Compliance is About More than Kickbacks, Referrals, & False Claims Liability: Check Our Top 3 Compliance Areas You May be Overlooking

Violations of Medicare-related laws such as the Anti-Kickback Statute, self-referral law and the False Claims Act can cost laboratories and pathology groups potentially millions of dollars and thus, … [Read more...]

Avoid Common Investigation-Related Compliance Mistakes

In our discussions with health care lawyers Gina L. Simms and Robert E. Mazer for their Perspectives on the government’s fraud enforcement initiatives (see pages 5-8), they revealed some compliance … [Read more...]

AG’s Office Offers Compliance Tips While Noting New Enforcement Strategies

The Department of Justice's Assistant Attorney General for the Criminal Division has offered some helpful tips regarding how to avoid liability for compliance violations relating to Medicare … [Read more...]

Enforcement and Guidance Efforts Serve as Reminder: Re-evaluate and Update Your Compliance Plans

Laboratories should revisit their compliance programs now that the government has released its latest report on the success of its fraud-fighting efforts as well as new compliance guidance for health … [Read more...]

Closely Scrutinize Arrangements with Physicians

Pay close attention to the arrangements your laboratory makes with physicians, because the government will too. The U.S. Department of Health and Human Services Office of Inspector General (OIG) … [Read more...]

OIG Advisory Opinion Makes Convenience and Efficiency Suspect

Exclusive payer contracts create challenges and hassles for laboratories outside the contract and physicians who do business with those laboratories. A recent Advisory Opinion from the U.S. Department … [Read more...]

News at a Glance – Apr 2015

Arizona Allows Lab Testing Without Doctor Order: Beginning in early July, Arizona residents will be able to order any laboratory test they want without a doctor’s authorization, under a new law … [Read more...]

Aetna Files $120 Million Lawsuit Against Texas Hospital for Fraudulent Billing

More complex than it seems, a lawsuit filed on Feb. 23 in the Southern District of Texas actually involves a hospital and an insurance company fighting over in-network versus out-of-network … [Read more...]

Stark and Anti-Kickback Issues Expected to Increase for Laboratories in 2015

Health care experts and attorneys predict 2015 will be a significant year for Health and Human Services Office of Inspector General (OIG) investigations of physician self-referral (Stark) and … [Read more...]

Class Action Suit Alleges Quest Diagnostics is a Monopoly

A class action lawsuit filed in the northern district of California on Jan. 29, includes accusations that Quest Diagnostics, Inc. (Quest) colluded with Aetna and Blue Shield of California to exclude … [Read more...]