OIG Monthly Work Plan Review: August 2018

Of the 12 new Work Plan items, four have direct implications for labs and billing of lab tests. 1. Medicare Payments for Clinical Diagnostic Laboratory Tests in 2017: Year 4 of Baseline Data Issue: … [Read more...]


Cybersecurity: LabCorp Reports What Could Be a Major Data Breach

Cyberattacks and data breaches against health providers are a daily occurrence. But when the breach takes place at a firm as big and powerful as LabCorp and potentially affects the health records of … [Read more...]


CMS Takes 3 New Measures to Bolster Medicaid Program Integrity

With Medicaid spending on the rapid ascent, CMS unveiled a trio of new initiatives to bolster program integrity and make states more accountable for compliance with federal rules. 1. MLR Audits CMS … [Read more...]


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 … [Read more...]


Case of the Month: Patients Can’t Sue Labs for Privacy Breaches, Federal Court Confirms

The HIPAA law sets out civil and criminal penalties that can be imposed on labs (and other providers) that commit privacy violations. But one thing the HIPAA law does not specify is whether an … [Read more...]


New Study Provides Most Comprehensive Overview of Genetic Test Development, Usage and Spending

As might be expected, there has been rapid growth in genetic test availability and spending on these tests since 2014. But, comprehensive new collaborative analysis conducted by Concert Genetics … [Read more...]


Value Care: CMS Value Modifier Programs Ends Not with a Bang but a Whimper

Thanks for nothing. While CMS likes to congratulate itself for using provider pay adjustments to "transform the healthcare delivery system," more often than not, the rhetoric fails to live … [Read more...]


Enforcement Trends: Whistleblowers Get in on the EHR “Meaningful Use” Action

Wrongful payment of electronic health records (EHR) "meaningful use" incentives has become a growth area in government health fraud enforcement. (See GCA, July 10, 2017). And now private … [Read more...]


EHR: Private Whistleblowers Getting in on “Meaningful Use” Crackdown

Wrongful payment of electronic health records (EHR) "meaningful use" incentives has become a growth area in federal health care fraud enforcement. And now private whistleblowers are getting … [Read more...]


Are Labs Personally Liable to Data Breach Victims—CareFirst Case May Provide the Answer

While data breaches inside labs and other health care settings happen all the time, lawsuits for money damages by victims have been relatively unusual. But now the U.S. Supreme Court is being asked to … [Read more...]