CODING

Urgent Care Centers Settle E/M Upcoding Charges for $2 Million

Case: The owners/operators of CareWell urgent care centers in Massachusetts and Rhode Island have agreed to shell out $2 million for improper coding of Evaluation and Management services. CPT code … [Read more...]

COMPLIANCE GUIDANCE

Stark Law: CMS Plan Would Make It Easier for Labs to Get Advisory Opinions

In late July, CMS proposed to update the advisory opinion process that labs and other providers use to get a determination about whether a proposed business arrangement would violate the Stark Law. … [Read more...]

ANTI-KICKBACK

Texas Scammer Gets 20 Years for Role in $50 Million Lab Test Ripoff

Case: The plot unfolded 10 years ago when a then 26-year-old woman and three co-conspirators set up 24 phony diagnostic testing centers in Houston. Offices were rented in 28 locations even though none … [Read more...]

Texas Health System Fined $431K for Falsely Billing Genetic Tests

Case: The feds contend that between 2016 and 2018, Decatur Hospital Authority (d/b/a Wise Health System) sent samples from surgical patients to Tennessee labs for medically unnecessary genetic tests. … [Read more...]

ANTI-KICKBACK

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

LabCorp Must Go to Trial to Defend against Deceptive Trade Practices Charges Case: Fourteen patients sued LabCorp for allegedly overcharging them for lab tests. In March 2018, a North Carolina … [Read more...]

COURT CASES

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

Federal Court Dismisses Whistleblowers' Urine Drug Test False Billing Claim Case: Whistleblowers accused a national lab company of falsely billing Medicare and Medicaid for high complexity … [Read more...]

NEWS

New York Breaks Up $28 Million Medicaid Diagnostics Mill

Case: One of the biggest Medicaid diagnostics fraud schemes in recent memory has resulted in multiple convictions, including two doctors and two corporate presidents. According to New York … [Read more...]

ANTI-KICKBACK

Maryland Hospital Fined $457.2K for Free Support Services Kickbacks

Case: Union Hospital of Cecil County, Inc. has agreed to pay $457,213 for a pair of self-disclosed kickback violations, namely, paying remuneration to: Physicians in the form of free support … [Read more...]

FALSE CLAIMS

Kentucky Lab Pays $125K to Settle Self-Disclosed SVT False Billing Charges

Case: VerraLab JA, LLC, has agreed to pay $125,983 after self-disclosing that it billed Medicare for specimen validity tests (SVT) performed to authenticate urine samples for drug testing. Unlike the … [Read more...]

COURT CASES

Labs In Court: A roundup of recent cases and enforcement actions involving the diagnostics industry

Drug Abuse Treatment Owner Guilty of $57 Million Drug Test Pass-Thru Billing Conspiracy Case: The owner of a northern Florida substance abuse treatment center pleaded guilty for his role in a … [Read more...]


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