Whistleblowers: Hospitals, Labs Dodge a Major Stark/False Claims Act Bullet

It’s the moment of truth in a whistleblower case. The defendant claims the whistleblower’s claims aren’t legally valid and asks the court to dismiss the case without a trial. If the motion is … [Read more...]

Compliance Perspectives: New Laws & the Top 5 Challenges Lab Compliance Officers Face in 2020

Labs remain at the forefront of the federal government’s suspicious persons list and health care fraud enforcement agenda. But in addition to the customary laws that labs are used to, the government … [Read more...]

Labs In Court

A roundup of recent cases and enforcement actions involving the diagnostics industry ACLA Goes for Knockout Punch in PAMA Lawsuit  Case: Having survived a first-round setback, the American … [Read more...]

Compliance Perspectives: California Case Illustrates Lab’s Liability Risks for “Causing” MDs to Submit False Claims

False Claims Act (FCA), 101: Knowingly submitting a false claim to Medicare or another federally funded health care program is a violation. But what’s lesser known is that your lab can also be liable … [Read more...]

COMPLIANCE

Genetic Testing Fraud Prosecutions are on the Rise around the Country. Are Your Genetic Testing Practices Compliant?

By Robert Liles bio Over the last year, a number of genetic testing fraud investigations and prosecutions have been initiated by Medicare, Medicaid and TRICARE investigators and auditors. While the … [Read more...]

WHISTLEBLOWERS

Case of the Month: U.S. Supreme Court Gives Whistleblowers Four More Years to Sue

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: Facing 3 against 1, Texas Lab Settles EHR Consulting Kickback Charges

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...]

FALSE CLAIMS

New York Doctor Busted for Falsely Billing Medicaid for Lab Drug Tests

Case: The State claims that the physician billed for $939,000 worth of drug testing services that his lab didn't and couldn't actually provide. For example, instead of charging for a single test on a … [Read more...]

FALSE CLAIMS

Florida Lab Owners Convicted for Role in Notorious Drug Distribution Scheme

Case: The two brothers who own a Palm Beach lab pleaded guilty to health care fraud for their role in the illegal drug distribution conspiracy carried out by notorious sober home operator Kenny … [Read more...]

COMPLIANCE PLANS

OIG Work Plan Monthly Review: July 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...]


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