decisionhealth Newsletters, Part B News - 2014 Issue 7 (July)
OIG clamps down on payment arrangements between physician practices, labs
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Article Overview
This article covers a June 25 OIG Special Fraud Alert focused on payment arrangements between physician practices and clinical laboratories. It explains why the government views certain lab-related payments and support arrangements as potentially risky under fraud-and-abuse laws, and it summarizes practical compliance considerations for physicians, practices, and legal/compliance teams. The piece is relevant to readers who manage physician-lab relationships, referral-based arrangements, or health care compliance programs.
Why This Topic Matters
Physician-lab arrangements can affect compliance exposure, federal program risk, and overall practice operations. Understanding the scope of the OIG’s concerns helps organizations assess existing relationships and review contracts, payments, and related policies.
Article Sections
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OIG Special Fraud Alert and compliance concerns
Overview of the alert’s focus and the general compliance issues it raises for physician-lab payment arrangements. The section frames the government’s concerns in the context of fraud-and-abuse oversight.
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Government scrutiny of lab payment arrangements
Discussion of the broader enforcement environment involving physician and laboratory financial relationships. This section addresses why these arrangements have attracted continued government attention.
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Five ways to reduce risk with lab deals
Practical compliance themes for evaluating and reviewing proposed arrangements with laboratories. The section summarizes general risk-management considerations and related legal review points.
What You Will Learn
- The general issues the OIG is examining in physician-lab financial arrangements
- Why certain laboratory payment structures are viewed as higher risk from a compliance standpoint
- How organizations can approach review of lab-related arrangements more carefully
- Which broad fraud-and-abuse laws and state law issues may be relevant to these relationships
Who Should Read This
- Physicians and physician practices
- Health care compliance professionals
- Health care attorneys
- Medical practice managers
- Laboratory administrators
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