SELF-DISCLOSURE

Compliance Perspectives: How the New OIG Fraud Risk Indicator System Heightens the Imperative of Self-Disclosure

As hard as you try to keep your lab 100% compliant with healthcare fraud and abuse laws, you may discover that an inadvertent violation has occurred. At that point, the compliance imperative switches … [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...]

FALSE CLAIMS

Compliance Perspectives: How to Spot & Avoid Kickback Risks under New EKRA Law

A new law passed to deal with the opioid epidemic has significant ramifications for labs including but not limited to those involved in drug addiction and recovery programs. Specifically, the … [Read more...]

DRUG TESTING

Enforcement Trends: CMS Looks to Recover $66.3 Million in Improper Specimen Validity Test Payments

The opioid crackdown has made urine drug testing an even greater priority for federal health fraud enforcers. One principle target is specimen validity testing (SVT) billed in combination with urine … [Read more...]

FALSE CLAIMS

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

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 … [Read more...]

DRUG TESTING

Enforcement Trends: CMS Orders Medicare Contractors to Go After Labs that Received Specimen Validity Test Payments

Reflecting the wider opioid crackdown, CMS is targeting labs that perform urine drug testing for potential billing abuses. The hottest initiative: Labs that bill specimen validity testing (SVT) in … [Read more...]

COURT CASES

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

$1.99 Million Settlement for False Billing of Genetic Tests Case: In a case that began as a whistleblower suit filed by two ex-employees, GenomeDx Biosciences has agreed to shell out $1.99 … [Read more...]

WHISTLEBLOWERS

Case of the Month: Facing 3 against 1, Texas Lab Settles EHR Consulting Kickback Charges

Question: What happens when multiple whistleblowers bring separate qui tam lawsuits against a lab for the same offense? Answer: Under the False Claims Act (FCA), only the first whistleblower to … [Read more...]

ENFORCEMENT

Pain Clinic Co-Owner Pleads Guilty to Drug Testing Kickback Charges

Case: The Louisiana physician received $336,000 in kickbacks from a drug testing lab representing a percentage of the reimbursement proceeds generated via the referrals of Medicare patients' urine … [Read more...]


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