As we pass the midpoint of the third year of the PAMA experiment—if that’s what it is—the OIG announced plans to review what happened in years one and two. One of the new items on the agency’s Work … [Read more...]
Coronavirus
OIG Temporarily Waives Anti-Kickback Restrictions for Certain COVID-19 Physician Arrangements
April 16, 2020
As it previously did with the Stark Law (See National Intelligence Report, NIR, March 25, 2020), the OIG is temporarily loosening Antikickback Statute (AKS) restrictions to clear the way for health … [Read more...]
OIG
Scorecard: OIG Enforcement Actions against Labs in 2019
January 2, 2020
Labs remain at the top of the OIG’s enforcement hit list, as illustrated by the number of cases involving labs cited in the agency’s new Semiannual Report to Congress for FY 2019: False Billing … [Read more...]
CMS
Kickbacks: OIG Withdrawal of Old Safe Harbor Proposals Clears Way for Meaningful Reform
August 26, 2019
Like the rest of the health care industry, labs need more not fewer new and modern Anti-Kickback Statute (AKS) safe harbors. So, the OIG's decision to cancel new safe harbors in incubation seems like … [Read more...]
GENETIC TESTING
OIG Issues Genetic Testing Fraud Alert
July 15, 2019
On June 3, the OIG issued a fraud alert warning of a genetic testing fraud scheme. According to the OIG, scammers are using telemarketing calls, booths at health fairs and public events and … [Read more...]
OIG
Medicaid Fraud Enforcement Trends By the Numbers
April 29, 2019
A new report from OIG details Medicare Fraud Control Unit (MCFU) enforcement activity in fiscal year 2018. Bottom Line on Top: The numbers were pretty consistent with previous trends with little in … [Read more...]
OIG
GAO: $77.3 Billion in Improper Medicare/Medicaid 2017 Payments, Including $1.82 Billion to Labs
April 23, 2019
Medicare made $36.2 billion and Medicaid $41.2 billion in improper payments in fiscal year 2017. That's the finding of a report from the Government Accountability Office (GAO) based on CMS estimates … [Read more...]
Enforcement Trends: Opioid Crackdown Is Diverting Resources from Traditional OIG Enforcement Activities
December 14, 2018
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...]
COMPLIANCE GUIDANCE
Kickbacks: OIG Okays Incentivizing MDs to Order More Early Screening Tests
November 16, 2018
Proactive rather than reactive has become a mantra of the modern health care model. Early and periodic testing of patients is a critical element in this strategy. The problem is that not a lot of … [Read more...]
