Just as the tide seemed to be turning against whistleblower lawsuits (see "New DOJ Policy Targeting Whistleblowers with Weak Cases May Make Life Easier for Labs," (Lab Compliance Advisor, March 4, … [Read more...]
WHISTLEBLOWERS
Case of the Month: U.S. Supreme Court Gives Whistleblowers Four More Years to Sue
May 23, 2019
ENFORCEMENT
Case of the Month: Another MD-Owned Lab Gets Busted for Urine Drug Test Abuses
April 29, 2019
Fraudulent utilization and billing of urine drug screening first became a priority for federal enforcers since the $256 million Millennium settlement of 2016. But the opioid crackdown has heightened … [Read more...]
DRUG TESTING
Enforcement Trends: CMS Orders Medicare Contractors to Go After Labs that Received Specimen Validity Test Payments
March 27, 2019
Reflecting the wider opioid crackdown, CMS is targeting labs that perform urine drug testing for potential billing abuses. The hottest initiative: Labs that bill specimen validity testing (SVT) in … [Read more...]
WHISTLEBLOWERS
Case of the Month: Facing 3 against 1, Texas Lab Settles EHR Consulting Kickback Charges
March 25, 2019
Question: What happens when multiple whistleblowers bring separate qui tam lawsuits against a lab for the same offense? Answer: Under the False Claims Act (FCA), only the first whistleblower to … [Read more...]
ENFORCEMENT
Pain Clinic Co-Owner Pleads Guilty to Drug Testing Kickback Charges
March 13, 2019
Case: The Louisiana physician received $336,000 in kickbacks from a drug testing lab representing a percentage of the reimbursement proceeds generated via the referrals of Medicare patients' urine … [Read more...]
DOJ
Enforcement Trends: New DOJ Policy Targeting Whistleblowers with Weak Cases May Make Life Easier for Labs
March 4, 2019
It's not just new laws, regulations or even court cases. Trends in health care fraud enforcement are sometimes driven by changes in prosecution policies, including those that aren't made public. Such … [Read more...]
FLSA
Case of the Month: Hospital Employees’ Wage Class Action Lawsuit Goes Terribly Wrong
February 11, 2019
It wasn't the outcome the four hospital employees envisioned when they filed their lawsuit charging the University of Pittsburgh Medical Center of violating the federal Fair Labor Standards Act (FLSA) … [Read more...]
LEGISLATION
Compliance Alert: New Private-Pay Opioid Law Puts All Drug Addiction & Rehab Labs at Risk of Federal Prosecution
January 7, 2019
Recent federal legislation addressing the opioid crisis may have unintended consequences on the lab industry. The idea was to allow the feds to prosecute a certain kind of abuse banned by the … [Read more...]
ENFORCEMENT
By the Numbers: DOJ Recovers Billions in FY 2018
December 31, 2018
Year after year, the False Claims Act (FCA) remains the federal government's most valuable fraud enforcement tool. Although recovery amounts have declined slightly in the past two years, FCA … [Read more...]
ANTI-KICKBACK
Enforcement Trends: Feds Administer a Double Dose of Civil Monetary Penalty Increases
October 23, 2018
Potential penalties for Medicare violations will be higher if they're assessed on or after Oct. 11, 2018. That's when the newly announced Dept. of Health and Human Services' (HHS) inflation-adjusted … [Read more...]
