On Jan. 31, Department of Health and Human Services Secretary Alex Azar floated a proposed rule to lower the prices and out-of-pocket costs of prescription drugs by having manufacturers give discounts … [Read more...]
ANTI-KICKBACK
HHS Proposes Eliminating Drug Rebates to Cut Medicare Prescription Costs
March 15, 2019
OIG OPINION
Is Your Billing Company Putting You At Compliance Risk?
March 11, 2019
By Sean McSweeney bio Does your orthopedic billing company charge a percentage of collections for their coding and billing? They might break out separate charges for statements or other … [Read more...]
ANTI-KICKBACK
North Carolina Hospital Settles Self-Disclosed Kickback Claims for $2.2+ Million
February 27, 2019
Case: Rex Hospital, Inc. d/b/a UNC Rex Healthcare, agreed to shell out $2,277,762 for kickbacks violations stemming from its deal to lease a doctor from a community hospital to provide cardiology … [Read more...]
COURT CASES
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
February 22, 2019
$1.99 Million Settlement for False Billing of Genetic Tests Case: In a case that began as a whistleblower suit filed by two ex-employees, GenomeDx Biosciences has agreed to shell out $1.99 … [Read more...]
COURT CASES
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
February 19, 2019
Texas Pathology Lab Settles EHR Consulting Kickback Claims for $63.5 Million Case: In 2006, HHS implemented an AKS safe harbor and Stark exception letting non-physician providers pay up to 85% … [Read more...]
ANTI-KICKBACK
Despite Vigorous Denial, Molecular Lab Pays $1.8 Million to Settle Fraud Charges
February 8, 2019
Case: The feds claim that Molecular Testing Labs, a toxicology and genetics lab in Washington State, paid local labs in exchange for Medicare and Tricare referrals; it then turned what had been an … [Read more...]
REIMBURSEMENT
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
January 23, 2019
Tennessee Pain Doctor Faces Jail for Opioid Abuses, Medicare Fraud Case: The doctor is facing 45 charges, including 22 counts of illegal distribution of a controlled substance for routinely … [Read more...]
ENFORCEMENT
New Law: EKRA Makes Drug Addiction & Rehab Labs Potential Targets for Federal Prosecution
January 15, 2019
Recent federal legislation addressing the opioid crisis may have unintended consequences on the lab industry. The idea was to allow the feds to prosecute a certain kind of abuse banned by the … [Read more...]
COURT CASES
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
January 15, 2019
Wisconsin Health System Settles Stark Claims for $12 Million Case: In a case that began as a whistleblower suit, a company affiliated with Advocate Aurora Health, Inc. has agreed to pay $12 … [Read more...]
LEGISLATION
Compliance Alert: New Private-Pay Opioid Law Puts All Drug Addiction & Rehab Labs at Risk of Federal Prosecution
January 7, 2019
Recent federal legislation addressing the opioid crisis may have unintended consequences on the lab industry. The idea was to allow the feds to prosecute a certain kind of abuse banned by the … [Read more...]
