G-2 Compliance Report

The Health and Human Services Office of Inspector General (OIG) plans to continue its review of inappropriate unbundling of clinical laboratory testing in the coming year, the agency says in its fiscal 2009 work plan, published October 1.

The Food and Drug Administration (FDA) warned LabCorp that it is marketing the company’s OvaSure ovarian cancer test in violation of the law.

The Centers for Medicare and Medicaid Services (CMS) has selected four new Recovery Audit Contractors (RACs), whose job it is to identify improper Medicare payments.

The Centers for Medicare and Medicaid Services (CMS) in October announced what it says are "aggressive new steps" to find and prevent waste, fraud, and abuse in Medicare.

A rule by the federal government requiring all hospitals to switch to a new health care coding system by 2011 would dramatically increase costs for physician practices and clinical laboratories, according to a study released October 14 by a group of provider organizations. The groups called on the Centers for Medicaid and Medicare Services (CMS) to reassess the implementation time frame.

Hospitals, clinical laboratories, and other medical care providers may be dangerously unaware that they have a looming deadline for compliance with complex new federal regulations.

A group of cardiologists in Colorado has filed a federal complaint against Health and Human Services Secretary Michael O. Leavitt, saying the Centers for Medicare and Medicaid Services (CMS) overstepped its authority in making a recent change to the physician self-referral rules (Colorado Heart Institute v. Leavitt).

A federal appeals court October 2 dismissed a lawsuit after finding no basis in either law or logic to adopt an express false certification theory that turns every violation of a Medicare regulation into the subject of a False Claims Act qui tam action (United States ex rel. Conner v. Salina Regional Health Center Inc.).

Compliance Program Guidance: The Health and Human Services Office of Inspector General (OIG) has published new voluntary supplemental compliance guidance for nursing facilities. The guidance responds to developments in the nursing facility industry, including changes in the way facilities deliver and receive reimbursement for health care services, evolving business practices, and changes in the federal enforcement environment. A significant goal of the guidance is fostering quality of care in facilities. As such, it is designed to help compliance professionals address areas such as staffing, resident care plans, medication management, appropriate use of psychotropic medications, and resident safety. The guidance is available at www.oig.hhs.gov/fraud/docs/complianceguidance/nhg_fr.pdf.