For the past five years, the DOJ has followed an enforcement policy designed to hold directors, officers and other top corporate officials responsible for the wrongdoing their companies commit. Last … [Read more...]
COMPLIANCE GUIDANCE
Enforcement Trends: DOJ Changes to Yates Memo Make It Easier for Labs to Get Credit for Cooperating with Investigators
July 1, 2019
ENFORCEMENT
Case of the Month: Feds Target Doctors Who Took Kickbacks from HDL
June 28, 2019
When it comes to breaking up lab kickback schemes, federal enforcers start with the lab that paid the kickbacks and then turn to the downstream providers that accepted them. This was the pattern in … [Read more...]
COMPLIANCE
New OIG Report Confirms that Labs Are Still on the Enforcement Radar
June 24, 2019
After a recent dip, OIG enforcement activity has seemingly rebounded, at least in terms of total recoveries. That's the basic punchline from the newly published OIG Semiannual Report to Congress … [Read more...]
WHISTLEBLOWERS
Case of the Month: U.S. Supreme Court Gives Whistleblowers Four More Years to Sue
May 23, 2019
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...]
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...]
