medicaid fraud

Ex-UroCor Execs Face Criminal Indictments

CEO SUMMARY: Criminal charges filed against ex-UroCor executives center around several marketing practices that have much in common with marketing strategies used by many lab- oratories today. These include discounted pricing for non-Medicare specimens, offering to waive charges to payers…

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California Medicaid Prepares To Issue Lab Contracts

CEO SUMMARY: California Medi-Cal officials may be creating more problems than they solve with their latest scheme to have independent laboratories sign contracts with their Medicaid program—while excluding hospital laboratory outreach programs and labs operated from physicians’ clinic…

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Health Line Clinical Labs, ChromaVision, Cytyc, TriPath, Quest Diagnostics

HEALTH LINE CLINICAL LABS SIGNS $10 MILLION FRAUD SETTLEMENT WITH FEDS DESPITE THE EVIDENCE that packing unnecessary tests into test panels is not acceptable to Medicare and Medicaid authorities, some laboratories continue the practice. Health Line Clinical Laboratories, Inc…

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Lab Marketing Strategy Triggers Legal Concerns

CEO SUMMARY: That famous phrase “everyone wants something for nothing” does not describe TennCare Select’s reaction to the “free testing” that Quest Diagnostics is performing for its beneficiaries. TennCare provides a real-world example of how this strategy can put a laboratory at o…

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Issues At Columbia/HCA Exist At Other Hospitals

CEO SUMMARY: Even as federal regulators attract big headlines in their investigation of Columbia/HCA, laboratory administrators in a variety of hospital settings may be surprised in the future to find federal investigators scrutinizing the billing practices at their institution. Columbia…

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SmithKline Announces $325 Million Settlement

CEO SUMMARY: Prosecutors continue to investigate. Criminal charges could be forthcoming against the company and individuals. Allegations against SmithKline expand the scope of laboratory practices that government regulators consider to be violations of existing statutes. De…

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