HEALTH CARE REFORM

Health Insurance Market: Two Recent Changes & Their Impact on Labs

Amid all the talk of sweeping reform of the health insurance marketplace, the smaller, interim changes get overlooked despite their direct impact on labs and other providers. Two such changes took … [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...]

ANTI-KICKBACK

Case of the Month: Individual Principles Hit with $114.1 Million Verdict for Role in HDL Blood Test Fraud

Roughly three years ago at this time, mega-scandals were in the news featuring diagnostic giants like Millennium, Health Diagnostic Laboratory (HDL), Biodiagnostic Laboratory Service and the like. But … [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...]

HEALTH CARE REFORM

Medicare Reimbursement: Federal Government Funding Extension Includes a Boatload of Medicare Changes

The government shutdown fiasco is having an impact on Medicare spending and reimbursement. But the crucial details are being buried in the legislative paperwork. So we decided to ferret them out for … [Read more...]

NEWS

Case of Month: Using Window Envelope to Mail HIV Info Costs Aetna $17+ Million

You talk about a mailroom mess-up! A shockingly bad choice in envelopes has just cost one of the country's largest health insurers over $17 million. The Lawsuit On Jan. 16, Aetna agreed to pay … [Read more...]

FOCUS ON

CLIA: After 36 Years, CMS Gives Lab Accreditation a Good Hard Look

"May you live in interesting times." If you've been in the clinical labs business for a while, you probably appreciate the wisdom behind this ancient Chinese curse. 2018 is shaping up to be a very … [Read more...]

ANTI-KICKBACK

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

Opioid Subscribing Doctor Convicted in Lab Referral Kickback Scam Case: Two doctors at a Maryland pain management clinic that prescribed pain relief medications to patients accepted kickbacks to … [Read more...]

EMPLOYMENT LAW

Employment Law Update for HR Managers October 2017

By Mike O'Brien  bio Here is my periodic update prepared for interested HR professionals trying to deal with the complex American employment laws. In this update: Federal agencies take … [Read more...]


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