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Regular amendments from the Clinical Laboratory Improvement Amendments (CLIA) create various complications for clinical laboratories. Other entities such as Medicare and Medicaid also pose various legal risk factors for laboratories. For instance, physicians can order several lab tests. However, Medicare only pays for what they deem necessary and reasonable. Clinical laboratory practitioners need good defense lawyers because they stand to lose their license if found or suspected of any violations. The following are some of the risk factors that expose lab technicians to litigation issues. These issues call for the need of good defense lawyers.
Billing and payment matters are handled by various third party entities such as Medicaid and Medicare. These organizations have a set procedure and rules that should be followed when billing. If they notice any diversion from the standard, a clinical laboratory is put under investigation. The medical board can easily revoke a license if a clinic is suspected of non-compliance. Clinical laboratory lawyers can help health care practitioners to defend against any billing charges. Seeking legal aid can prevent stern action.
Medical necessity has created lots of antagonism between laboratories and entities such as Medicare and Medicaid. The government is also a major stakeholder in such cases. Clinical laboratories need to ensure that physicians are not ordering for tests that are not necessary. The laboratory needs to gather all pertinent information to ensure that the tests done are correct and necessary. These laboratories are also tasked with ensuring that there is a good flow of communication between lab technicians. This ensures that there is no mix-up and the tests performed are the ones asked for. As evidenced, this exposes the clinic to several litigation issues should they fail to hold their end of the bargain.
Standing orders are allowed by the OIG. However, there are strict rules that must be adhered to. These orders need to be regularly monitored. Standing orders have an expiration date, and they need to be renewed once they expire. Clinical laboratory defense lawyers can offer both defensive and preventative measures. They will guide you on how to handle future standing orders to avoid litigation problems.
Medicare and Medicaid audit target healthcare providers such as clinical laboratory practitioners. These audits are carried out to investigate over-payments, coding, and billing. It is ill-advised for healthcare professionals to accept charges at face value. As a practitioner, you have the right to question these audits. It is wise to have legal counsel by your side to shed more light on these issues. Otherwise, you may find that you admitted fault to something that you are not guilty of. If your clinic is being audited, a lawyer will help you prepare the right documents. The lawyer will also look at your accounts to ensure that they are above board.
Facing any of these or more charges on your laboratory can be overwhelming. To protect your practice and source of livelihood, consult with an experienced clinical laboratory lawyer.