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the stark law

New source of lab test abuse surfaces in the form of HOPDs and MSOs

This is an excerpt from a 2,350-word article in the Oct. 30, 2017 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: …

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Lab Scheme Recruits Hospitals To Bill as In-Network Providers

CEO SUMMARY: Management companies using a new generation of potentially fraudulent schemes are targeting hospitals and health systems for arrangements that use questionable means to increase lab test volume and revenue. The management companies often use the term “hospital outpatient de…

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Toxicology Lab Millennium Pays $256M to DOJ, Files For Bankruptcy

IN ANOTHER MAJOR LAB FRAUD CASE, toxicology lab company Millennium Health will pay $256 million to settle allegations in a whistleblower lawsuit that it overbilled federal healthcare programs for unnecessary lab testing. Just 22 days after this agreement, Millennium Health filed a pe…

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Georgia Lab Pays Docs For Urine Test Referrals

CEO SUMMARY: Physicians could make $400 or more per sample, according to one physician. But under the federal Stark Law, the federal Anti-kickback Law, and under Florida state law, physicians and other healthcare providers are prohibited from referring patients or doing work for kickbacks…

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EHR Donation Ruling in WA Raises Questions for Labs

CEO SUMMARY: When the Washington State Attorney General issued an Attorney General Opinion last fall, he created confusion among pathologists and lab directors whose labs have paid to have EHR software installed in physicians’ offices. The Washington AG’s ruling not only conflicts wit…

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MD Self-Referral Issues Target of Utilization Study

CEO SUMMARY: When it comes to the in-office ancillary service (IOAS) exception to physician self-referral, the issue of in-clinic pathology services has become a hot potato. Publication in Health Affairs of a study of urologists’ self-referral of their patients for anatomic pathology se…

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Anatomic Path Insourcing Expected to Be Ongoing

CEO SUMMARY: Insourcing of anatomic pathology services by office-based physicians has been especially prevalent and is increasing among three specialties (gastroenterology, urology, and dermatology), according to a survey conducted last month. Survey respondents also indicated that the tr…

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Lawyers Provide Insights About Top Legal Concerns

CEO SUMMARY: After conducting the first-ever survey of the most important legal, compliance and managed care concerns for clinical labs and pathology groups, THE DARK REPORT asked leading lab industry attorneys who participated in the survey to say a few words about these topics….

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Pathology Group Establishes Lab Test Exchange Networks

CEO SUMMARY: After several decades of steadfastly maintaining their independence from other pathology groups in their community, progressive hospital-based pathology groups are beginning to create regional laboratory testing networks. These collaborations generally start small an…

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Medicare Pays Doctors To Switch to E-Prescribing

CEO SUMMARY: It’s a major step on the road to integration of healthcare informatics. During the next few years, the Medicare program is offering financial incentives to encourage office-based physicians to adopt e-prescribing. This is a positive development for local laboratori…

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