tci Medicare Compliance & Reimbursement - 2005 Issue 1

LABS: Could Dialysis Arrangements Put Labs At Risk?

Providing services and supplies on the house invites kickback troubles. If you want to help dialysis facilities with specimen prep, you need to beware of garnering improper referrals, according to a HHS Office of Inspector General advisory opinion (No. 04-16).Example: A laboratory provides dialysis facilities with both composite rate tests (included in the composite rate that Medicare pays) as well more lucrative non-composite rate tests (separately billable and not Medicare-covered). Could that lab provide the dialysis facilities with lab workers and supplies needed to centrifuge, sort, pack and ship specimens to the lab - at no cost to...

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