Is Billing Medicare for Tests a False Claim If Your Lab Has Committed a CLIA Violation?

SITUATION XYZ Labs knows that it is currently committing quality control and other Clinical Laboratory Improvement Amendment (CLIA) violations. But it continues to bill Medicare for tests. A … [Read more...]


Complying with ACA’s Nondiscrimination Requirements

Section 1557 of the Affordable Care Act (ACA) requires covered entities to take certain actions to ensure they comply with their duty not to discriminate on the basis of race, color, national origin, … [Read more...]


Compliance Issues Permeate Discussions Throughout Lab Institute

During three days of presentations, compliance issues for laboratories and pathologists permeated most of the discussions. Beginning with a workshop on workforce issues, speakers addressed compliance … [Read more...]


G2 Compliance Corner

MODEL SECTION 1557 CIVIL RIGHTS GRIEVANCE PROCEDURE How to Comply with New ACA Non-discrimination Requirements Background Section 1557 of the Affordable Care Act (ACA) requires covered entities … [Read more...]


Compliance Officers: Establish Credibility with Consistent, Well-Documented Decisionmaking

One of the tougher issues a non-lawyer compliance officer faces is a challenge to their decisions and recommendations by other members of the management team. This happens more often when the person … [Read more...]


Remember to Check Excluded Status

Background checks aren't just for spotting criminal records. Are you checking the Office of Inspector General's List of Excluded Individuals and Entities (LEIE)? In 2013, the Office of Inspector … [Read more...]


Compliance Certification Keeps Staff Up-to-Date, Increases Compensation

Laboratories should encourage or even require their compliance professionals to obtain compliance certification. As the Health Care Compliance Association (HCCA) reported in a recent compliance … [Read more...]


Train Staff to Be Alert to Phishing Attacks

When asked why he robbed banks, the notorious outlaw Willie Sutton famously replied: "Because that's where they keep the money." The same logic explains why labs and other providers have become a … [Read more...]


No One-Size-Fits-All Answer for Frequency of Billing and Coding Audits

Q. How often should a laboratory conduct compliance audits of its billing and coding? A. The answer depends on many factors and will vary from provider to provider. The Office of Inspector General's … [Read more...]


Check Compliance Policies Against Current Operations

While labs may draft a comprehensive compliance plan and policies and procedures, those policies, procedures and plan can be a liability if they aren't being followed. There can often be "a lot of … [Read more...]