OIG Sheds Light on Kickback Implications of Online Healthcare Directories
Recent advisory opinion offers insight on how healthcare providers may want to structure arrangements involving online directories.
National Lab Reporter
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Enforcement Trends: OIG Calls Out CMS for Not Preventing Medicare Genetic Testing Overpayments
Inadequate CMS oversight resulted in $888.2 million in improper payments for the highest reimbursing molecular pathology genetic tests, report says.
Medicare Reimbursement: CMS Proposes to Cut Part B Payments to Physicians
The proposed PFS rule also includes other changes that will affect physician, lab, and other reimbursements in 2024 and beyond.
New CMS TCET Rule Likely Won’t Hasten Medicare Coverage of Breakthrough Devices
Recently proposed rule seems too stringent to reduce the lag between FDA approval and Medicare coverage.
CMS Provides New Guidance on When International Labs Must Seek CLIA Certification
Recently released Centers for Medicare and Medicaid Services guidance shares when CLIA regulations apply to international labs.
Congress Moves to Require Medicare Coverage of Multi-Cancer Early Detection Tests
Federal lawmakers have renewed efforts to pass legislation ensuring Medicare coverage of multi-cancer early detection (MCED) tests.
Whistleblowers: SCOTUS Gives DOJ Wider Authority to Dismiss Meritless Qui Tam Cases
Ruling could spell good news for labs and other healthcare providers targeted by whistleblowers in False Claims Act qui tam lawsuits.
Enforcement Trends: The Urine Drug Testing Crackdown and Three Ways to Avoid It
False billing of urine drug tests (UDTs) continues to be a focus for enforcement agencies in 2023, here’s how to avoid compliance issues.
Billing & Coding Alert: CMS Adds 15 New PLA Codes to Medicare Clinical Laboratory Fee Schedule
Here’s what to know about the new codes that CMS recently added to the national HCPCS table as well as which ones were removed.
OIG Semi-Annual Report Calls Out Drug, Genetic, and COVID-19 Testing Fraud
These three lab testing areas were the main sources of fraud and abuse revealed in the OIG’s latest Semi-Annual Report to Congress.
Congress Moves to Permanently Restore Medicare Coverage of Pharmacy Lab Tests
Congress is renewing its previous efforts to make Medicare reimbursement of pharmacy testing permanent—here’s what that could mean for labs.
Compliance Alert: OIG Sounds the Alarm on Medicare Overpayments for Physician Services Provided to Inpatients
According to a recent report, Medicare overpaid for such services over a two-year period between 2019 and 2020.
Special Report: The Current State of Genetic Testing Fraud Enforcement
Current genetic testing enforcement trends and what you can do to minimize the liability risks of your lab.
