TAG:
medicare fraud
Steep Sentence Underscores Scrutiny of Genetic Testing
The sentencing tied to a $522 million genetic testing fraud scheme is more than just the latest fraud headline for clinical laboratory professionals. Instead, it serves as another warning that federal scrutiny surrounding genetic testing is continuing and unlikel…
Expect RESULTS Act Vote by End of the Year
CEO SUMMARY: Evidence at the 2026 Executive War College suggests a coming push in clinical lab advocacy, focusing on the RESULTS Act to establish a permanent, database-driven reimbursement model. Simultaneously, federal regulators have floated the idea of heightened scruti…
Lab Fraudster Warned of ‘Bad Players’ in Old Interview
The audacity of some criminals can be startling. Using fraudulent reimbursement to buy expensive vehicles and mocking Medicare beneficiaries seem to be routine parts of the dishonesty playbook. Former NFL prospect Keith J. Gray, owner of two cl…
A Whistleblower Risk for Lab Leaders to Navigate
Our lead briefing details a federal appeals cou…
Office of Inspector General Briefs
Congress Wants Review of Test Fraud As part of a spending bill approved by Congress recently, there is a small provision that hints at future review of clinical laboratory tests by the US Department of Health and Human Services’ Office of Inspector General (OIG)….
Using Sophisticated Schemes, Fraudsters Hit the Next Level
Investigators and fraudsters appear to be upping their game as the government seeks to punish those filing unscrupulous Medicare claims. These aspects were clear in the US Department of Justice’s (DOJ) announcement last month of the largest healthcare fraud takedown reportedly in US history. Cli…
OIG: Billing Code 81408 Is at ‘Risk of Improper Payment’
CEO SUMMARY: Clinical lab executives familiar with molecular test coding and billing will not be surprised to learn that billing code 81408—commonly used on genetic test claims—is at risk of fra…
Labcorp to Pay $19m to Settle Whistleblower Allegations
LABCORP AGREED TO SETTLE WHISTLEBLOWER ALLEGATIONS that it violated the False Claims Act by allowing its phlebotomists to draw blood from patients when the company allegedly knew kickbacks were behind the test orders for other lab firms. As part of the settlement, Labcorp in Burli…
Feds Target Genetic Test and Telemedicine Fraud
MEDICARE FRAUD TOTALING $562 MILLION in genetic and cardiovascular tests is at the heart of recent federal criminal cases involving telemedicine that names clinical laboratory owners, physicians, and healthcare marketers as defendants. A host of indictm…
September 19, 2022 Intelligence: Late-Breaking Lab News
Déjà vu? Lawmakers in Congress question whether public health officials have done enough to stay ahead of monkeypox, including the availability of diagnostic tests. Concerns about such testing came up during a Sept. 14 hearing before the Senate’s Health, Education, Labor, and Pensions Committee. …
CURRENT ISSUE
Volume XXXIII, No. 7 – May 26, 2026
Momentum is building on Capitol Hill to pass the RESULTS Act, which would stave off drastic 15% reimbursement cuts under PAMA. Advocates seek lobbying help from clinical labs and anatomic pathology practices. Also, The Dark Report examines Roche’s deal to acquire PathAI.
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