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 … [Read more...]
COMPLIANCE
Genetic Testing Fraud Prosecutions are on the Rise around the Country. Are Your Genetic Testing Practices Compliant?
September 10, 2019
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...]
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...]
FALSE CLAIMS
New York Doctor Busted for Falsely Billing Medicaid for Lab Drug Tests
February 21, 2019
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
January 4, 2019
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
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...]
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...]
COMPLIANCE
OIG Work Plan Monthly Review: April 2018
May 7, 2018
Four of the six new items that the OIG added to its workplan have an impact—albeit indirect—on labs: 1. CMS Recovery of Medicare Overpayments Issue: Between Oct. 1, 2014 and Dec. 31, 2016, OIG … [Read more...]
COMPLIANCE PLANS
OIG Work Plan Monthly Review: December 2017
December 27, 2017
None of the six items the OIG added to its Work Plan this month directly address labs or labs services. However, five of the new items, including the two dealing with opioid abuse, might affect labs … [Read more...]
NEWS
OIG Work Plan Monthly Review: October 2017
October 24, 2017
Drugs continue to command the OIG's attention with three of this month's five new Work Plan items dedicated to the issue. Although none of the new items specifically address lab services, four of them … [Read more...]
