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
OIG Temporarily Waives Anti-Kickback Restrictions for Certain COVID-19 Physician Arrangements
April 16, 2020
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
January 27, 2020
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
January 15, 2020
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
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...]
OIG Workplan
OIG Work Plan: Agency to Focus on Vaccine Adverse Event Reporting
January 2, 2020
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
January 2, 2020
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
November 28, 2019
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
November 20, 2019
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...]
