G2 Guide to Navigating FCA Enforcement Policies and Programs

Now Available from the G2 Master Compliance Series:

G2 Guide to Navigating FCA Enforcement Policies and Programs

What You Need to Know about Current False Claims Act Enforcement Program and Policies, and What You Need To Do to Help Avoid of FCA Investigations, Fines and Penalties

“LabScam” changed the world for clinical labs.

Implemented in 1990, Labscam turned clinical labs a major target for False Claims Act investigations and enforcement actions.  Labscam has also given rise to a growing cascade of extremely expensive qui tam lawsuits against labs.

Today, as Federal agencies cooperate far more closely in FCA investigations, and enforcement actions become more extensive and effective, it is absolutely critical to understand current enforcement programs and policies, and know what basic protective steps lab and compliance managers can take to help avoid massive FCA fines and penalties.

To help your lab navigate today’s complex FCA enforcement landscape, G2 Intelligence has just released an important new 34-page Special Report: G2 Guide to Navigating FCA Enforcement Policies and Programs.

Here is just a sample of what your new Special Report covers:

  • The Legacy of LabScam: The Rapid Growth of FCA Enforcement and the 6 Major Billing Activities that Trigger FCA Investigations
  • Current Areas of Enforcement Focus for Labs: The 6 Areas of Lab Business and Operations that the Government (and Whistleblowers) Focus On to Uncover Potential Violations
  • Referral Relationships: How and Why Referral Relationship Mistakes Can Result in Treble Damages and Six or Seven Figure Settlements
  • Reference Labs: Why Reference Lab Arrangements Are Now a Prime Target for Government Investigations and How These Arrangements Raise Both Billing “Red Flags” and Kick-Back Concerns
  • Test Ordering and Medical Necessity: Why Medical Necessity is Now “The Single Biggest Thing We See In Audits Today”, and the 6 Factors Labs Absolutely Must Consider On Any Test Order
  • Standing Orders and Panels: Why Standing Orders Are Now Particular “Red Flags” for Investigation and What To Do to Help Your Standing Orders Stand Up Under Investigation
  • Medical Necessity and Genetic Testing: Payment and Compliance Problems that May Arise when Billing for Genetic Tests and the 3 Critical Omissions that Can Trigger Billing Investigations
  • Operation Double Helix and the Genetic Testing Crackdown: A Look Inside the Recent HHS, DOJ and FBI Operation that Charged 35 Individuals Associated with Genetic Testing Labs
  • Medical Necessity and FISH Tests: The Only 2 Limited Situations When FISH Tests Are Deemed Medically Necessary and the OIG’s 8 Criteria for Identifying Questionable FISH Lab Test Billing
  • Documenting Medical Necessity: What to do: Four Critical Steps to Always Take to Document Medical Necessity and Avoid Scrutiny
  • Performance of Tests: How and Why Failure to Conform to CLIA Standards Can Trigger FCA Investigations and Qui Tam Lawsuits, and the 5 Quality-Of-Care Concerns Your Lab Should Routinely Review
  • Reporting Tests: How Your test Reporting Practices Can Create Liability Under FCA, and the 5 Issues Labs Should Consider to Help Manage Test Reporting Risk
  • Billing Tests: The 4 Potential Problem Areas Of lab Service Billing That Have Given Rise to FCA Investigations
  • Billing and Coding Genetic Testing: The Only 3 Criteria Under Which Medicare Will Pay for Genetic Testing, 2 Recent Actions Involving NIPT testing
  • Billing and Coding of Nuclear Stress Tests: The 3 Reasons NSTs are High on the List of FCA Enforcement Priorities, and Recent Enforcement Action
  • NST Bundling: Why Coding for NSTs Raises Red Flags, the 3 NST Codes for Image Billing, the 9 Problematic NST Billing Practices that Labs Should Avoid
  • Billing and Coding Sleep Study Tests: The Current OIG Crackdown on Sleep Clinic Billing, Danger in Failure to List Code Modifiers, 3 Requirements for Documenting the Need for Sleep Testing
  • Sales and Marketing Practices: The Rapid Acceleration of FCA Cases Against Lab Sales and Marketing Practices, Recent Cases and Why the labs Were Targeted and Charged, Often-Overlooked State FCA Laws

And That’s Just a Sample!  It is absolutely imperative that EVERY clinical lab manager stay on top of current FCA investigation and enforcement programs and policies.  The penalties for violations can be staggering.  This new Special Report gives you the practical, plain-language help you need to understand the FCA current enforcement, and take practical, proven steps to protect your lab from costly fines and penalties.

Get this 30 page PDF now by adding to cart or by calling Customer Service at 855-528-6903.

For multi-user/multi-location pricing, please contact Sokha Pearson at 855-528-6903 or via email at spearson@g2intelligence.com.