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...]

ANTITRUST

Enforcement Trends: New Emphasis on MD Practices Puts Labs at Growing Risk of Antitrust Enforcement

In addition to the usual Medicare and Medicaid anti-fraud laws, labs have a new liability risk to contend with: stepped-up federal and state enforcement of antitrust laws. The driving force behind … [Read more...]

ENFORCEMENT

Focus On: State AGs Break New Ground by Teaming Up to Enforce HIPAA

Lab managers and compliance officers take note: For the first time ever, state attorneys general (AGs) have banded together to go after a health care provider for HIPAA violations. Although the … [Read more...]

ENFORCEMENT

Kickbacks: Massachusetts Practice Latest Provider Busted for Taking Kickbacks from Millennium

A northern Massachusetts medical practice became the latest downstream provider to pay the OIG a five-figure fine to settle kickback claims in the form of accepting free point-of-care test cups from … [Read more...]

ENFORCEMENT

Compliance Perspectives: Feds Using Medicare Laws to Prosecute Non-Medicare Arrangements

Myth: Risk of federal prosecution for health fraud and abuse applies only when you deal with Medicare, TRICARE or other federal health programs. Truth: While that used to be true, the times they are … [Read more...]

FOCUS ON

State Law Round-up: New Privacy Breach Notification Laws Potentially Affecting Labs

As illustrated by the recent MIE settlement (click here for the story), security breaches involving patients' electronic protected health information (ePHI) exposes your lab to liability risks under … [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...]

ENFORCEMENT

Case of the Month: Feds Target Doctors Who Took Kickbacks from HDL

When it comes to breaking up lab kickback schemes, federal enforcers start with the lab that paid the kickbacks and then turn to the downstream providers that accepted them. This was the pattern in … [Read more...]


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