Compliance News Roundup: What You Can Learn From the OIG's Review of Mount Sinai

1. Blood Testing Lab Quest Diagnostics to Pay $6 Million to Settle Healthcare Whistleblower’s Allegations of Kickbacks and Unnecessary Testing - Quest Diagnostics agreed to pay the U.S. government $6 million to settle a healthcare whistleblower lawsuit brought by whistleblower Dr. Michael Mayes against Berkeley HeartLab. The qui tam suit was brought in federal district court in South Carolina in 2011 and alleged that Berkeley HeartLab, Inc., a blood testing laboratory acquired by Quest Diagnostics, violated the False Claims Act by paying kickbacks to physicians and patients, thereby influencing doctors to use the lab for blood testing services and charge for medically unnecessary tests. To get the full scoop: http://www.natlawreview.com/article/blood-testing-lab-quest-diagnostics-to-pay-6-million-to-settle-healthcare

2. JAMA takes sweeping aim at conflicts of interest in medicine On May 2, 2017, Medscape reported, “In a wide-ranging multifaceted review, the current edition of JAMA, published online May 2, explores the complex landscape of physician conflicts of interest (COIs) and suggests remedial solutions. “As healthcare expenditure, transparency, patient-centered medicine, and physician–patient trust take center stage, the 44-page, 23-essay review offers opinions and strategies from medical specialists as well as ethicists, public policy advocates, health economists, and experts in decision-making behavior.

“‘This issue has been an important one in medicine for well over a decade,’ said JAMA Editor-in-Chief Howard C. Bauchner, MD, a professor of pediatrics at Boston University School of Medicine in Massachusetts, in an interview with Medscape Medical News. ‘[COI] is critical to the health and well-being of the medical profession because the profession relies on trust. We have to get this right.’” To get the full scoop: http://www.hcca-info.org/Resources/View/tabid/451/ArticleId/9883/Former-Orange-County-lab-owner-convicted-of-healthcare-fraud-Quest-Diagnostics-agrees-to-pay-6M-False-Claims-Act-settlement-JAMA-takes-sweeping-aim-at.aspx#s3

3. Deeper Than The Headlines: What You Can Learn From the OIG's Review of Mount Sinai - You need to know the rules for replaced devices and/or device credit to maintain superstar compliance status.
Earlier this month, the OIG posted their most recent hospital Medicare Compliance Review, a review performed on a well-known hospital, Mount Sinai Hospital in New York. Though the hospital didn’t agree with all the findings, (and surely there is another side of the story when it comes to this compliance review), it’s useful to study the details of the report to see the kinds of services and issues the OIG spent much of their time reviewing. To get the full scoop: http://www.healthicity.com/blog/deeper-than-the-headlines-what-you-can-learn-from-oigs-review-mount-sinai

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