decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Fraud Alerts / OIG Special Fraud Alerts / Special Fraud Alert_October 1994 / Provision of clinical lab services
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Article Overview
This article summarizes an OIG Special Fraud Alert focused on clinical laboratory relationships with referral sources and the fraud-and-abuse risks those arrangements can create. It is relevant to compliance staff, administrators, physicians, laboratory leaders, and billing/coding professionals who need to understand the general scope of the government’s concern and the types of clinical lab service arrangements addressed in the alert.
Why This Topic Matters
The alert highlights how certain lab-provider relationships may draw scrutiny under federal fraud and abuse enforcement. Readers can use it to understand the broad compliance context surrounding clinical lab services and referral-related arrangements.
What You Will Learn
- The general compliance concerns raised by clinical laboratory arrangements
- Why referral-source relationships involving labs may attract government scrutiny
- The role of fair market value in evaluating lab-related transactions at a high level
- How the OIG framed enforcement attention toward both labs and providers
Who Should Read This
- Compliance officers
- Healthcare administrators
- Physicians
- Clinical laboratory managers
- Billing and coding professionals
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