State Laws

New Legislative Efforts Aim to Keep Payors from Denying Patients’ Access to Genetic Biomarker Testing

Payor use of preauthorization requirements to hold up providers and deny patients medically necessary care has come under fire not only within the Department of Health and Human Services and US … [Read more...]

Enforcement Trends

Labs Figure Prominently in Latest DOJ Telemedicine, COVID-19 and Sober Homes Fraud Takedown

Telemedicine was a minor but growing blip on the enforcement radar before the public health emergency. But with the dramatic step up in utilization during the COVID-19 pandemic, it was all but … [Read more...]

Enforcement Trends

Federal False Claims Act Recoveries Hit 5-Year High

For more than a decade, enforcement of the federal false claims act was a government cash cow. But in recent years, investment returns on the activity actually declined. That trend came to an end last … [Read more...]

Enforcement

Fraud Recoveries Grow as Feds Target Telemedicine and COVID-19 Add-On Test Scams

Despite the COVID-19 pandemic and continued sequestration of enforcement funds, the federal Health Care Fraud and Abuse Control Program (Program) reversed recent trends and recovered more money in FY … [Read more...]

Labs in Court

University of Miami Settles Lab Testing False Claim Charges for $22 Million

Case: In this particular case, “The U” stands for unnecessary, as in medically unnecessary lab tests billed to Medicare by the University of Miami’s lab and off campus hospital-based facilities. The … [Read more...]

DATA SECURITY

Health Care Data Breaches Hit a New High in First Half of 2021

While health care data breaches have become an all-too-common occurrence, the problem seems to be getting worse. According to the HHS’ Office for Civil Rights (OCR), there have already been 360 … [Read more...]

Labs in Court

Texas Provider Pays $214K for Violating Federal COVID-19 Workplace Protocols

Case: In what appears to be a first, the Texas parent of an Iowa nursing home has agreed to repay $214,200 in federal monies for not following COVID-19 safety protocols during an outbreak at the … [Read more...]

FALSE CLAIMS

University of Miami Settles Lab Testing False Claim Charges for $22 Million

The University of Miami’s sports teams proudly refer to their school as “The U.” But to the whistleblowers who brought the original lawsuit against the University at the center of this settlement, … [Read more...]

FALSE CLAIMS

Texas Provider Pays $214K for Violating Federal COVID-19 Workplace Protocols

In one of the first of what will likely be a flood of enforcement actions, the Texas parent of an Iowa nursing home has agreed to repay $214,200 in federal monies for not following coronavirus safety … [Read more...]

Enforcement Trends

The Federal COVID-19 Relief Fraud Crackdown Begins

As with so many other businesses, federal COVID-19 relief was (and, in some cases, still is) the only thing that kept some labs afloat during the darkest days of the pandemic. But with the virus in … [Read more...]


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