FALSE CLAIMS

Case of the Month: FMC Settlement Is Poster Child for False Billing of Lab Tests

In the grand scheme of things, $2 million is fairly small potatoes for false billing of lab tests—especially considering that it allegedly went on for 10 years. Even so, if you're running your lab's … [Read more...]

COMPLIANCE CORNER

Fixing a Hole in Whistleblower Retaliation Protection

SITUATION Fictional Laboratories (FL) plans to deliberately bill Medicare for tests it does not actually provide. To carry out the scheme, it orders Pathologist A to falsely attest that she performed … [Read more...]

WHISTLEBLOWERS

Tool: Model Hotline Allegations Investigation Procedure

The OIG Model Compliance Plan for Clinical Laboratories requires labs to establish mechanisms for not only receiving but promptly investigating internal complaints and reports of potential compliance … [Read more...]

LEGISLATION

New Laws: House Bans Firing Whistleblowers for Disobeying Orders to Break the Law

It's clearly against the law to fire an employee in retaliation for filing a whistleblower suit against your lab. So it goes without saying that the ban on retaliation also prevents you from firing an … [Read more...]

ENFORCEMENT TRENDS

FISH Test Crackdown against 21st Century Oncology Nets Nearly $25 Million… and Counting

$24.86 million. That's how much a whistleblower has made for the government and herself—so far—in a case against 21st Century Oncology for alleged fraudulent billing of fluorescence in situ … [Read more...]

COMPLIANCE

OIG Highlights Hotline to Encourage Fraud Reporting

Reporting compliance concerns is a key component of effective compliance plans. A recent U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) podcast highlights the … [Read more...]

WHISTLEBLOWER

Tread Carefully When Disciplining Employees Who Have Blown the Whistle

The False Claims Act (FCA) has become the federal government's primary weapon in combating fraud and abuse. However, most FCA cases are initiated not by the government but private individuals filing … [Read more...]

WHISTLEBLOWER

After the Whistle Blows: Disciplining Whistleblowers without Committing Retaliation

The False Claims Act (FCA) has become the federal government’s primary weapon in combating fraud and abuse. Paradoxically, though, most FCA cases are initiated not by the government but private … [Read more...]


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