ENFORCEMENT

CMS, OIG Reps Address PAMA, Fraud Enforcement at ACLA Annual Meeting

At the American Clinical Laboratory Association annual meeting in Washington, D.C. March 23, representatives of the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector … [Read more...]

COMPLIANCE

OIG and DOJ Provide Tips for Determining Effectiveness of Compliance Programs

Labs have two new compliance tools—from the Department of Justice (DOJ) and the Office of Inspector General (OIG)—focused on evaluating the effectiveness of compliance programs. The DOJ's resource … [Read more...]

OIG

OIG Fraud Alert Warns of Hotline Scammers

The OIG issued a Fraud Alert recently—but it didn't warn about improper referral arrangements or billing for medically unnecessary testing. It was a warning that scammers are representing themselves … [Read more...]

ENFORCEMENT

Health Care Fraud and Abuse Program Faces Declining ROI

The federal government's return on investment (ROI) in the fight against health care fraud continues a steady decline according to the latest numbers reported for the Health Care Fraud and Abuse … [Read more...]

COMPLIANCE

OIG Updates Threshold for Nominal Value Gifts

Just as the civil monetary penalties have gotten an update to adjust for inflation (see "Civil Monetary Penalties Rules Updated" Lab & Pathology Insider, Jan. 3, 2017), so too have the thresholds … [Read more...]

ENFORCEMENT

Semiannual OIG Report to Congress Outlines Challenges as Well as Successes

The Office of Inspector General's latest semiannual report to Congress provides a guide to the enforcement priorities the agency will continue to pursue, and proclaims its achievements in oversight … [Read more...]

COMPLIANCE

New OIG Advisory Opinion Repeats Warning that Free Labeling Services Can Be Kickbacks

The government's longstanding aversion to labs providing free items or services to referral sources remains unaffected by changes in reimbursement methods. A laboratory sought an advisory opinion from … [Read more...]

ANTI-KICKBACK

Labs Can Take Advantage of Transportation Anti-Kickback Safe Harbor

There are many benefits laboratories can't provide to beneficiaries or referral sources without violating the Anti-Kickback Statute. New changes to safe harbor regulations, however, allow labs to … [Read more...]

ENFORCEMENT

OIG Report Highlights Aggressive Enforcement

The OIG's latest semiannual report to Congress, as usual, touts its successes with oversight and enforcement and provides a guide to the enforcement priorities the agency will continue to pursue. Here … [Read more...]

ENFORCEMENT

2017 OIG Work Plan Holds Few Surprises for Labs

There are few surprises in the Health and Human Services Office of Inspector General's 2017 Work Plan. The OIG's annual Work Plan provides a summary of new and continuing reviews that the agency is … [Read more...]


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