The Latest Medicare Fraud Takedown: New Administration, Same Enforcement Strategy

Although the Obama Justice Department didn't invent coordinated health care fraud enforcement, it did advance the strategy more than any previous administration. So when the Trump crew took over, some … [Read more...]


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...]


CMS Dished Out $729.4 Million in Wrongful EHR Incentive Payments & We’re Going to Get that Money Back

Wrongful payments of Electronic Health Records (EHR) incentives are at the focus of two of the month's biggest stories in health care compliance. The first came down on May 31 when the Justice … [Read more...]


Medical Necessity Requirement Bites Anatomic Pathologists

By Robert Mazer  bio The DOJ has announced two separate settlements involving claims for allegedly unnecessary special stains. Medicare permits a pathologist to order special stains when … [Read more...]


Another Decision in the HDL Case Highlights Kickback Risks of Patient Responsibility Waivers Involving Private Payers

The Health Diagnostics Laboratory, Inc. (HDL) and Singulex saga continues. The latest chapter involves not the labs themselves but BlueWave Healthcare Consultants, their marketing firm. And it raises … [Read more...]


False Billing of Nuclear Stress Tests at Center of $50 Million Cardio Fraud Scheme

The feds arrested a cardiologist, neurologist and four others for their role in an elaborate fraud scheme. The government contends that over a 12- year period, the defendants' New York City medical … [Read more...]


23andMe Gains FDA Approval for DTC Test

23andMe and the U.S. Food and Drug Administration (FDA) announced this month that the agency allowed marketing of 23andMe's Personal Genome Service Genetic Health Risk (GHR) tests for 10 diseases or … [Read more...]


CMS, OIG Reps Address Attendees at ACLA Annual Meeting

At the American Clinical Laboratory Association annual meeting in Washington, D.C. March 23, representatives of the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector … [Read more...]


Brief Your CEO: 8 Changes in Trump Travel Ban

Although it applies to all industries, the Trump travel ban will have a disproportionate impact on labs and other health care providers. We recently outlined the major effects and the steps you can … [Read more...]


Arizona Fraud Suit Opens New Front in the Legal War against Theranos

Suing Theranos has become something of a cottage industry. And now a whole new front in the legal war appears ready to open: state consumer fraud lawsuits. The Arizona Attorney General's Office (AGO) … [Read more...]