OIG Watch

Agency to Review First Two Years of PAMA-Based Medicare Reimbursements for Lab Tests

As we pass the midpoint of the third year of the PAMA experiment—if that’s what it is—the OIG announced plans to review what happened in years one and two. One of the new items on the agency’s Work … [Read more...]

CORONAVIRUS

HHS Puts Information Blocking and EHI Operability on Hold Due to COVID-19 Crisis

On March 9, 2020, the HHS Office of the National Coordinator for Health Information Technology (ONC) and CMS issued but didn’t publish final rules designed to improve patient access to their own … [Read more...]

Coronavirus

OIG Temporarily Waives Anti-Kickback Restrictions for Certain COVID-19 Physician Arrangements

As it previously did with the Stark Law (See National Intelligence Report, NIR, March 25, 2020), the OIG is temporarily loosening Antikickback Statute (AKS) restrictions to clear the way for health … [Read more...]

OIG

OIG Work Plan: Agency to Focus on Vaccine Adverse Event Reporting

The five new items the OIG added to its Work Plan have no direct impact on labs or lab services, although three of them might have an indirect effect on some labs. Here’s the rundown. CDC … [Read more...]

LABS IN COURT

Massachusetts Practice Busted for Taking Free POCT Cups from Millennium

Case: A northern Massachusetts medical practice and Detroit pain clinic became the latest downstream providers to pay the OIG a five-figure fine to settle kickback claims in the form of accepting free … [Read more...]

ENFORCEMENT

Enforcement Trends: Increase in OIG Fraud Recoveries Belies Continued Decline in Enforcement Actions

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...]

OIG Workplan

OIG Work Plan: Agency to Focus on Vaccine Adverse Event Reporting

The five new items the OIG added to its Work Plan in December 2019 have no direct impact on labs or lab services, although three of them might have an indirect effect on some labs. Here’s the … [Read more...]

OIG

Scorecard: OIG Enforcement Actions against Labs in 2019

Labs remain at the top of the OIG’s enforcement hit list, as illustrated by the number of cases involving labs cited in the agency’s new Semiannual Report to Congress for FY 2019: False Billing … [Read more...]

COMPLIANCE PLANS

OIG Work Plan: Agency to Focus on Collection of Medicare Advantage Ordering Provider Identifiers

OIG needs ordering provider identifiers in the Medicare Advantage (MA) encounter data to be available so it can use the data to identify and prevent potential fraud, waste and abuse. However, although … [Read more...]

ENFORCEMENT

Quest Pays $88.7K to Settle Specimen Collection Fee Kickback Charges Against Its Subsidiary

Case: After self-disclosing, Quest has settled kickback claims against its wholly-owned subsidiary, Quest Diagnostics TB LLC, for $88,780. The OIG alleges that from June 2011 to December 2016, the lab … [Read more...]


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