Pricing Issues Affecting Laboratories

Baker Donelson
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Craig Holden co-presented "New Compliance Red Flags Workshop," a workshop hosted by G2 Intelligence.

Over the past five years, the Departments of Justice and Health and Human Services have recovered $19.2 billion from health care providers charged with fraud or with inappropriately receiving payments from federal health care programs. That’s more than double the $9.4 billion recovered in the previous five-year period.

This stepped up enforcement does not appear to be letting up, with the early 2014 announcement of a $389 million settlement with DaVita HealthCare Partners and a $15.75 million settlement with PremierTox LLC, a drug testing lab in Kentucky, and affiliated addiction treatment centers.

As federal and state governments become more aggressive in their pursuit of health care fraud and overpayments, clinical and anatomic pathology laboratories must stay on top of new compliance red flags and ensure they are in full compliance with all relevant laws and regulations.

Please see full publication below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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