CEO SUMMARY: While working in the office of a physician who was a client of Health Diagnostic Laboratory, a phlebotomist says he was instructed to write the same 10 diagnoses on every test requisition a doctor sent to HDL, a lab company in Richmond, Virginia. HDL is under federal investigation, according to published reports. The same 10 diagnoses were recorded for every patient even though some of these tests were appropriate only for women, the source said.
Tag: medicare compliance
CEO SUMMARY: In addition to a steep cut in the 88305 CPT code, anatomic pathology laboratories can expect cuts in the payment from Medicare for molecular and prostate biopsy testing. Two national experts in lab billing and reimbursement warn labs to expect confusion in how both public and private payers implement these new policies. Overall,
CEO SUMMARY: For labs and all healthcare providers, the risk of an audit is growing because the number of auditors seeking overpayments is rising. In their efforts to eliminate waste and make the Medicare and state Medicaid programs more efficient, federal officials have introduced several different audit programs in recent years. A consultant who helps
Because THE DARK REPORT is willing to tackle tough issues regarding the business end of the pathology profession, I am writing to call attention to a serious situation. What follows is presented as mostly factual and minimally perceptive. While I have no fear of transparency regarding our lab organization, I prefer anonymity to ensure
CEO SUMMARY: As the closing year of the first decade of the new century and the new millennium, 2009 brought neither disruption nor upheaval to the majority of laboratories in the United States. Rather, it was marked by at least two themes. One was how public disclosure of problems with lab testing services generated media
TWICE DURING THE PAST 12 MONTHS, the Office of the Inspector General (OIG) has issued a negative opinion on a marketplace arrangement between a laboratory company and a physician group. The most recent was OIG Advisory Opinion 05-08, released on June 13, 2005 and responding to a request to evaluate how a lab might reimburse
CEO SUMMARY: In a remarkable finding, THE DARK REPORT demonstrates how 17.5% of the public laboratory companies in operation since 1990 have had an existing or former CEO indicted for federal crimes! This is a powerful statement about business practices in the laboratory industry and the allure of “skirting” the full intent and meaning of
CEO SUMMARY: Since 1991, there have been criminal indictments or criminal convictions of four former CEOs of public lab companies. Given the limited number of public lab companies active in the market at any moment in time, this is a remarkably high rate of criminal behavior. Moreover, the “bad behavior” of such lab firms puts
CEO SUMMARY: In responding to a request for an advisory opinion, the Office of the Inspector General (OIG) issued an advisory opinion which declares that anatomic pathology (AP) lab condominiums “could potentially generate prohibited remuneration under the anti-kickback statute.” It also voices concerns about how the operation of such AP laboratory condos could violate the
CEO SUMMARY: During the past decade, Laboratory Corporation of America’s Brad Smith faced the spear point of evolving Medicare/Medicaid compliance initiatives which changed so many laboratory industry business practices. Smith believes that business models for in-house anatomic pathology labs now being offered to specialist physician groups fail to meet important Medicare compliance criteria.
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