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Lab Owners Beware – Conflicting EKRA Opinions Muddy the Landscape on Payments for Physicians' Test Referrals

The Eliminating Kickbacks in Recovery Act (EKRA), a law that became effective in October 2018, extended federal kickback prohibitions to services provided by recovery homes, clinical treatment facilities, and laboratories...more

OIG Nixes Arrangements Involving Free Tests

Labs Attempt to Counter Exclusive Lab Arrangements - With increasing frequency, clinical laboratories have found themselves unable to receive any payments for tests performed for individuals whose third-party insurer...more

Pathology Lab That Cannot Demonstrate Adequate Physician Orders Suffers Medicare Loss

Much has been written regarding various Medicare policies that may cause a clinical laboratory to suffer the resulting financial consequences when a test requested by a physician is found to be not medically necessary, most...more

Medicare Permits Ambulatory Surgical Centers to Submit Claims for Services of Physicians and Practitioners

A recent revision to the Medicare Program Integrity Manual (MPIM) states that physicians and non-physician practitioners may reassign benefits to an ambulatory surgical center (ASC), if the arrangement complies with a...more

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