decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Clinical Lab Services / Fraud alerts / Special Fraud Alert_October 1994
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Article Overview
This premium article reviews an October 1994 Special Fraud Alert concerning clinical laboratory services and financial relationships with referral sources. It is relevant to compliance, revenue integrity, and healthcare fraud and abuse review because it discusses the types of lab-provider arrangements that drew government scrutiny and the broader enforcement context. The article is organized as a fraud alert overview with follow-on sections covering the practices addressed in the alert.
Why This Topic Matters
Healthcare organizations and billing/compliance staff need to understand how OIG fraud alerts frame risky lab arrangements and why those relationships may attract enforcement attention. The article helps readers identify the general compliance issues discussed in the alert without replacing the underlying premium guidance.
Article Sections
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Provision of clinical lab services
Introduces the subject of clinical laboratory services and the fraud-alert context surrounding lab arrangements with referral sources.
What You Will Learn
- The compliance context for an OIG Special Fraud Alert involving clinical laboratory services.
- How fraud alerts are used to highlight arrangements that may draw scrutiny under healthcare fraud and abuse rules.
- The general categories of laboratory practices discussed in the alert.
- The enforcement and compliance significance of lab-provider financial relationships.
Who Should Read This
- Compliance professionals
- Medical coders
- Revenue cycle staff
- Healthcare administrators
- Risk management teams
- Billing managers
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