“August 22, 2005 Intelligence: Late Breaking Lab News”

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In California, some physicians continue to seek illegal kickbacks from clinical laboratories. The problem is widespread enough that the FBI has conducted several “sting operations.” In a jury trial related to the long-running “Durascam” healthcare fraud investigation, a married pair of doctors, Adelina Vorperian, M.D. and Kevork Vorperian, M.D., were convicted on charges of accepting kickbacks in exchange for referring laboratory specimens. The pair admitted receiving nearly $6,800 in payoffs from a lab representative who was cooperating with federal investigators. Mrs. Vorperian faces 10 to 16 months in prison, while her hubby faces 6 to 12 months for his lessor role in the fraud.

MORE ON: Lab–MD sting

Launched in California in 1998, Durascam became the largest undercover medical fraud inquiry in U.S. history. With FBI agents posing as doctors and patients at a fake medical clinic in Los Angeles, the investigation un- covered illegal kickbacks or false insurance billing for
HME (Home Medical Equipment). Over 400 people were arrested in connection with this investigation, which also triggered a rash of legislation in California and Florida requiring accreditation for HME providers.

MORE CONSUMERS GET EXPERTS TO CHALLENGE ERRORS IN MED BILLS

Now days more and more consumers are paying a billing expert to verify and challenge their healthcare bills. Media sources are now writing stories about the growing demand for “medical billing advocates.” These are individuals who help consumers analyze medical bills and negotiate with providers in the event of discrepancies. Consumers are motivated to retain these services for two reasons. First, consumers know that an estimated nine of every ten medical bills contain significant errors. Second, facing higher co-pays, deductibles, and out-of-pockets, consumers are paying closer attention to the cost of health services provided to them by hospitals, physicians, and laboratories.

ADD TO: “Bad Bills”

This trend is already visible in the laboratory industry. Labs are telling THE DARK REPORT that growing numbers of consumers are calling to “negotiate” their lab testing bill. Lab directors and pathologists may want to study this issue and prepare written guidelines for their billing and collections staff.

“HIGH RISK” CONCERNS AT AP LAB CONDO CO.?

When the CEO of your anatomic pathology laboratory condominium company has his resume posted on a Web site, it might be a sign that things are less than great with either this business model or company…or both. Recently seen posted on the Web site of the American College of Healthcare Executives (ACHE) was the resume of one Ken Flowers, MBA, CHE. Current position: CEO of Uropath, LLC in Dallas, Texas. He’ll relocate to any of 15 states, including Alaska. By the way, Mr. Flowers lists as “personal interests” wildlife video and classic vehicle restoration.

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