tci Medicare Compliance & Reimbursement - 2003 Issue 18

Laboratories: LAB UNBUNDLING SCRUTINY NEVER DIES

Laboratory claims have long been a chief target of fraud enforcement agencies, and the scrutiny isn't letting up. Federal prosecutors in Philadelphia April 22 filed a False Claims Act suit against Abington Memorial Hospital, charging the facility with illegally unbundling Medicare lab claims - even after the Pennsylvania health department warned it of problems with its lab billing on the Medicaid side. According to U.S. Attorney Patrick Meehan, Abington submitted more than 70,000 false claims to Medicare between 1991 and 1999. Specifically, the feds maintain that the hospital: unbundled blood chemistry tests; double-billed, unbundled or upcoded certain...

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