Case: A month after going public, Progenity agreed to shell out $49 million to settle claims of overbilling and paying physicians kickbacks to order its noninvasive prenatal tests (NIPT). The case, … [Read more...]
Compliance Alert
Be Sure You Can Document Medical Necessity of COVID-19 ‘Add-On Tests’
August 4, 2020
Memo to Lab Compliance Managers: Brace yourself for what may become the next big federal false billing crackdown against labs, specifically labs performing COVID-19 tests. The OIG has let it be known … [Read more...]
Reimbursement
Payors Gradually Increasing Coverage of Liquid Biopsies but Obstacles Remain
July 28, 2020
Gaining the acceptance of insurers and payors for new tests and testing technology is a perennial challenge for laboratories and test developers. This has been especially true with liquid biopsy … [Read more...]
Medicare Reimbursement
CMS Waivers Expand COVID-19 Testing Coverage Rules
June 1, 2020
On May 1, CMS issued regulatory waivers temporarily expanding coverage and clarifying billing of COVID-19 testing for Medicare and Medicaid beneficiaries during the public health emergency (PHE). Here … [Read more...]
Labs In Court
Colorado MDs Pay $55K for Taking Specimen Processing Fee Kickbacks from HDL and Singulex
May 28, 2020
Case: Two physicians and their family medical practice have agreed to fork over $54,982 to the OIG to settle claims of soliciting and accepting illegal remuneration from lab companies Health … [Read more...]
