TAG:
anti kickback statute
OIG’s Issues New Opinion on Use of Gift Cards for Lab Specimens
CEO SUMMARY: This new Advisory Opinion from the Office of Inspector General (OIG) outlines a narrow situation in which it may be allowable for clinical laboratories to use gift cards to encourage pa…
Important Court Rulings & Pending New Federal Law
IMPORTANT THINGS ARE HAPPENING WITH COURT DECISIONS AND PROPOSED FEDERAL LEGISLATION that will affect a substantial number of the nation’s clinical laboratories and anatomic pathology groups. In this issue of The Dark Report, you’ll be alerted to those developments we th…
New OIG Advisory Opinion Dubious of ‘Fair Market’
CEO SUMMARY: There is a new advisory opinion from the Office of the Inspector General (OIG). It reviewed a proposal in which a clinical lab network would pay fair market value to hospitals for specimen collection based on volume of patients tested. The OIG said this arrangement woul…
DOJ Charges Execs over Alleged Lab Kickbacks to Obtain Restitution
CEO SUMMARY: Multiple executives and sales representatives at True Health Diagnostics and Boston Heart Diagnostics have been named as defendants in a civil suit filed by the U.S. Department of Justice. The complaint centers on alleged kickbacks in return for clinical laboratory test…
Innovation Showcased at Executive War College
CEO SUMMARY: This year’s Executive War College on Laboratory and Pathology Management proved to be a high-energy event. A record 900 attendees showed up and responded enthusiastically to visions and predictions of a post-COVID-19 healthcare system that hungers for large volumes of…
DOJ: EKRA Governs Lab Sales and Marketing Commissions
BY FILING A MOTION IN A U.S. DISTRICT COURT RECENTLY, officials from the federal Department of Justice (DOJ) took steps to oppose an earlier ruling by a federal judge in Hawaii dealing with the way the Eliminating Kickbacks in Recovery Act of 2018 (EKRA) governs how percentage-based commission…
In Civil Suit, DOJ Seeks Triple Damages for Lab Test Fraud
CERTAIN CLINICAL LABORATORY EXECUTIVES AND LAB SALES PROFESSIONALS may soon be made to pay where it hurts most—in their wallets. The U.S. Department of Justice (DOJ) announced on April 4 that it had joined a civil complaint against 18 defendant…
Federal Healthcare Fraud Enforcement Turns to Emerging Areas
CEO SUMMARY: Healthcare compliance attorneys say the Department of Justice (DOJ) is turning its focus to fraudulent activity related to COVID-19 testing. But that’s not the only area attracting greater scrutiny by the DOJ. Fraud stemming from opioid treatment has snared clinical l…
Another 10 Doctors Settle Laboratory Kickback Cases, Pay Back $1.68m
FALLOUT CONTINUES FROM A LARGE LABORATORY KICKBACK INVESTIGATION in Texas, as another 10 physicians and one healthcare executive agreed to settle with the government and pay back $1.68 million. Clinical lab sales teams throughout the United States will …
Seven Doctors Settle Lab Test Fraud Case
CEO SUMMARY: In January, a U.S. Attorney from East Texas announced that seven physicians and a hospital CEO had agreed to settle allegations of fraud involving the payment of bribes in exchange for lab test orders. This is a positive development for the clinical laboratory profession because it…
CURRENT ISSUE
Volume XXX, No. 8 – May 30, 2023
Much lies underneath the surface of UnitedHealthcare’s (UHC) new policy mandating Z-code use for molecular tests covered under its commercial health plans. This development, which creates headaches for many genetic testing companies, is analyzed in depth here. Also, one company shows how data analytics improves lab productivity and TAT.
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