TAG:
healthcare fraud
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 …
Lab Scheme Recruits Hospitals To Bill as In-Network Providers
By Joseph Burns | From the Volume XXIV No. 15 – October 30, 2017 Issue
CEO SUMMARY: Management companies using a new generation of potentially fraudulent schemes are targeting hospitals and health systems for arrangements that use questionable means to increase lab test volume and revenue. The management companies often use the term “hospital outpatient de…
Positive Patient ID System Catches Patients Cheating on Toxicology Tests
By Pamela Scherer McLeod | From the Volume XXIV No. 13 – September 18, 2017 Issue
CEO SUMMARY: The urine drug testing industry is challenged every day to detect the large number of patients trying to cheat on their drug tests. GenoTox Laboratories of Austin, Texas, developed a DNA-authentication method for urine samples that allows the lab to detect when patients have …
Florida AG Opposes Bill Over Customary Charges
By Joseph Burns | From the Volume XXIII, No. 2 – February 8, 2016 Issue
CEO SUMMARY: It was a surprise to the Florida Attorney General that a bill had surfaced in the Florida Legislature to amend the existing state law’s definition of usual and customary pricing to the Medicaid program. The bill would even make that change in definition retroactive. If this…
New Developments in $1 Billion Lab Fraud Case
By R. Lewis Dark | From the Volume XXII NO. 13 – September 14, 2015 Issue
CEO SUMMARY: Court documents filed last month in the federal qui tam case against Health Diagnostic Laboratory, Singulex, Berkeley Heart Lab, BlueWave Healthcare Consultants, and several lab executives allege that the defendants used illegal inducements and kickbacks to file false c…
OIG Says It Is Ready to Target Physicians in Kickback Cases
By Robert Michel | From the Volume XXII NO. 9 – June 22, 2015 Issue
PHYSICIANS WHO PARTICIPATE IN schemes that violate anti-kickback and fraud statutes will be at greater risk of prosecution by federal healthcare officials. This development comes following the June 9 release by the OIG of “Fraud Alert: Physician Compensation Arrangements May Result in Significant Li…
Medicare Special Stain LCD May Hinder Pathology Workflow
By Joseph Burns | From the Volume XXI No.16 – November 24, 2014 Issue
CEO SUMMARY: Under a proposed rule for Medicare region J-11, a pathologist will no longer be able to use “reflex templates or pre-orders for special stains and/or IHC stains prior to review of the routine H&E.” While the proposed LCD is designed to target a relatively small number…
Path Group Responds to FBI Visits in Stokes Case
By Robert Michel | From the Volume XIV No. 12 – August 27, 2007 Issue
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 wha…
Lab Billing Indictments Underscore Docs’ Risks
By Robert Michel | From the Volume XIV No. 12 – August 27, 2007 Issue
CEO SUMMARY: Physicians should consider the precedent established recently when the U.S. Attorney for the Western District of Michigan obtained a 72-count indictment against a local dermatologist, including 35 counts of submitting fraudulent claims for lab tests he did not perform, as wel…
“August 22, 2005 Intelligence: Late Breaking Lab News”
By Robert Michel | From the Volume XII No. 12 – August 22, 2005 Issue
In California, some physicians continue to seek illegal kickbacks from clinical laboratories. The problem is widespread enough that the FBI has conducted several “sting operations.” In a jury trial related to the long-running “Durascam” healthcare fraud investigation, a married pair of doctor…
CURRENT ISSUE
Volume XXXI, No. 5 – April 8, 2024
The fragmentation of consumer markets is reflected in clinical lab services, and The Dark Report examines this trend and how it will impact labs in the coming years. Also, The Dark Report notes that the FDA has issued a controversial memo to reclassify many high-risk IVD assays.
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!
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.
Topics
- Anatomic Pathology
- Clinical Chemistry
- Clinical Laboratory
- Clinical Laboratory Trends
- Digital Pathology
- Genetic Testing
- In Vitro Diagnostics
- IVD/Lab Informatics
- Lab Intelligence
- Lab Marketplace
- Lab Risk & Compliance
- Laboratory Automation
- Laboratory Billing
- Laboratory Compliance
- Laboratory Equipment
- Laboratory Information Systems
- Laboratory Management
- Lean Six Sigma
- Managed Care Contracts
- Molecular Diagnostics
- Pathology Trends
- People
- Uncategorized