Nov 14, 2011 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Pathology, Laboratory Sales and Marketing
Two Senate committees seem interested in how certain medical laboratories offer discounted laboratory test prices to selected health insurers
Is it a coincidence that discounted medical laboratory test pricing offered by the nation’s two largest clinical laboratory companies appears to now be the subject of interest for the Senate Judiciary and Senate Finance Committees? Last Tuesday, Senator Max Baucus (D-Montana) and Senator Chuck Grassley (R-Iowa) issued a press release titled “Grassley, Baucus Scrutinize Practice by Health Insurers and Testing Labs.”
Baucus is Chairman of the Senate Finance Committee and Grassley is the Ranking Member of the Senate Judiciary Committee. Together, these two Senators sent letters last week to two clinical laboratory companies and three big health insurance firms: (more…)
Nov 9, 2011 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Some medical laboratory organizations risk coming up short on the deadline for implementation of 5010 standards
Less than eight weeks remain before the January 1, 2012, deadline for implementation of Form 5010. Every sector of the healthcare system—from government and private payers to hospitals, physicians, pathologists, and clinical laboratories—is involved in this important healthcare reform.
Many providers and payers are scrambling to meet the Health Insurance Portability and Accountability Act (HIPAA) version 5010 compliance deadline. This is the latest version of standards for the conversion of electronic health records (EHRs).
The Centers for Medicare and Medicaid Services (CMS) continues to maintain a hard line position regarding the deadline, according to an article in Modern Healthcare. “There is no wiggle room,” Denise Buenning, Director of the Administrative Simplification Group in CMS’ Office of E-Health Standards and Services, stated. “We’re holding fast to the date.”
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Mar 27, 2009 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Allegations of false claims implicate discounted client billing practices
It’s the first major whistleblower lawsuit in the laboratory industry in recent years. On March 20, California State Attorney General Edmund G. Brown Jr. announced that his state had joined a qui tam lawsuit that alleges a number of laboratories have filed false claims on a “massive” scale, thus defrauding the California Medi-Cal program of “hundreds of millions of dollars.”
The unusual twist in this whistleblower lawsuit is that it was originally filed by the owner of a California-based laboratory. In 2005, Chris Reidel, owner and CEO of Hunter Laboratories, in Campbell, California, initiated the legal action, alleging what AG Brown characterized as “massive Medi-Cal fraud and kickbacks. Medi-Cal is the state’s Medicaid health program for the poor.
The original lawsuit filed by Reidel seeks to recover at least $100 million. However, one of his attorneys, Joe Cotchett, of the San Francisco-based law firm of Cotchett, Pitre & McCarthy, believes the state’s actual losses could be more than $1 billion. The lawsuit is pending in San Mateo Superior Court and was filed under seal in 2005.
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