Focus on:Medicare Physician Pay: Lawmakers Still Working on Long-Term SGR Reform

While Congress in late December passed a short-term Medicare Physician Fee Schedule patch blocking a planned 20.1 percent reduction in the fee schedule update for 2014, lawmakers still face the task … [Read more...]

Labs Breathe Sigh of Relief Over Exemption From EHR Safe Harbor Extension

Clinical and anatomic pathology laboratories are breathing a sigh of relief now that they no longer will be forced into providing referring physicians with electronic health record (EHR) software and … [Read more...]

OIG: Doctors Billed Medicare $139M in 2011 For Questionable Nerve Damage Tests

Physicians billed $139 million in 2011 for questionable Medicare electrodiagnostic tests, a service area that is vulnerable to fraud, waste, and abuse, according to a report from the Department of … [Read more...]

Reaction Split on New Changes to Clinical Laboratory Fee Schedule

Industry reaction to a new law that makes changes to the Clinical Laboratory Fee Schedule (CLFS) appears to be split, with some laboratory groups applauding the changes and others concerned that it … [Read more...]

OIG Terminates Earlier Opinion on EHR Referral Fee, Concludes Fee Could Generate Improper Referrals

The Department of Health and Human Services Office of Inspector General (OIG) April 8 terminated a December 2011 advisory opinion (No. 11-18) that found a low risk of improper inducement of referrals … [Read more...]

OIG Says Lab Processing and Registry Arrangement May Violate Anti-Kickback Law

The Department of Health and Human Services Office of Inspector General (OIG) June 25 warned clinical laboratories and physicians that providing remuneration to physicians to collect, process, and … [Read more...]

Labs Reassess Processing and Handling Payments in Light of OIG Special Fraud Alert

Clinical and anatomic pathology laboratories that pay referral sources for processing and handling (P&H) of specimens are reassessing their business models in light of a recent special fraud alert … [Read more...]

Cigna Sues HDL Over Patient Inducements

Embattled Health Diagnostic Laboratory (HDL) has yet another problem to worry about: Cigna Health has filed a lawsuit against the Richmond, Va.-based lab, alleging that it induced patients to use its … [Read more...]

OIG Efforts Expected to Recover $4.9 Billion in Improper Payments in FY 2014

Investigative and oversight efforts by the Department of Health and Human Services Office of Inspector General are expected to return $4.9 billion in improper payments to the government in fiscal year … [Read more...]

Enforcement Trends — Labs Continue to Be a Focus

Laboratories continue to draw attention from the Department of Justice (DOJ) and the Office of Inspector General (OIG) as 2014 came to a close. In December, the DOJ announced two guilty pleas and one … [Read more...]


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