ANTI-KICKBACK

Alabama Doctors, Cardio Practice, Settle Genetic Testing Kickback Claims for $1.1 Million 

Case: Three doctors and a cardiology practice, all based in Alabama, have agreed to shell out $1.1 million for allegedly taking bribes from a now-bankrupt genetic testing company in the Seattle area. … [Read more...]

LABS IN COURT

Feds Take Down Florida Substance Abuse Clinic Principles for Drug Test Fraud

Case: A trio of individuals associated with a Miami substance abuse facility were charged with taking part in a scheme to bill private insurers for tests that weren’t medically necessary or, in some … [Read more...]

Labs In Court

A roundup of recent cases and enforcement actions involving the diagnostics industry   Lab’s ‘False Positive’ Drug Test Report ≠ Defamation of Employee  Case: An Arkansas nurse got fired … [Read more...]

FALSE CLAIMS

Federal Court Dismisses Urine Drug Test False Billing Claim

Case: Whistleblowers accused a national lab company of falsely billing Medicare and Medicaid for high complexity quantitative urine drug tests under CPT code G0431 at up to $476 per test. According to … [Read more...]

CO-ORDINATING DATA

Laboratory Information Systems (LIS): What You Need To Know To Get Paid

By Sean McSweeney  bio Today, laboratory billing claims require more and more data to successfully get paid. One of the biggest reasons your claims may be getting denied is because you're not … [Read more...]

OPERATIONS

Lab Management: Billing Company Contract Liability Risks & How to Avoid Them

Like many labs, you may outsource your billing and coding to an outside medical billing company. While this might be cost-effective, be aware that it can put your lab at risk for liability under … [Read more...]

OIG OPINION

Is Your Billing Company Putting You At Compliance Risk?

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...]

CODING

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 prescribing oxycodone and other Schedule II drugs without examining and … [Read more...]

COMPLIANCE PLANS

OIG Monthly Work Plan Review: April 2019

Among the 10 new Work Plan items this month, three may have potential ramifications for at least some labs. Medicaid Managed Care Organization Denials Issue: The State Medicaid agency and the … [Read more...]

ENFORCEMENT

Case of the Month: Another MD-Owned Lab Gets Busted for Urine Drug Test Abuses

Fraudulent utilization and billing of urine drug screening first became a priority for federal enforcers since the $256 million Millennium settlement of 2016. But the opioid crackdown has heightened … [Read more...]


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