2017 Work Plan in September target state and federal government agencies, including the Department of Health and Human Services itself—specifically, … [Read more...]

COMPLIANCE

Here’s my latest Employment Law update prepared for many HR professionals

By Mike O'Brien  bio Lots of ADA Facility Lawsuits in Utah: Here is an interesting legal news update from my partner Mike Judd: Title III of the Americans with Disabilities Act (ADA) … [Read more...]

ENFORCEMENT

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

Spine Clinic Owner Indicted for Falsely Billing Quantitative Urinalysis Tests Case: The co-owner and billing manager of a Louisiana spine and pain management clinic have been charged with falsely … [Read more...]

ENFORCEMENT TRENDS

OIG Switches from Semi-Annual to Monthly Work Plan Strategy

New OIG Work Plans every six months are a thing of the past. In June, the agency announced plans to update its Work Plan website monthly. The self-proclaimed "dynamic," web-based strategy is … [Read more...]

CASE OF THE MONTH

Theranos and Walgreens Bury the Hatchet—For Now

It all looked so promising back in 2015. Privately-held Theranos was poised to usher in a new era of diagnostics with its revolutionary fingerprick technology for performing a wide array of tests with … [Read more...]

EMPLOYMENT LAW

Employment Law Update for August 2017

By Mike O'Brien  bio Here is my periodic update prepared for interested HR professionals trying to deal with the complex American employment laws. In this update: REPEAL? REPAIR? REPLACE? … [Read more...]

ENFORCEMENT TRENDS

Clinical Laboratories Continue to Figure Less Prominently in New OIG Enforcement Report

The Office of Inspector General just published its most recent Semiannual Report to Congress. To the untrained eye, the newest OIG Report, which covers Oct. 1, 2016 through March 31, 2017, is not … [Read more...]

ENFORCEMENT

Avoid Liability for Commission-Based Marketing Arrangements

Contracts between labs and sales and marketing firms raise red flags under both the Anti-Kickback Statute (AKS) and Stark Law, especially when payment is by commission or based on the volume or value … [Read more...]

REIMBURSEMENT

CMS Exercises Enforcement Discretion for PAMA Reporting

As we previously reported, the Centers for Medicare & Medicaid Services (CMS) has indicated that laboratories had sought relief from the March 31 deadline for reporting applicable information … [Read more...]


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