PAMA

MedPAC Explores Simplified PAMA Reporting to Cut Burdens & Restore Lab Prices

The upcoming report of the Medicare Payment Advisory Commission (MedPAC) gives the lab industry new hopes for relief from the administrative burdens of Protecting Access to Medicare Act of 2014 (PAMA) … [Read more...]

HIPAA Enforcement

New OCR Data Shed Light on the Costs of Privacy Noncompliance

HIPAA enforcement isn’t nearly as fat a cash cow as enforcement of False Claims Act (FCA) and other healthcare fraud laws is, it still takes a lot of money out of the pockets of providers and into the … [Read more...]

False Claims

Federal Court Nixes Appeal of Physician Convicted of Participating in Urine Drug Test Billing Scam

Before the pandemic began, fraudulent utilization and false billing of medically unnecessary urine drug screening had climbed to the top of the agenda for federal enforcement. (See National Lab … [Read more...]

Labs in Court

Massachusetts Mental Health Hospital Fined $65,000 for HIPAA Right of Access Violation

Case: The HIPAA Privacy Rule gives providers 30 days and, in some instances, 60 days to respond to patients’ requests of access to their medical records. But it took Massachusetts behavioral health … [Read more...]

Enforcement Trends

Silicon Valley Becomes Epicenter of Lab Investment Scams

On paper, the Silicon Valley venture capital and innovation that have lifted so many other industries seem like the perfect elixir for medical labs. Perhaps one day it will prove to be just that. But … [Read more...]

Kickbacks

The HDL Saga Continues with $114 Million Verdict against Lab’s CEO and Marketing Principles

Health Diagnostics Laboratory, Inc. (HDL) has been gone for years but prosecution efforts targeting the massive kickback scandal it authored lives on. Naturally, the initial wave of actions targeted … [Read more...]

Labs in Court

EHR Technology Vendor Settles Kickback Charges for $18.25 Million

Case: Athenahealth Inc., a Massachusetts-based EHR software vendor has agreed to fork over $18.25 million to settle charges of paying kickbacks to generate sales. The DOJ complaint cites three … [Read more...]

Labs In Court

Michigan Cardiologist Shells Out $2 Million to Settle False Billing Charges

Case: The feds claim that over an 11-year period the physician and his metropolitan Detroit area practice and lab sites violated the False Claims Act by billing Medicare, Medicaid and TRICARE for … [Read more...]

Labs in Court

Florida Court Upholds Conviction of Physician at Center of Massive Drug Test Scam

Case: In February 2019, the physician/medical director of a pair of sober home clinics in clinics was sentenced to 11 years in prison and ordered to pay $1 million in restitution for his role in a … [Read more...]

Labs in Court

Theranos Redux? Feds Target New Silicon Valley Diagnostics Start-Up Investment Scam

Case: Federal prosecutors have filed criminal charges against the co-founders of a San Francisco biotechnology start-up firm with defrauding investors by making bloated claims about a revolutionary … [Read more...]


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