HHS' inspector general's office issued its fifth fraud alert last week-the second in less than two months-warning consumers about illegal kickback schemes involving clinical laboratories.
Other alerts have dealt with physician recruitment strategies and pro- vider joint ventures (Aug. 29, p. 26).
HHS Inspector General June Gibbs Brown released the alert last week at a healthcare fraud seminar in Washington.
The anti-kickback provisions of Medicare and Medicaid fraud and abuse statutes bar any form of remuneration to induce patient referrals.
The new fraud alert addresses inducements offered to providers by clinical laboratories to use their services. The alert outlines several examples of suspect business practices:
An arrangement in which a phlebotomist loaned to a physician's office to collect specimens performs other work to induce referrals.
A deal in which a lab charges below-market prices to a renal dialysis center for specific work in exchange for the referral of other, more expensive work.
An arrangement in which a lab performs work for managed-care patients for free in exchange for the referral of work covered by other insurers.
Lewis Morris, deputy associate general counsel for HHS' inspector general's office, said he believed the fraud alert will help labs that feel pressured by physicians to provide free services to keep business.
Labs have been of particular interest to the inspector general's office, which supported federal legislation passed in 1989 that bars physicians from owning labs to which they refer Medicare patients. Backers of the law said such deals created a financial incentive to refer patients to physicians' labs for costly and unnecessary testing.