TAG:
federal false claims act
Several Big Surprises in 2018’s Top 10 Lab Stories
CEO SUMMARY: This year’s list of the Top 10 Lab Industry Stories for 2018 is dominated by new directives from Medicare and private health insurers, as well as significant decisions by federal courts. Collectively, these developments create new compliance risks for all clinical laborator…
In HDL Case, Judge Imposes Damages, Penalties of $114 Million
LAST WEEK, A FEDERAL JUDGE in South Carolina issued an order imposing civil damages and penalties of more than $114 million on Tonya Mallory, the former CEO of Health Diagnostic Laboratory, in Richmond, Va., and two owners of the lab’s marketing partner, BlueWave Healthcare…
Attorney Says Labs Face Increased Legal Liability
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…
D.C. Circuit Court Reverses Medical Necessity Ruling
MANY LAB EXECUTIVES were concerned last year after a judge in the District of Columbia Circuit Court ruled that clinical laboratories need to determine that all lab test services physicians order are medically necessary. The court also ruled that ordering physicians do not need to determine medical …
Health insurance fraud cases take new turn with HDL-BlueWave outcome
This is an excerpt from a 2,700-word article in the February 12, 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. CEO SUMMARY:…
Lab Executives Lose Big in Federal Jury Trial
RATHER THAN ENTER INTO A NEGOTIATED SETTLEMENT with federal prosecutors, the former executives of Health Diagnostic Laboratory (HDL) and BlueWave Healthcare Consultants decided to take their case to a jury in a federal court in South Carolina. The outcome has notable…
Insights from Jury Verdict in HDL, BlueWave Case
CEO SUMMARY: After a two-week trial, the executives of Health Diagnostic Laboratories and BlueWave Healthcare Consultants were found guilty of violating the federal False Claims Act. Defendants Tonya Mallory, Floyd Calhoun Dent III, and Robert Bradford Johnson were ordered to pay the Unit…
UnitedHealthcare Warns Labs: Don’t Waive Patient Fees
This article is an excerpt from a 1,500-word article in the March 21 issue of THE DARK REPORT. Full details of UHC’s battle against out-of-network labs, as well as its plans to begin requiring pre-authorization for genetic testing, are included in the original article, available to paid members…
UnitedHealthcare Warns Labs Not to Waive Patient Fees
CEO SUMMARY: UnitedHealthcare directly tackled the issue of out-of-network labs waiving or capping copayments, coinsurance and deductibles that are to be paid by patients. In a network bulletin this month, UHC said that such arrangements may violate federal law and could lead to state ins…
Toxicology Lab Millennium Pays $256M to DOJ, Files For Bankruptcy
IN ANOTHER MAJOR LAB FRAUD CASE, toxicology lab company Millennium Health will pay $256 million to settle allegations in a whistleblower lawsuit that it overbilled federal healthcare programs for unnecessary lab testing. Just 22 days after this agreement, Millennium Health filed a pe…
CURRENT ISSUE
Volume XXVII No. 9 – June 22, 2020
THE NEWS ON THE SEROLOGICAL TEST FRONT is discouraging, even bleak, as THE DARK REPORT analyzes the outcome of the FDA’s own review of 11 tests previously listed as marketable. Only three tests passed the review, and yet a quality control expert consulted by THE DARK REPORT has dim views of the FDA’s testing operation, leading to even more doubts. Also, health insurers are scraping away at mandated COVID-19 test reimbursements, leaving lab revenues once again at their mercy.
See the full table of contentsHow Much Laboratory Business Intelligence Have You Missed?
Lab leaders rely on THE DARK REPORT for actionable intelligence on important developments in the business of laboratory testing. Maximize the money you make-and the money you keep! Best of all, it is released every three weeks!
Need A Group Membership? Company Discounts are Available!
Sign up for TDR Insider
Join the Dark Intelligence Group FREE and get TDR Insider FREE!
Never miss a single update on the issues that matter to you and your business.
Copyright 2020 © The Dark Report. All rights reserved.
The Dark Report • 21806 Briarcliff Dr • Spicewood, TX 78669
Phone: 512-264-7103 • Toll Free Number: 800-560-6363
Email: customerservice@darkintelligencegroup.com
