ONE MORE LAB COMPANY has settled allegations of fraud and abuse. Last month, UTC Laboratories agreed to pay a fine of $41.6 million and will be excluded from all federal healthcare programs for 25 years.
Announced Oct. 9, the settlement resolves allegations that UTC violated the False Claims Act by paying kickbacks in exchange for laboratory
CEO SUMMARY: Clinical labs must assess their responsibilities to report lab test market prices to CMS as part of the Protecting Access to Medicare Act. A panel of three experts took up this topic at a recent webinar hosted by THE DARK REPORT. On June 23, the federal Centers for Medicaid & Medicare Services published
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
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.
CEO SUMMARY: In the fourth month of the current year, there is plenty of confusion and uncertainty over how the Medicare program will establish prices for the new molecular CPT codes and when both government and private payers will begin to regularly reimburse laboratories. As of this date, even lab billing experts and lawyers are
CEO SUMMARY: For labs currently processing prostate biopsy cases with five or more cores and for those pathologists interpreting those cases, there is a lack of clarity about new Medicare policies. As one example, risk of an audit is significant because of recent guidance issued by one Medicare contractor. Another source of risk for labs
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
CEO SUMMARY: It was a signal win for federal healthcare officials when a federal district court judge in Washington, DC, dismissed a case brought by UroPath, LLC. UroPath had sued HHS Secretary Michael Leavitt seeking to challenge the physician fee schedule final order and the anti-markup rule. The judge’s decision provides Medicare officials with useful
CEO SUMMARY: On February 14, Federal District Judge Thomas J. Whelan denied the request for a temporary restraining order (TRO) by three San Diego labs that would have stopped the Medicare Laboratory Competitive Bidding Demonstration pilot project until several legal challenges were adjudicated. It is believed that CMS received bid applications from an unknown number
CEO SUMMARY: Effective on January 1, 2008, new rules take effect that restrict the circumstances under which physicians can mark up the anatomic pathology services provided to their patients. However, ambiguities in how the rules are written are likely to make the intent of the new rules difficult to apply to all the types of