ENFORCEMENT

Enforcement Trends: False Claims Act Recoveries Increase as Labs Remain in Firing Line

The dollars paid by healthcare providers in federal False Claims Act settlements and judgments increased for the second year in row in 2019. After a surprising decline in 2017, total recoveries … [Read more...]

ENFORCEMENT

Enforcement Trends: The Top 5 Lab False Claims Act Settlements of 2019

Labs were on the paying end of at least eight million-dollar False Claims Act (FCA) settlements or judgments in the 2019 fiscal year. Here’s a review of the top 5 reported FCA recoveries against a lab … [Read more...]

ENFORCEMENT

Investment Returns on the Federal Enforcement Dollar Continue to Drop

The business of enforcing federal health care fraud laws isn't as robust as it used to be. While revenues have remained pretty steady, return on investment (ROI) has been trending downward, providing … [Read more...]

ENFORCEMENT

Enforcement Trends: Investment Return on Fraud Fighting Continues to Decline

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...]

COMPLIANCE GUIDANCE

Enforcement Trends: DOJ Changes to Yates Memo Make It Easier for Labs to Get Credit for Cooperating with Investigators

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

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

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

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

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

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...]


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