Clinical Laboratories and Payer Scrutiny: Increased Audits, Recoupment Actions, Litigation
Recording of a 90-minute CLE video webinar with Q&A
This CLE course will guide healthcare counsel on compliance considerations for clinical laboratories. The panel will discuss how the Stark Law framework, Anti-Kickback Statute, and related exceptions and safe harbors apply to laboratory testing. The panel will also discuss developments in compliance requirements for client account billing for laboratory testing and identify risks and issues commonly associated with payer audits.
Outline
- Compliance considerations for clinical laboratories
- Developments in compliance requirements for client account billing for laboratory testing
- Risks and issues commonly associated with payer audits
- Information on how clinical labs can be prepared for payer audits
Benefits
The panel will review these and other key issues:
- How are more and tougher payer audits raising compliance challenges for clinical laboratories?
- What steps should clinical labs take to ensure compliance with requirements for client billing for testing?
- What risks and other issues are associated with payer audits?
Faculty
Elizabeth Sullivan
Member
McDonald Hopkins
Ms. Sullivan chairs the firm’s National Healthcare Practice. She assists clinical laboratories, hospitals,... | Read More
Ms. Sullivan chairs the firm’s National Healthcare Practice. She assists clinical laboratories, hospitals, physician specialty groups, surgery centers, pharmacies, and other healthcare providers on regulatory, licensing, compliance, reimbursement, contractual, and corporate matters. She provides support to entities during licensure and accreditation surveys and assists in navigating state professional licensure laws, CLIA standards and state laboratory laws, government and private payor reimbursement, fraud and abuse rules, state telehealth laws, HIPAA rules and regulations, and state and federal pharmacy regulation.
Close
Courtney G. Tito
Partner
Michael Best & Friedrich
Ms. Tito counsels and represents clients in government and private payer audits and other payer disputes, and... | Read More
Ms. Tito counsels and represents clients in government and private payer audits and other payer disputes, and compliance false claims act investigations and related proceedings. She represents clients before the Department of Health and Human Services, Civil Remedies Division related to appeals, revocations or payment suspensions. She also counsels and represents clients in business and commercial litigation and litigation-related matters. Her practice focuses on litigation and dispute resolution in a broad array of cases including business torts, breaches of contract, lender liability, restrictive covenant disputes, and intellectual property disputes.
Close