Federal Compliance Blitz: Enforcement Challenges Ahead for Labs and Pathologists


Given the federal government’s recent efforts to step up its fraud enforcement, now is a good time for all health care providers, including clinical laboratories and pathologists, to review policies and procedures to ensure they are in compliance with all applicable laws and regulations, advises Hope Foster, an attorney with Mintz Levin in Washington, D.C.

Foster addressed the challenges ahead during Washington G-2 Reports’ 28th Annual Lab Institute, held in Arlington, Va., Oct. 13-15.

In the past 18 months, lawmakers have passed a number of laws giving the feds increased enforcement authority, including the Fraud Enforcement and Recovery Act of 2009 (FERA) and the Patient Protection and Affordable Care Act (PPACA). In May 2009 the departments of Justice and Health and Human Services announced a new interagency initiative to combat Medicare fraud—the Health Care Fraud Prevention and Enforcement Action Team (HEAT).

In fall 2009, President Obama announced a new interagency financial fraud enforcement task force and proposed a budget of $1.7 billion for the Health Care Fraud and Abuse Control Program (HCFACP). And in March 2010, the president issued a memorandum regarding finding and recapturing improper payments, which effectively expanded the use of payment recapture audits.

“Follow the money,” notes Foster. “If you want to see what the government cares about, see where it’s spending its money. And if it’s spending more money on enforcement, it means there will be more enforcement.”

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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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