Tag: billing medicare

Is New Cycle of Laboratory Fraud Plaguing the Industry?

CEO SUMMARY: Taken collectively, the growing number of federal investigations of lab companies and health insurer lawsuits against lab companies alleging fraudulent business practices signals a disturbing new trend for the lab industry.  In THE DARK REPORT’s typical hard-hitting analysis of an emerging clinical laboratory trend, it is noted that while these allegations are leveled at just a handful of

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Is New Cycle of Fraud Plaguing Lab Industry?

Fraud

CEO SUMMARY: Taken collectively, the growing number of federal investigations of clinical lab companies and health insurer lawsuits against lab companies alleging fraudulent business practices signals a disturbing new trend for the lab industry. Although these allegations are leveled at just a handful of lab companies, the amount of money these labs took out of the system exceeds a billion dollars. Some experts expect payers will enact tough requirements to stop such abuses.

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CMS Anti-Markup Rules Target In-Office Ancillaries

CEO SUMMARY: Medicare officials are again attempting to rein in what they consider to be potentially abusive forms of in-office ancillary services, including anatomic pathology. Proposed new rules published this month would clarify and perhaps expand the application of the Medicare anti-markup for purchased diagnostic testing services and for diagnostic tests provided by an ordering

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UroCor’s Sales Tactics Violated Medicare Laws

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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