ENFORCEMENT

New Laws: Congress Doubles Penalties for Medicare Fraud & Abuse

Sneaky may be too strong a word. But what is fair to say is that the new hikes in federal health care fraud violation penalties have flown totally under the radar despite their obvious and immediate … [Read more...]

FALSE CLAIMS

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

Using Nuclear Stress Tests as Screening Procedure = Medical Necessity Violation Case: A California cardio clinic and its physician owners will pay $1.2 million to settle charges of falsely billing … [Read more...]

LAB SAFETY

Safety lapses continue with select agents

By Dan Scungio, MT (ASCP), SLS, CQA (ASQ)  bio The approach of the holiday season signals the end of another year. Was this just another year in a long line of them for you in lab safety, … [Read more...]

EMPLOYMENT LAW

Employment Law Update for HR Managers October 2017

By Mike O'Brien  bio Here is my periodic update prepared for interested HR professionals trying to deal with the complex American employment laws. In this update: Federal agencies take … [Read more...]

DOJ

Medical Necessity Requirement Bites Anatomic Pathologists

By Robert Mazer  bio The DOJ has announced two separate settlements involving claims for allegedly unnecessary special stains. Medicare permits a pathologist to order special stains when … [Read more...]

REIMBURSEMENT

CMS Enforcement Discretion Eases Pressure on Labs

After we went to press last month, the Centers for Medicare and Medicaid Services (CMS) announced just in the nick of time that it wouldn't impose civil monetary penalties against labs which failed to … [Read more...]

ENFORCEMENT

Liability Traps to Avoid:
Commission-Based Lab Marketing Arrangements

Contracts between labs and sales and marketing firms raise red flags under both the Anti-Kickback Statute (AKS) and Stark Law, especially when payment is by commission or based on the volume or value … [Read more...]

ENFORCEMENT

Enforcement EĀ¢onomiĀ¢$: ROI on US Fraud & Abuse Program Continues to Decline

While still profitable, the business of enforcing health care fraud laws has been providing the federal government a steadily declining return on investment (ROI) in recent years. This long-term trend … [Read more...]

CASE OF THE MONTH:

Feds Net Another Million-Dollar Settlement in 21st Century Oncology FISH Testing Case

AFlorida-based urologist is the latest 21st Century Oncology defendant to fork over seven figures to settle charges of false billing for fluorescence in situ hybridization (FISH) tests. The Original … [Read more...]

INDUSTRY BUZZ

Arizona Fraud Suit Opens New Front in the Legal War against Theranos

The Arizona Attorney General's Office (AGO) recently issued a request for proposal signaling a new legal battle for Theranos: state consumer fraud lawsuits. The AGO indicated in its request that it … [Read more...]


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