compliance program Archives - The Dark Intelligence Group

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compliance program

After Two-Year Battle with CMS, True Health on Verge of Collapse

By Robert Michel | From the Volume XXVI No. 11 – August 12, 2019 Issue

CEO SUMMARY: In 2017, an auditor for CMS alleged that True Health filed fraudulent claims and the federal Medicare program cut all payments to the lab company and one month later reduced the cut to 35% of the billed amount. Two months ago, CMS ended all payments again. These facts became …

Attorney Says Labs Face Increased Legal Liability

By Jon Stone | From the Volume XXV No. 6 – April 16, 2018 Issue

CEO SUMMARY: For many reasons, including cuts to lab test prices that health insurers pay, narrow networks, and more competition for lab test referrals, a significant number of lab companies are seeking ways to increase market share. These methods include the use of new laboratory test ar…

Sale of Tox Lab Company Attracted Multiple Buyers

By Joseph Burns | From the Volume XXV No. 4 – March 5, 2018 Issue

CEO SUMMARY: In the midst of expanding their toxicology testing services nationally, DrugScan and DSI Medical Services (collectively Toxicology Holdings Inc.) hired a brokerage firm last year to pursue a sale of the two toxicology companies. Multiple potential buyers responded with intere…

Allegations of Lab Test Fraud Involve Multiple Defendants

By Pamela Scherer McLeod | From the Volume XXV No. 2 – January 22, 2018 Issue

CEO SUMMARY: UnitedHealth made national news when it filed a $100 million lawsuit against Next Health and other defendants in Dallas in January 2017. The insurer alleged fraud involving clinical laboratory tests. That lawsuit is just the latest chapter in an almost decade-long string of …

Allegations in UHC health insurance fraud case involve multiple defendants

By Mary Van Doren | From the Volume XXV No. 2 – January 22, 2018 Issue

This is an excerpt from a 5,000-word article in the January 22, 2018, issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. …

Why Theranos Is a Big Test for CMS and CLIA

By R. Lewis Dark | From the Volume XXIII No. 8 – June 13, 2016 Issue

OFFICIALS AT THE FEDERAL CENTERS FOR MEDICARE & MEDICAID SERVICES are at what may be the most important crossroads in the history of clinical laboratory regulation since Congress passed the CLIA 1988 legislation. Will CMS pursue the severe sanctions it disclosed to Theranos, Inc.,…

In Massachusetts, AG Targets Drug Testing Labs

By Robert Michel | From the Volume XVIII No. 14 – October 17, 2011 Issue

CEO SUMMARY: Since taking office in 2007, Massachusetts Attorney General Martha Coakley has aggressively pursued civil charges against drug testing labs. Last month, Coakley announced a criminal arrest in one ongoing investigation after a grand jury indicted a physician in a kick…

Will Lawsuits Re-shape Current Lab Practices?

By Robert Michel | From the Volume XVIII No. 9 – July 5, 2011 Issue

CEO SUMMARY: Recent events in California, triggered by a lab whistleblower lawsuit filed in 2005 and unsealed in 2009, provide the latest example of how these lawsuits and related government enforcement actions can cause fundamental changes in the pricing and marketing p…

How Could So Many Labs Violate California Law?

By Robert Michel | From the Volume XVII No. 18 – December 27, 2010 Issue

CEO SUMMARY: If a 40-year-old state law on Medi-Cal pricing was known to regulators and clinical laboratories alike, how did the legal and compliance departments of so many laboratories—staffed by some of the smartest legal minds in California and nationally—interpret the law…

New Privacy Breach Law Requires Labs to Respond

By Robert Michel | From the Volume XVI No. 15 – November 02, 2009 Issue

CEO SUMMARY: There were plenty of headlines about the passage of HITECH last February because of how it expanded funding for electronic medical records. But lesser known are new requirements that providers, including labs and pathology groups, must now take specific compliance ac…

Volume XXVII No. 8 – June 1, 2020

THE DARK REPORT brings news that the national media has overlooked: Lab revenues, cut precipitously during the coronavirus pandemic, will leave many labs without the resources to continue operation in the near future. As calculated by THE DARK REPORT, the nation’s clinical lab industry had lost $6.8 billion in revenue by week 12 of the crisis. Also reported is that in many cases, the culprit is a frustrating lack of supplies that would allow labs to replace lost routine testing with new COVID-19 testing.

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