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Lab Scheme Recruits Hospitals To Bill as In-Network Providers

Federal, state laws implicated in hOpD and MSO arrangements

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 department (HOPD) billing model” to describe these arrangements. The scammers want the hospitals, as in-network …

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