COMPLIANCE TIPS

No One-Size-Fits-All Answer for Frequency of Billing and Coding Audits

Q. How often should a laboratory conduct compliance audits of its billing and coding? A. The answer depends on many factors and will vary from provider to provider. The Office of Inspector General's … [Read more...]

ENFORCEMENT

OIG Report Indicates Limited Success for Senior Medicare Patrol

An Office of Inspector General report detailing results of 2015 enforcement efforts by the Senior Medicare Patrol (SMP) show success but not overwhelming recoveries. However, the report cautions that … [Read more...]

INNOVATION

Senior Medicare Patrol Projects Show Low ROI in Fighting Fraud and Abuse

An Office of Inspector General report detailing results of 2015 enforcement efforts by the Senior Medicare Patrol (SMP) show success but not overwhelming recoveries. However, the report cautions that … [Read more...]

DATA

Data Analytics Fuels Billions of Dollars in Fraud Recoveries Says OIG, CMS

By Kelly A. Briganti, Editorial Director, G2 Intelligence A common message emerging from the government enforcement agencies is that data analytics have been critical to fraud and abuse efforts. As … [Read more...]

ENFORCEMENT

Physician Kickbacks the Focus of OIG “Eye on Oversight” Video

The U.S. Health and Human Services Office of Inspector General’s (OIG’s) concern about kickbacks to referral sources is nothing new. But the OIG is keeping the heat on the issue with a new video … [Read more...]

ANTI-KICKBACK

OIG Advisory Opinion Says GPO That Includes Labs Has “Acceptably Low” Anti-Kickback Risk

Group purchasing organizations (GPOs) are entities that act as a purchaser of supplies and equipment for a number of other entities—usually health care providers like hospitals. Laboratories, often … [Read more...]

NEWS

News at a Glance – June 2016

Medicare Fraud Prevention System Saves $1.5 Billion. The Centers for Medicare & Medicaid Services (CMS) claims Big Data has yielded big savings for Medicare. CMS claims its Fraud Prevention System … [Read more...]

COMPLIANCE

OIG Updates 2016 Work Plan Adding New Lab Agenda Item

By Kelly A. Briganti, Editorial Director, G2 Intelligence The U.S. Health and Human Services Office of Inspector General released its mid-year update to the Annual Work Plan, adding and revising … [Read more...]

Compliance

OIG Mid-Year Work Plan Update Adds PAMA-Focused Lab Item

The U.S. Department of Health and Human Services Office of Inspector General released its mid-year update to the Annual Work Plan, adding and revising items relevant to lab enforcement efforts. The … [Read more...]

REIMBURSEMENT

Lab Sector Continues to Actively Fight Potential Medicare Co-Payment Collections

While laboratory developed tests and PAMA’s impact on Medicare reimbursement are front of mind for most laboratories, there remains a lingering concern within the industry that the government hasn’t … [Read more...]


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