Although it's still a profitable endeavor, enforcing federal health care fraud laws isn't providing the investment returns of yesteryears. That's the main takeaway of the new joint HHS and … [Read more...]
ENFORCEMENT
Enforcement Trends: Investment Return on Fraud Fighting Continues to Decline
July 16, 2019
COMPLIANCE GUIDANCE
Enforcement Trends: DOJ Changes to Yates Memo Make It Easier for Labs to Get Credit for Cooperating with Investigators
July 1, 2019
For the past five years, the DOJ has followed an enforcement policy designed to hold directors, officers and other top corporate officials responsible for the wrongdoing their companies commit. Last … [Read more...]
DOJ
Compliance Perspectives: Use New DOJ Criteria to Vet the Effectiveness of Your Lab Compliance Program
June 28, 2019
One of the primary responsibilities of a lab manager is to ensure that the lab's compliance program is effective. There's a lot on the line. Having an effective compliance program can help prevent … [Read more...]
COMPLIANCE
DOJ Explains What It Wants from a Compliance Program
June 17, 2019
While it may not prevent all violations, the right compliance program can help your lab get lighter penalties if things go wrong. But what exactly is "the right compliance program." On April 30, the … [Read more...]
COMPLIANCE GUIDANCE
Brief Your CEO: Explain How New DOJ Guidance Can Get Your Lab Out of FCA Hot Water
June 10, 2019
New guidance from the DOJ lays out sheds light on a crucial matter that many high-ranking lab executives are forced to confront: whether to "play ball" with the federal government when internal … [Read more...]
FALSE CLAIMS
Enforcement Trends: Feds Targeting Commercial & Private-Pay, Not Just Medicare Fraud
May 21, 2019
Risk of federal prosecution for health fraud and abuse applies only when you deal with Medicare, TRICARE or other federal health programs. Right? Wrong! While that used to be true, the times they … [Read more...]
DOJ
Enforcement Trends: New DOJ Policy Targeting Whistleblowers with Weak Cases May Make Life Easier for Labs
March 4, 2019
It's not just new laws, regulations or even court cases. Trends in health care fraud enforcement are sometimes driven by changes in prosecution policies, including those that aren't made public. Such … [Read more...]
COMPLIANCE
Enforcement Trends: After 2017 Decline, False Claims Act Healthcare Recoveries Bounce Back
January 21, 2019
Although the False Claims Act (FCA) remains a federal enforcement cash cow, the growth rate has fallen off in recent years, at least in the healthcare sector. But that short-term trend could be in … [Read more...]
EXPOSED THERANOS FRAUD
Investigative Journalist Wins Kellison Award
October 25, 2018
John Carreyrou, the Pulitzer prize-winning journalist who exposed Theranos as a fraud, was presented with the Kellison & Company Distinguished Service Award at Lab Institute today. Pictured … [Read more...]
FALSE CLAIMS
Dissolution: The Final Act of the Theranos Tragedy
September 26, 2018
Tragedy was a genre invented by the ancient Greeks to portray the fall of not just ordinary but great individuals. And while "Theranos" is not actually a Greek word (it's actually an amalgamation of … [Read more...]
