FEE SCHEDULES

OIG Backs CMS on PAMA Market Rate Setting—and the Lab Industry Is None Too Pleased

CMS did it right and saved Medicare a boatload of money in the process, concludes a new OIG report examining the agency's work in carrying out its PAMA mandate of establishing market-based Medicare … [Read more...]

REIMBURSEMENT

Enforcement Trends: OIG Report Suggests that Urine Drug Testing Is Making Labs a Juicy Target Once Again

The Office of Inspector General just published its Semiannual Report to Congress (covering Oct. 1, 2017 through March 31, 2018). Here are the key things labs and lab managers need to know about this … [Read more...]

COMPLIANCE

Medicaid Fraud: Enforcement Continues to Trend Down as Labs Drift Deeper into the Background

Last month, the OIG published its annual summary of Medicaid Fraud Control Unit (MCFU) activity for FY 2017. Here is a summary of the key findings, trends and impact on labs. Background The 50 MCFUs … [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...]

DRUG TESTING

Part B Reimbursement: OIG Flags $66.3 Million in Improper Urine Specimen Validity Test Payments

These are tense times for providers of urine drug tests for Medicare and Medicaid patients. And on Feb. 20, the hot seat got even hotter with the issuance of a new OIG report saying CMS made $66.3 … [Read more...]

FOCUS ON

Anti-Kickback Statute: OIG Eyes Changes to Safe Harbor Rules

As it does every year, the OIG is reviewing the federal Anti-Kickback Statute (AKS) current safe harbor rules. The deadline to comment: end of business, Feb. 26. Here's a quick rundown of what's at … [Read more...]

OIG

Enforcement Trends: The OIG’s Recent Safe Harbor Changes

On February 26, the OIG will wrap up public comments on changes to the federal Anti-Kickback Statute (AKS) current safe harbor rules. While such review takes place every year, 2018 could be a year of … [Read more...]

COMPLIANCE

Labs Figure Prominently in OIG’s Newest Top 10 Challenges List

Although the OIG has its flaws, lack of transparency is not among them. Exhibit A: the agency's ongoing list of top 10 management and performance challenges facing the Department of Health and Human … [Read more...]

ENFORCEMENT

Enforcement Trends: 5 Takeaways from OIG’s New Semiannual Report

Veteran OIG semiannual report aficionados will find little in the most recent edition to distinguish it markedly from its predecessors. But while a new administration has done little to change the … [Read more...]


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