Tag: the laboratory

Hospital Board Expressed Doubts about Lab Billing

CEO SUMMARY: Pass-through billing arrangements, particularly those involving clinical laboratory tests, have long been recognized by healthcare attorneys as having great potential to violate certain federal and state laws. Despite this fact, board members of a financially-struggling community hospital went forward with a pass-through billing agreement that news accounts says committed the hospital to pay

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Use of ‘1099 Marketers’ and Lab Compliance Risk

CEO SUMMARY: Experts in lab compliance predict that clinical laboratories and anatomic pathology groups must anticipate tougher enforcement of federal and state laws this year. One source of increased compliance risk for lab companies is the rising use of third-party marketing agreements. David Gee, an experienced lab industry attorney at Davis Wright Tremaine, said lab

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Pulling Aside the Curtain on Alleged Lab Fraud

IN RECENT YEARS, MANY CLINICAL LAB ADMINISTRATORS AND PATHOLOGISTS have looked with dismay at the increased fraud associated with the laboratory test referrals of office-based physicians. High-profile federal cases involving lab companies accused of fraud garner national headlines.

Small companies sending sales reps into physicians’ offices, however, have changed the landscape in 2018 versus that of

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What’s in the cards for ACLA’s PAMA-CMS lawsuit?

This is an excerpt from a 2,580-word article in the January 2, 2018, issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group.
CEO SUMMARY: This expert analysis shows that laboratories may face an uphill fight

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ACLA Suit Challenges HHS’ Data-Collection Efforts

CEO SUMMARY: In a lawsuit filed last month, the American Clinical Laboratory Association charged that HHS failed to comply with the statutory requirements of the Protecting Access to Medicare Act of 2014 when setting the 2018 Clinical Laboratory Fee Schedule. In the lawsuit, ACLA said HHS disregarded the law’s requirement that all applicable laboratories would

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Aetna Sues Hospitals over Alleged Lab-Billing Scheme

CEO SUMMARY: In September, Aetna filed a lawsuit in Pennsylvania accusing 14 defendants—including a hospital, a hospital management company, eight lab companies or lab management companies, two physicians, and two individuals—of defrauding Aetna, its client employers, and its members. The lawsuit is an example of a lab test arrangement in which independent lab companies and

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