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...]
LABS IN COURT
Massachusetts Practice Busted for Taking Free POCT Cups from Millennium
January 15, 2020
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...]
OIG
Work Plan: OIG Targets Medicare Part B Urine Drug Testing
October 28, 2019
Falsely billing Medicare Part B for urine drug testing has loomed large on the OIG’s radar even before the opioid crackdown began. Last February, for example, the OIG issued a report claiming that CMS … [Read more...]
Anti-Kickback
Special Report: Long Awaited Kickback Relief Rules Keep Labs in the Cold
October 22, 2019
They’re finally here! After years of talking about adapting the decades-old kickback laws to modern medical market conditions, CMS and OIG proposed new rules (the Proposal) on Oct. 9, 2019. Whether it … [Read more...]
COMPLIANCE PLANS
OIG Monthly Work Plan Review: August 2019
August 28, 2019
Of the 12 new items in the OIG's Work Plan this month, six indirectly impact lab providers and services. Medicare Payments of Positive Airway Pressure (PAP) Devices for Obstructive Sleep Apnea (OSA) … [Read more...]
CMS
Kickbacks: OIG Withdrawal of Old Safe Harbor Proposals Clears Way for Meaningful Reform
August 26, 2019
Like the rest of the health care industry, labs need more not fewer new and modern Anti-Kickback Statute (AKS) safe harbors. So, the OIG's decision to cancel new safe harbors in incubation seems like … [Read more...]
