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EXAMINING CLINICAL LABORATORY SERVICES

EXAMINING CLINICAL LABORATORY SERVICES A Review by the Healthcare Fraud Prevention Partnership MAY 2018 HEALTHCARE FRAUD PREVENTION PARTNERSHIP TABLE OF CONTENTS Executive Summary .. 2 Background, Introduction, and Objectives .. 3 The LABORATORY Testing Industry in the Context of Fraud .. 4 LABORATORY Industry .. 4 Regulation and Oversight .. 4 Estimates of the Cost of Fraud and 5 Systemic Challenges .. 6 Major Fraud and Abuse Schemes .. 7 Abuse of billing Standards ..7 Improper LABORATORY Relationships.

potential for fraud and abuse in clinical laboratory services, including the: • Number and variability of laboratories • High-volume, low-dollar nature of ordering, providing, and billing for clinical laboratory services • Technical complexity and continuing evolution of clinical laboratory services

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