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Search Results for: anti-kickback law

Cigna Sues HDL, Alleges Unlawful Fee Scheme

Laboratory Compliance / By Joseph Burns

CEO SUMMARY: In court papers, Cigna alleged that HDL misrepresented patients’ responsibilities by promising not to collect co-payments, co-insurance, or deductibles. Also, HDL promised not to seek reimbursement from patients for any portion of its bills that the health insurer did not cover, the court documents show. HDL misleadingly billed the health insurer at exorbitant …

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Florida Law Better Defines Lab Marketing Violations

Laboratory Compliance / By Joseph Burns

CEO SUMMARY: Despite clear language in Florida’s new state law that bans the placement of laboratory employees in a physicians’ office, some clinical lab companies want to continue the practice of placing specimen collectors in physicians’ offices. These opinions were voiced by lab executives during a meeting on June 28 in Tallahassee, Florida, at the …

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In Florida, New Law Bans Certain Lab Sales Practices

Laboratory Compliance / By Joseph Burns

CEO SUMMARY: Florida law has long prohibited clinical laboratories from giving kickbacks and other forms of remuneration to physicians to induce specimen referrals. Specifically, state regulations have prevented labs from placing specimen collectors in physicians’ offices. Despite these clear prohibitions, labs regularly violated state rules by placing specimen collectors and other lab employees in physicians’ …

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Former Lab CEO Explains Why He Filed Lawsuit

The Dark Report / By Robert Michel

CEO SUMMARY: It may be the first time that a former public laboratory CEO has turned whistleblower. Andrew Baker, formerly Chairman and CEO of Unilab Corporation in the 1990s, filed a qui tam case in federal court last year that centers on the practice of lab companies offering private health plans deeply-discounted lab test pricing …

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Lawyers Provide Insights About Top Legal Concerns

Laboratory Compliance / By Robert Michel

CEO SUMMARY: After conducting the first-ever survey of the most important legal, compliance and managed care concerns for clinical labs and pathology groups, THE DARK REPORT asked leading lab industry attorneys who participated in the survey to say a few words about these topics. Here are useful nuggets of wisdom, advice, and insights about the …

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New Federal Anti-kickback Investigation

Commentary and Opinion by R. Lewis Dark / By R. Lewis Dark

POTENTIAL ANTI-KICKBACK VIOLATIONS in ancillary clinical service arrangements between referring physicians and providers like radiologists and laboratories continue to attract the interest of federal healthcare investigators. Right now, it appears radiology is a primary target. Last week, the Wall Street Journal disclosed that federal health investigators issued warrants and subpoenas to University MRI & Diagnostic …

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UroCor’s Sales Tactics Violated Medicare Laws

Laboratory Compliance / By Robert Michel

CEO SUMMARY: By issuing a multi-count criminal indictment against three former UroCor executives, one federal attorney is creating new legal precedents for the laboratory industry. The criminal charges accuse UroCor of inducing physicians through such gambits as deeply-discounted pricing and “free testing” when not a contracted network laboratory. Labs should review compliance with these types …

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Lawyer Argues: UroCor Charges Are a Concern

Laboratory Compliance / By Robert Michel

CEO SUMMARY: Criminal charges in the case against three ex-UroCor executives will likely alter existing compliance practices that affect how a lab offers price discounts to physicians and the way a lab uses “waiver of charges” in situations where it is an out-of-network provider. Attorney Jane Pine Wood was one of the first to see …

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Revised Stark and AKS Rules Are Good News for Labs

Laboratory Compliance / By Robert Michel

CEO SUMMARY: It must be rewarding for federal rulemakers at the Centers for Medicare and Medicaid Services and the Office of the Inspector General to hear that attorneys representing clinical labs and pathology groups consider the new final rules for the Stark Law and the Anti-Kickback Statute to be helpful for clarifying how labs and …

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Several Big Surprises in 2018’s Top 10 Lab Stories

Laboratory Management / By Robert Michel

CEO SUMMARY: This year’s list of the Top 10 Lab Industry Stories for 2018 is dominated by new directives from Medicare and private health insurers, as well as significant decisions by federal courts. Collectively, these developments create new compliance risks for all clinical laboratories and anatomic pathology groups. What is more notable about these top …

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