REIMBURSEMENT

Atlanta Medical Group Execs Jailed for $8.5 Million Allergy Testing Scheme

Case: The two owners of now defunct Primera Medical Group pled guilty to criminal charges for their role in billing insurers for allergy blood tests that weren't medically necessary, ordered by a … [Read more...]

COURT CASES

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

New York Breaks Up Massive $28 Million Medicaid Diagnostics Mill Case: One of the biggest Medicaid diagnostics fraud schemes in recent memory has resulted in multiple convictions, including two … [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...]

ANTI-KICKBACK

56 Months’ Jail for Lab Technician Caught in Texas Toxicology Scam

Case: A former toxicology testing company account rep pled guilty to conspiring with a medical clinic lab technician to steal patient identities and urine specimens from the clinic and send them to … [Read more...]

WHISTLEBLOWERS

Case of the Month: U.S. Supreme Court Gives Whistleblowers Four More Years to Sue

Just as the tide seemed to be turning against whistleblower lawsuits (see "New DOJ Policy Targeting Whistleblowers with Weak Cases May Make Life Easier for Labs," (Lab Compliance Advisor,  March 4, … [Read more...]

NEWS

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

West Virginia Medicaid Recovers $17 Million for $8.5 Million Opioid Scam Case: A subsidiary of Acadia Healthcare Co. has agreed to pay $17 million to settle charges of falsely billing West … [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...]

FALSE CLAIMS

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

WV Hospital & Marketing Consultant Sued for Elaborate Kickback Scheme Case: A new DOJ lawsuit accuses a West Virginia non-profit hospital and its business consultant of seeking to dominate the … [Read more...]

ENFORCEMENT

Case of the Month: Milwaukee Clinic the Latest MD-Owned Lab Busted for Urine Drug Test Abuses

Fraudulent utilization and billing of urine drug screening has become a priority for federal enforcers since the $256 million Millennium settlement of 2016. Subsequent cases have targeted abuses … [Read more...]

OIG

Medicaid Fraud Enforcement Trends By the Numbers

A new report from OIG details Medicare Fraud Control Unit (MCFU) enforcement activity in fiscal year 2018. Bottom Line on Top: The numbers were pretty consistent with previous trends with little in … [Read more...]


(-00000g2)