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hospital billing

DOJ Indicts Ten Individuals for Pass-Through Lab Test Billing Fraud

PASS-THROUGH LAB TEST BILLING SCHEMES involving rural hospitals and $1.4 billion in fraudulent lab test claims are at the core of multiple indictments announced recently by the federal Department of Justice (DOJ). Ten individuals—including laboratory owners, billing company…

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Rural Hospital Group Says Lab Billing Model Is Legal

CEO SUMMARY: In recent years, many rural hospitals have entered into agreements to expand their laboratory outreach businesses. In an interview, the president of the National Association of Rural Hospitals said rural hospitals often bill for lab outreach services under Medicare’s 70/30 …

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Rural Hospital Spokesman: Hospital Lab Outreach Programs Are Legal

CEO SUMMARY: As the debate grows more heated, supporters of hospital outpatient department (HOPD) billing schemes have ramped up their defense of the practice. The president of the National Association of Rural Hospitals tells THE DARK REPORT that rural hospitals…

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Quest to Manage Six Labs at HCA HealthONE Hospitals

CEO SUMMARY: For decades, hospitals were reluctant to allow any outside lab company to run their inpatient lab operations because they preferred to maintain control over quality results and turnaround times. That attitude may be changing as health systems face increasing margin compressio…

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Federal Judge Rules Against Idaho Hospital in Antitrust Case

LAST MONTH, A FEDERAL JUDGE RULED that St. Luke’s Health System of Boise, Idaho, violated antitrust laws when, in 2012, it acquired Saltzer Medical Group, the largest independent medical practice in the state. In ruling against the merger of a hospital and physici…

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From Modest Beginnings, Two Lab Networks Find Success

“For 20 years, our regional laboratory network here in Detroit has played an important role in helping member …

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Seven Deadly Sins of Lab Management Are Much Too Common

CEO SUMMARY: Pity the poor laboratory manager of today. Lab budgets are shrinking. It is difficult to staff adequate numbers of skilled medical technologists. Baby boomers are now retiring. At the same time, accreditation and licensure inspections are becoming tougher. Recently, …

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Catholic Hospital in Illinois Loses Tax-Exempt Status

HOW HOSPITALS BILL and collect from uninsured patients is becoming a national issue. The latest shot fired is a ruling by the Illinois Department of Revenue revoking the state property tax exemption of Provena Covenant Medical Center, located in Urbana, Illinois. Th…

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Price Discount Practices May Prove Troublesome

CEO SUMMARY: Some laboratories continue to offer deeply-discounted prices to the nation’s largest managed care plans as a way to maintain provider status and keep market share. In one case, these deep discounts surprised a long-time lab executive, who decided to share the information, a…

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McKesson on HBOC, PAML, Medicare Coding, Abbott Laboratories

SCANDAL AT HBO & CO. TAINTS MCKESSON HBOC FIVE EXECUTIVES WERE SACKED by McKesson HBOC Inc.’s Board of Directors last month in response to allegations of financial improprieties. All five were employed by HBOC prior to its acquisition by McKesson last year. The termin…

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