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...]
ENFORCEMENT TRENDS
Enforcement Trends: Labs Get Cameo, Rather than Starring Role in OIG’s New Enforcement Report
June 14, 2017
FDA
GAO Faults U.S. Handling of Zika Outbreak; IDs Challenges to Test Development
June 12, 2017
The US. Government Accountability Office (GAO) found that the U.S. Department of Health and Human Services was "reactive" in its handling of the Zika virus outbreak including in its preparedness, … [Read more...]
ENFORCEMENT
CMS, OIG Reps Address PAMA, Fraud Enforcement at ACLA Annual Meeting
March 31, 2017
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
March 31, 2017
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
March 7, 2017
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
February 7, 2017
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
January 6, 2017
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
December 22, 2016
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
December 22, 2016
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
December 22, 2016
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...]
