Lab Compliance Essentials 2017: Managing Medicare Fraud & Abuse Liability Risk
How to Protect Your Lab against Costly Investigations, Fines, Penalties and Criminal Prosecutions for Medicare Fraud
Introducing Lab Compliance Essentials — the First Complete, Practical Plain-Language Guide to Protecting Your Lab against the Federal Government’s New Stepped-Up Investigation and Enforcement Program against Medicare Fraud & Abuse
Fraud and abuse investigations and enforcement actions against healthcare providers are virtually certain to expand aggressively in 2017 — and diagnostic labs are a major target.
Under the FCA, labs can be targeted for falsely billing Medicare and Medicaid for laboratory services, including overcharges, medically unnecessary services, and kickbacks in exchange for referrals.
But increased FCA enforcement is just the tip of the iceberg!
The ACA also confronts labs with stiff new fines and penalties for fraud and abuse … provides CMS with $350 million in extra funding for enforcement activities … and makes it easier to bring whistleblower andAnti-Kickback Statute claims against providers.
How Will Your Lab Comply with the Law and Protect Your Against Costly Legal Risk?
To help you understand and comply with the latest of Federal laws and regulations, G2 Intelligence is now making available a Special Research Report, Lab Compliance Essentials 2017: Managing Medicare Fraud & Abuse Liability Risks, that gives you the practical, “how-to” help you need to quickly and easily comply with the latest laws fraud and abuse laws … and avoid costly legal problems.
Here’s is just a sample of the help you get:
- It gives you an up-to-date overview of the latest fraud and abuse laws, rules and regulations that affect labs, including FCA, ACA, recent OIG Guidance, and relevant criminal laws that may come into play in an investigation or enforcement action
- It clearly breaks down today’s most critical legal and compliance challenges for labs from a practical, operational perspective so that you understand not only what the law says but what you must do to comply.
- It gives you a crystal-clear explanation of the False Claims Act … explains how the FCA affects labs and what a “false claim” is under the current law … points out how to avoid common FCA traps for labs … alerts you to the “reverse” false claims and the pending clarifications to the 60-day repayment rule … explains the recently updated Provider Self-Disclosure Protocol (SDP) … gives you a full rundown on FCA penalties and other compliance pitfalls … and much more!
- It explains the tricky “qui tam” provisions allow actions to be brought not just by the federal government but also by private individuals (“whistleblowers” or “relators”) who most frequently are employees … tells how qui tam lawsuits work … why these lawsuits are growing rapidly … gives the limits and barriers to qui tam lawsuits … and much more
- It clearly guides you through the anti-retaliation provisions that protect whistleblowers … reveal why it is absolutely critical for lab managers to understand the anti-retaliation provisions … tells what to do immediately if a qui tam complaint is filed against you … explains the 4 things whistleblowers must prove to qualify for anti-retaliation protection … tells the 2 most effective ways to avoid qui tam complaints … and much more
- It gives you an up-to-date overview of recent FCA enforcement actions against clinical labs … identifies the 6 current areas that FCA focuses on for investigation and enforcement actions
- It points out why FCA investigations look very closely at relationships between labs and physicians … tells what to do to document medical necessity to protect physicians and your lab … gives common practical examples to clarify confusing rules
- It reveals why alleged failure to follow CLIA rules could give rise to claims of false billing under FCA … and why your practices for reporting test results can create liability under FCA and other laws
- It explains how your billing practices can give rise to FCA liability … points out 9 problematic billing practices that every lab should avoid
- It tells why sales and marketing practices are now the second most frequent reason for FCA investigations … explains how the Anti-Kickback and Stark statues are a driving force behind lab investigations … highlights recent legal actions and settlements under these statues that help you avoid liability … explains how the AKS and Stark laws work … points out the “safe harbors”, including Regulatory Safe Harbors.
- It highlights Stark Law penalties … and the Stark law exceptions to help you avoid frequent areas of liability … PLUS, it gives you the rules for contract sales personnel including the critical rules for contract sales agreements
- It explains how to avoid legal problems when labs contract health care professionals to provide research, training, education, and other services … including important exceptions to these rules … plus, tells how to safely navigate the rules for placing a lab employee in a physician’s office … and alerts you to AKS and Stark Law red flags for lab payments to physicians for specimen collection, processing, and packaging, along with recent OIG guidance.
- It also alerts you to critical rules for registry payments … leasing or renting space from physicians …and free supplies and equipment for referring physicians … donating EHR software to clients … participating in provider referral exchanges .. and much more
- It highlights the often overlooked kickback rules that may come into play when providing physicians with access to laboratory information systems (LISs)
- It gives you an updated listing of the specific gifts that are banned under Stark laws, including free trials
- It explains how to navigate the complex and changing rules that apply to hospital contracting with hospital-based pathologists, including current laws and regulations … negotiations with pathologists … committee participation … liability issues when contracting for medical director services … frequently overlooked AKS risks … and much more!
PLUS, you get 10 Ways to Protect Your Lab … the 10 critical steps every lab needs to take to build Stark and AKS protection to an acceptable minimum level. These 10 steps alone could be the most important protections your lab puts into place to prevent FCA, AKS and Stark law investigations and penalties.
Don’t Put Your Lab at Risk in 2017!
Order your copy of Lab Compliance Essentials 2017: Managing Medicare Fraud & Abuse Liability Risks, TODAY!