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.
Tag: compliance laws
WHERE WAS MUCH TO BE LEARNED when, on April 9, federal prosecutors announced settlements of multiple whistleblower lawsuits against Health Diagnostics Laboratory, Inc. of Richmond, Virginia, and Singulex Inc. of Alameda, California.
CEO SUMMARY: Settlements in the big whistleblower suits involving major lab companies typically generate national headlines. But seldom do the views of the “quiet majority” of lab owners and lab executives get much attention. These are the majority of lab professionals working hard to follow compliance laws and requirements. They want to meet both the
Because THE DARK REPORT is willing to tackle tough issues regarding the business end of the pathology profession, I am writing to call attention to a serious situation. What follows is presented as mostly factual and minimally perceptive. While I have no fear of transparency regarding our lab organization, I prefer anonymity to ensure
CEO SUMMARY: As the FBI launched its investigation of fraudulent billing by Michigan dermatologist Robert W. Stokes, D.O., two years ago, staff at several pathology labs found themselves “up close and personal” with federal healthcare fraud prosecutors. One pathology lab, based on what it learned, decided to revamp its compliance program. It ceased deep discounts
IT’S A HOT TOPIC ACROSS THE ANATOMIC PATHOLOGY PROFESSION. Increasing numbers of physician groups are hiring laboratories to perform the technical component of an anatomic pathology case and engaging pathologists to diagnose the cases. This phenomenon is often called TC/PC, to represent how the technical component (TC) is being performed and billed independently of the
CEO SUMMARY: Since 1991, there have been criminal indictments or criminal convictions of four former CEOs of public lab companies. Given the limited number of public lab companies active in the market at any moment in time, this is a remarkably high rate of criminal behavior. Moreover, the “bad behavior” of such lab firms puts
CEO SUMMARY: Among other things, we declare the end to the heyday of the independent commercial lab company which offers a broad test menu to all types of office-based physicians. In its place springs forth the specialty or niche testing laboratory. Small and focused on a specific number of reference and esoteric tests, the number
CEO SUMMARY: During the past decade, Laboratory Corporation of America’s Brad Smith faced the spear point of evolving Medicare/Medicaid compliance initiatives which changed so many laboratory industry business practices. Smith believes that business models for in-house anatomic pathology labs now being offered to specialist physician groups fail to meet important Medicare compliance criteria.
EFFORTS BY SPECIALIST
EFFECTIVE AUGUST 27, Nasdaq Stock Market, Inc. delisted the stock of IMPATH, Inc. Less than a week earlier, IMPATH had disclosed that it was under investigation by the Securities and Exchange Commission (SEC).
IMPATH can truly be described as a company under siege. It is short of cash, under regulatory investigation, and defending itself from at