G2 Compliance Perspectives: Preparing for 2013: Molecular Pathology Codes Represent Dominant Path and Lab CPT Changes

The budgetary and policy climate will greatly impact laboratories in 2013. With the increased growth shift toward the adoption of accountable care organizations (ACOs), as well as bundled … [Read more...]

Strategies for Assessing the Effectiveness Of Your Lab Compliance Program

Despite ongoing reports of clinical laboratories that have had enforcement actions brought against them as a result of a weak or faulty compliance program, many labs fail to routinely measure the … [Read more...]

G2 Compliance Perspectives: Administrative Simplification Requires Interoperability, New Financial Management Platforms

Administrative simplification has an aggressive timetable, with far-reaching consequences for laboratories, providers, and payers and new demands for information exchange and technology … [Read more...]


WHO SHOULD COMPLIANCE OFFICER REPORT TO? An overwhelming majority (80 percent) of compliance officers opposed having their compliance department report to their organization’s corporate counsel, … [Read more...]

OIG-Sanctioned Checks: All Labs Do Them, But Questions Remain

Clinical laboratories and pathology practices should pay close attention to new guidance issued by the Health and Human Services Office of Inspector General (HHS OIG) on how to handle individuals who … [Read more...]

Caris Life Sciences Seeks Dismissal of Whistleblower Lawsuit

A whistleblower case against Caris Life Sciences Inc. may be dismissed based on legal technicalities without the court ever addressing the allegations made by the relators. In a motion to dismiss … [Read more...]

Documentation Is Key: Medically Necessary Denials May Have Nothing to Do With Patient Care

When Medicare denies a claim because it is not medically reasonable and necessary, the decision may have nothing to do with whether the test is necessary and effective in the treatment of a patient. … [Read more...]

Florida Hospital Pays $26 Million in a Suit Filed by Auditing Firm

A whistleblower lawsuit filed by the president of a consulting firm hired by Shands HealthCare resulted in the $26 million settlement of alleged False Claims Act (FCA) violations, according to an … [Read more...]

G2 Compliance Perspectives: Revised Coverage Process May Be Step Backward for Labs

The laboratory community, which fought to get standardized national coverage decisions (NCDs) almost a decade ago so it would not have to deal with local coverage decisions (LCDs) that differed by … [Read more...]

Compliance Corner

Our hospital is taking a conservative view/interpretation of a coding service’s comment, insisting on receiving “narratives only” diagnosis information from physicians submitting orders for our … [Read more...]