Texas Health System Fined $431K for Falsely Billing Genetic Tests

Case: The feds contend that between 2016 and 2018, Decatur Hospital Authority (d/b/a Wise Health System) sent samples from surgical patients to Tennessee labs for medically unnecessary genetic tests. … [Read more...]

ANTI-KICKBACK

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

LabCorp Must Go to Trial to Defend against Deceptive Trade Practices Charges Case: Fourteen patients sued LabCorp for allegedly overcharging them for lab tests. In March 2018, a North Carolina … [Read more...]

COMPLIANCE PLANS

OIG Monthly Work Plan Review: August 2019

Of the 12 new items in the OIG's Work Plan this month, six indirectly impact lab providers and services. Medicare Payments of Positive Airway Pressure (PAP) Devices for Obstructive Sleep Apnea (OSA) … [Read more...]

COMPLIANCE

Compliance Perspectives: What to Do When Respiratory Safety & Religious Rights Collide

THE SCENARIO A lab requires all employees who work with or near materials emitting toxic vapors to wear respirators with tight-fitting facepieces. Since facial hear interferes with a tight seal, … [Read more...]

FALSE CLAIMS

Pennsylvania M.D. Used Addiction Clinics as Front for Opioid Scheme

Case: A 57-year-old doctor pleaded guilty to running an elaborate opioid distribution and insurance fraud scheme out of the Liberation Way addiction treatment center for whom he served as medical … [Read more...]

NEWS

New York Breaks Up $28 Million Medicaid Diagnostics Mill

Case: One of the biggest Medicaid diagnostics fraud schemes in recent memory has resulted in multiple convictions, including two doctors and two corporate presidents. According to New York … [Read more...]

LAB OPERATIONS

Earning our Spot on the Patient-Centered Care Team

By Jennifer Dawson, MHA, FACHE, CPHQ, LSSBB, DLM(ASCP)SLS, QIHC, QLC  bio There is a lot of talk these days about integrating the laboratory into patient-centered care teams1 and about … [Read more...]

ANTI-KICKBACK

Maryland Hospital Fined $457.2K for Free Support Services Kickbacks

Case: Union Hospital of Cecil County, Inc. has agreed to pay $457,213 for a pair of self-disclosed kickback violations, namely, paying remuneration to: Physicians in the form of free support … [Read more...]

OIG OPINION

Is Your Billing Company Putting You At Compliance Risk?

By Sean McSweeney  bio Does your orthopedic billing company charge a percentage of collections for their coding and billing? They might break out separate charges for statements or other … [Read more...]

CYBERSECURITY

Compliance Perspectives: Complying with HIPAA Isn’t Enough to Manage Data Breach Liability Risks

Memo to lab managers and compliance officers: It may be time to rethink your data breach response strategy. This directive is the result not of any substantive changes to the HIPAA rules but rather to … [Read more...]


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