TAG:
OIG
Providers May Be Ordering Inappropriate Vitamin D Tests
Heightened consumer interest has been driving demand for vitamin D testing in recent years. However, clinical laboratories should be aware that some providers could be ordering the wrong test to measure levels of the vitamin, in part due to the way that online or…
Clinical Labs Must Prep for Heightened Audits
CEO SUMMARY: A new report from the Office of Inspector General sheds interesting light on just how much genetic testing has increased among Medicare Part B beneficiaries. With billions of dollars in reimbursement at stake for clinical laboratories, expect federal officials…
Elizabeth Holmes Seeks Trump Clemency for Conviction
Elizabeth Holmes, the convicted former CEO of Theranos, is again drawing public attention as she seeks clemency from President Donald Trump, reviving interest in one of the most notorious fraud cases in Silicon Valley and clinical laboratory history. …
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…
Federal Court Reverses Conviction in AKS Case
CEO SUMMARY: A federal appeals court has overturned the conviction of an operator of a durable medical equipment company who was accused of violating the Anti-Kickback Statute. A marketing company’s lack of true influence over decision-making related to the case seemed t…
OPKO Settles Allegations of Fraudulent Billing
DEMONSTRATING THAT EVEN ROUTINE TESTS CAN CAUSE LEGAL HEADACHES for clinical laboratories, the U.S….
OIG Issues New Report on Medicare 2023 Lab Spend
CEO SUMMARY: When the Office of the Inspector General (OIG) at the Department of Health and Human Services (HHS) issued its latest report on Medicare spending in 2023 for clinical laboratory tests, it attracted relatively little attention from the lab industry. Maybe other issues—such a…
Federal Cases against Labs Result in Convictions
CEO SUMMARY: Over the past 24 months, federal prosecutors have announced a steady parade of criminal convictions, guilty pleas, and settlement agreements involving fraud and clinical laboratory testing. Not only are these cases numerous, but some resolve legal actions initiated by the fed…
Physicians Tempted by Lure of In-Office Labs, Payers Balk
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CURRENT ISSUE
Volume XXXIII, No. 4 – March 23, 2026
A federal court ruling has established a safe harbor for clinical labs when they run tests ordered by physicians. Lab leaders should examine this briefing for pitfalls. Also, it turns out that providers may be ordering inappropriate vitamin D tests, according to one expert.
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