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...]
Billing & Collections
OIG Targets Pandemic’s Impact on Billing of Medicare Part B Lab Testing
February 22, 2021
Enforcement Alert
OIG to Audit Medicare Part B Lab Testing During the Pandemic
February 20, 2021
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
January 6, 2021
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
December 20, 2020
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
November 27, 2020
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
November 27, 2020
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
October 29, 2020
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
September 18, 2020
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’
August 4, 2020
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
July 20, 2020
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...]
