Billing & Collections

OIG Targets Pandemic’s Impact on Billing of Medicare Part B Lab Testing

Looking upon Medicare billing and payment of lab services with suspicion is and has always been part of the OIG’s organizational DNA. So, the fact that audits of Medicare Part B lab services during … [Read more...]

Enforcement Alert

OIG to Audit Medicare Part B Lab Testing During the Pandemic

Fraudulent and abusive billing of lab services has long been a favorite target of OIG enforcers. And with the unprecedented surge of COVID-19 testing during the public health emergency, it’s hardly … [Read more...]

Consumer Fraud

OIG Warns Medicare Beneficiaries Not to Fall for COVID-19 Scams

Pharma companies, diagnostics manufacturers, labs and other parts of the healthcare industry have done a commendable job in pivoting in response to the current public health industry. Sadly, it seems … [Read more...]

Enforcement Trends

COVID-19 Distractions Cause 2020 OIG Health Care Fraud Recoveries to Dip to 5-Year Low

Not surprisingly, the COVID-19 pandemic is hampering federal fraud fighting. The recoveries numbers bear this out. Here are the key findings from the OIG’s new Semi-Annual Report to Congress … [Read more...]

Kickbacks

OIG Issues Fraud Alert on Pharmaceutical Company In-Person Speaker Programs

Before the pandemic put the chill on live conference events, it was fairly common for pharmaceutical companies, device makers and diagnostics companies to offer healthcare professionals fees for … [Read more...]

Consumer Fraud

OIG Warns Medicare Beneficiaries Not to Fall for COVID-19 Scams

Pharma companies, diagnostics manufacturers, labs and other parts of the healthcare industry have done a commendable job in pivoting in response to the current public health crisis. Sadly, it seems … [Read more...]

Labs in Court

Michigan Reference Lab Settles False Billing Charges for $1.2 Million

Case: The OIG claimed that Michigan reference lab Great Lakes Medical Laboratory, Inc. ripped off Medicare and United Mine Workers Association (UMWA) health plans by billing for routine urine and … [Read more...]

OIG Findings

OIG Reports that 2018 Medicare Part B Lab Test Spending Increased Despite PAMA Cuts

It wasn’t supposed to happen like this. The expectation was that the new PAMA market-based pricing system was going to save Medicare 10 percent or more on lab test reimbursements. But it hasn’t … [Read more...]

Compliance Alert 

Be Sure You Can Document Medical Necessity of COVID-19 ‘Add-On Tests’

Memo to Lab Compliance Managers: Brace yourself for what may become the next big federal false billing crackdown against labs, specifically labs performing COVID-19 tests. The OIG has let it be known … [Read more...]

Compliance Alert

OIG Targets COVID-19 Test Labs for Potential Add-on Testing Abuses

Are labs taking advantage of the unprecedented demand for COVID-19 testing to bill Medicare for high reimbursing and medically unnecessary add-on tests? That’s what the OIG suspects and it plans to … [Read more...]


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