REIMBURSEMENT

Enforcement Trends: OIG Report Suggests that Urine Drug Testing Is Making Labs a Juicy Target Once Again

The Office of Inspector General just published its Semiannual Report to Congress (covering Oct. 1, 2017 through March 31, 2018). Here are the key things labs and lab managers need to know about this … [Read more...]

COMPLIANCE

Enforcement Trends: Private Insurers Are Cracking Down on the Labs that Scam Them

Once the almost exclusive domain of federal law enforcers and inside whistleblowers, the lucrative industry of going after labs for improper billing has opened to a wide range of players encompassing … [Read more...]

COMPLIANCE

Medicaid Fraud: Enforcement Continues to Trend Down as Labs Drift Deeper into the Background

Last month, the OIG published its annual summary of Medicaid Fraud Control Unit (MCFU) activity for FY 2017. Here is a summary of the key findings, trends and impact on labs. Background The 50 MCFUs … [Read more...]

ENFORCEMENT

Case of the Month: $33.2 Million Alere Settlement Sends Warning Shot Across Bow of LDT & DX Device Makers

One of the reasons Abbott Laboratories got cold feet about consummating the $5.3 billion Alere acquisition was concern over the legal proceedings against the target firm. Now one of those cases … [Read more...]

COMPLIANCE

Physician Referrals: New Rules Offer Some Stark Law Relief but Not Nearly Enough

Like most budget bills, the new federal Bipartisan Budget Act of 2018 includes a number of changes to Medicare fraud and enforcement requirements. One set of changes affects the current physician … [Read more...]

FOCUS ON

New Laws: Very Quietly, 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...]

OPIOIDS

Enforcement Trends: Labs Getting Swept into the Opioid Crackdown Vortex

Best known for its employment applications, urine drug testing is also medical protocol for patients prescribed opioid drugs. Urine tests are used to ensure patients are not developing addictions and … [Read more...]

FOCUS ON

DOJ to Prosecutors: Show Tough Love to Whistleblowers with Weak Cases

A newly leaked internal Justice Department memo signals a new prosecution policy that may make it harder for whistleblowers to bring qui tam whistleblower lawsuits under the False Claims Act (FCA). … [Read more...]

ENFORCEMENT

EHR: Private Whistleblowers Getting in on “Meaningful Use” Crackdown

Wrongful payment of electronic health records (EHR) "meaningful use" incentives has become a growth area in federal health care fraud enforcement. And now private whistleblowers are getting … [Read more...]

COMPLIANCE

Labs Figure Prominently in OIG’s Newest Top 10 Challenges List

Although the OIG has its flaws, lack of transparency is not among them. Exhibit A: the agency's ongoing list of top 10 management and performance challenges facing the Department of Health and Human … [Read more...]


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