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...]
LEGISLATION
Compliance Alert: New Private-Pay Opioid Law Puts All Drug Addiction & Rehab Labs at Risk of Federal Prosecution
January 7, 2019
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...]
CYBERSECURITY
Case of the Month: Anthem Settles Massive HIPAA Breach Case for Record $16 Million
October 19, 2018
Pop Quiz: What's the highest amount a health care entity ever paid to the HHS Office for Civil Rights (OCR) to settle a HIPAA violation? The answer used to be $5.5 million paid by Advocate Health … [Read more...]
ENFORCEMENT
Alabama Hospital and Lab Subsidiary Agree to $4.25 Million Kickback Settlement
October 19, 2018
Case: Aperian Laboratory Solutions and its parent East Alabama Medical Center will fork over $4.25 million + legal costs to settle charges of paying kickbacks for referrals and then falsely billing … [Read more...]
ENFORCEMENT
Ohio Hospital System Settles Kickback Claims for $14.25 Million
August 31, 2018
Case: Mercy Health has agreed to pay $14.25 million to settle charges of having improper financial relationships with six referring staff physicians. The feds accused the Cincinnati-based nonprofit … [Read more...]
COMPLIANCE
Florida Lab Pays $100K to Settle Claims of Violating Bioterrorism Law
August 22, 2018
Case: The OIG claimed that a Florida lab violated Federal Select Agent regulations by transferring a select toxin to an entity not registered to possess, use or transfer it and failing to get … [Read more...]
COMPLIANCE PLANS
OIG Work Plan Monthly Review: July 2018
August 20, 2018
None of the six new items that OIG added to its Work Plan last month directly impact labs. 1. Identification of HHS Cybersecurity Vulnerabilities Questions: Where are the cybersecurity … [Read more...]
BILLING AND COLLECTIONS
Insurer Accuses Florida Lab, California Hospital of Toxicology Test Billing Fraud
Case: Anthem Blue Cross Blue Shield is suing Reliance Laboratory Testing for allegedly conspiring with California hospital Sonoma West Medical Center to create a fraudulent billing organization in a … [Read more...]
ANTI-KICKBACK
Case of the Month: Jury Socks HDL Blood Test Fraud Principles with $114.1 Million Verdict
July 23, 2018
Roughly three years ago at this time, mega-scandals were in the news featuring diagnostic giants like Millennium, Health Diagnostic Laboratory (HDL), Biodiagnostic Laboratory Service and the like. But … [Read more...]
