NEW LAW

New Laws: Proposed Kickback Changes Would Provide Needed Relief But Also Largely Exclude Labs

In what could be the most significant story in health care fraud and abuse compliance of the past several years, the CMS and OIG proposed new rules (the Proposal) to adapt 20th century kickback laws … [Read more...]

Labs In Court

A roundup of recent cases and enforcement actions involving the diagnostics industry ACLA Goes for Knockout Punch in PAMA Lawsuit  Case: Having survived a first-round setback, the American … [Read more...]

Anti-Kickback

Special Report: Long Awaited Kickback Relief Rules Keep Labs in the Cold

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...]

ANTI-KICKBACK

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

Quest Pays $88.7K to Settle Specimen Collection Fee Kickback Charges Against Its Subsidiary Case: After self-disclosing, Quest has settled kickback claims against its wholly-owned subsidiary, … [Read more...]

Brief Your CEO: It May Become Easier to Get CMS Stark Clearance for Business Deals with Referral Sources

Part of the challenge of running a lab compliance program is making your officers aware of how business transactions your lab makes with a physician that refers patients to you for testing creates the … [Read more...]

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...]


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