Texas Lab Loses $30.6 Million Whistleblower Suit over False Billing of Technician Travel Mileage Case: A case that began as a whistleblower complaint by a competing lab ended with a $30.6 million … [Read more...]
Labs In Court
Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry
March 4, 2020
CMS Increases 2020 Maximum Civil Monetary Penalties
February 27, 2020
Every year, HHS adjusts for inflation the maximum civil monetary penalty (CMP) amounts that a lab or other provider can be fined. In 2020, CMP maximums will increase by 2.522%. The new higher CMP … [Read more...]
Enforcement Trends: OCR Continues to Crack Down on HIPAA Right of Access Violations
February 27, 2020
On Sept. 9, 2019, the Office for Civil Rights (OCR), the HHS agency in charge of federal HIPAA enforcement, did something it had never done before by entering into a monetary settlement with a … [Read more...]
Labs in Court
Drug Abuse Treatment Owner Guilty of $57 Million Drug Test Pass-Thru Billing Conspiracy
February 6, 2020
Case: The owner of a northern Florida substance abuse treatment center pleaded guilty for his role in a $57 million pass-through lab testing billing and money laundering scheme. The way it worked: The … [Read more...]
ENFORCEMENT
Enforcement Trends: False Claims Act Recoveries Increase as Labs Remain in Firing Line
January 24, 2020
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
January 24, 2020
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...]
Employment Law Update
New overtime rule now in effect
January 14, 2020
By Mike O’Brien bio Jan. 1, 2020 was the deadline to comply with new FLSA overtime rule. At the end of September the Department of Labor issued its long-awaited final rule updating the salary … [Read more...]
In Brief: OIG Opens Second Avenue for Anti-Kickback Statute Revisions
January 13, 2020
Even as we wait for the second draft of the proposed new value-based kickback relief rules—see National Intelligence Report (NIR), Nov. 15, 2019—the OIG issued its annual call for recommendations for … [Read more...]
ENFORCEMENT
Enforcement Trends: Increase in OIG Fraud Recoveries Belies Continued Decline in Enforcement Actions
January 3, 2020
OIG fraud recovery has been a solid growth business for nearly two decades. So, when the agency announced a decline in FY 2018 recovery figures, it was more than a bit surprising. But things got back … [Read more...]
Compliance Perspectives: New Laws & the Top 5 Challenges Lab Compliance Officers Face in 2020
January 2, 2020
Labs remain at the forefront of the federal government’s suspicious persons list and health care fraud enforcement agenda. But in addition to the customary laws that labs are used to, the government … [Read more...]
