ENFORCEMENT

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

Anthem Settles Data Breach Lawsuit for Record $115 Million Case: Anthem, the nation's second largest health insurer, has agreed to shell out $115 million to settle a class action lawsuit over a … [Read more...]

ENFORCEMENT TRENDS

New Fraud Takedown Shows that Coordinated Enforcement Remains Alive & Well under Trump

Last year at this time, the Justice Department announced the results of a nationwide takedown involving "the most defendants charged and largest alleged loss amount in Medicare Strike Force … [Read more...]

ENFORCEMENT

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

Lab Tech and Account Rep Face Jail for Test Fee and Commissions Scheme. Case: A pair of Texans face criminal charges for allegedly conspiring to cheat Medicare of nearly $837,000 over a 6-month … [Read more...]

ENFORCEMENT

Compliance Scorecard: Significant New HIPAA Fines

Health data and information security figured prominently in May enforcement activity. In addition to the blockbuster eClinicalWorks EHR software settlement discussed on page 3, there was an unusually … [Read more...]

ENFORCEMENT

Notorious File: Feds Take Down Three More Doctors in BLS Lab Bribery Scheme

The Biodiagnostic Laboratory Service (BLS) case continues to be the poster child for the evils of fraud and greed in the health care industry, generating record numbers of prosecutions against medical … [Read more...]

NEWS

Electronic Health Records: The eClinicalWorks False Claims Settlement—Big Fines & Unprecedented CIA Obligations

False Claims Act actions targeting health care vendors have become more common. eClinicalWorks (ECW), one country's biggest electronic health records software vendors, learned that lesson the hard way … [Read more...]

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

Quest Fined for Self-Disclosed Violations for Second Time in 2017. Case: Quest Diagnostics, Inc., New Jersey agreed to pay over $1.151 million for three Civil Monetary Penalties Law … [Read more...]

BILLING & CODING

Reimbursement Trends: 5 More New Molecular Tests Get the Medicare Green Light from Palmetto

Normally among the slowest payors to accept promising but unproven new tests, Medicare continues to loosen the reins for molecular assays. In May, Palmetto GBA (Columbia, SC), one of Medicare's most … [Read more...]

ENFORCEMENT TRENDS

Enforcement Trends: Labs Get Cameo, Rather than Starring Role in OIG’s New Enforcement Report

The Office of Inspector General just published its Semiannual Report to Congress (covering Oct. 1, 2016 through March 31, 2017). It's mostly more of the same other than the fact that, for once, … [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...]


(-0000g2)