DRUG TESTING

Enforcement Trends: CMS Looks to Recover $66.3 Million in Improper Specimen Validity Test Payments

The opioid crackdown has made urine drug testing an even greater priority for federal health fraud enforcers. One principle target is specimen validity testing (SVT) billed in combination with urine … [Read more...]

HIPAA

Enforcement Trends: Record Breaking Year for HIPAA Fines

The federal Office for Civil Rights (OCR) reports that 2018 was a record year for HIPAA enforcement, with 10 settlements and one judgment bringing in $28.7 million in fines, easily surpassing the old … [Read more...]

COMPLIANCE

Enforcement Trends: After 2017 Decline, False Claims Act Healthcare Recoveries Bounce Back

Although the False Claims Act (FCA) remains a federal enforcement cash cow, the growth rate has fallen off in recent years, at least in the healthcare sector. But that short-term trend could be in … [Read more...]

ENFORCEMENT

New Law: EKRA Makes Drug Addiction & Rehab Labs Potential Targets for Federal Prosecution

Recent federal legislation addressing the opioid crisis may have unintended consequences on the lab industry. The idea was to allow the feds to prosecute a certain kind of abuse banned by the … [Read more...]

Enforcement Trends: Opioid Crackdown Is Diverting Resources from Traditional OIG Enforcement Activities

The OIG won't admit it, but the opioid crackdown is diverting resources from traditional Medicare fraud and waste enforcement efforts. At least that's the most likely explanation for the dramatic … [Read more...]

ENFORCEMENT

Feds Continue Roundup of Physicians on Receiving End of Millennium Labs Test Cups Freebie

The Millennium Laboratories free point of care test (POCT) cups scandal has been described as the biggest kickback scandal involving lab services in history. And its legacy has now entered a new … [Read more...]

FALSE CLAIMS

Florida Doctor Jailed 5 Months for Lying to a Medicare Auditor

Lying to a Medicare auditor or otherwise obstructing a Medicare audit is a crime that can get you jailed. A 73-year-old endocrinologist specializing in diabetes management just learned that lesson the … [Read more...]

HOSPITAL OUTREACH

Case of the Month: Fraud or Legitimate Rural Hospital Lab Outreach Business?

A North Carolina lawsuit pitting one of the nation's largest health insurers and a national hospital management company raises novel legal issues that test the legal limits of provider contracts … [Read more...]

CYBERSECURITY

Case of the Month: Alabama Hospital Lab Settles Data Breach Class Action Suit

Class action lawsuits by patients victimized by data breaches have become increasingly common. And, more often than not, they prove unsuccessful. But a recent case involving Flowers Hospital in … [Read more...]

SETTLEMENT

Connecticut Hospital Settles Self-Disclosed Stark Violations for $423K

Case: A major settlement in Connecticut in June was authored by Hartford Hospital after it made the mistake of leasing office space to a physician practice (and Medicare referral source) at below … [Read more...]


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