Reference no: EM133200815 , Length: 2 pages

Question: The goal of this project is to create a new compliance plan for a new clinical laboratory company. We want to create a compliance plan that focuses on the prevention laboratory fraud and abuse.

Based on the industry chosen (we have chosen clinical laboratory services) and the risk factors peculiar to the industry, we must design our plan to include an in-depth analysis of FOUR specific compliance standards and whatever other action/activities our team believes are required to ensure compliance with regulations.

Below are the two compliance standards I have chosen and need assistance writing about. I have listed requirements and questions to be answered in the paragraphs. APA style format required. APA schoarly sources required no later than 2016.

Compliance Standard 1: Billing Practices and Preventing Fraud & Abuse and Billing Errors

Look up billing rules and regulations under the Centers for Medicare & Medicaid Services (CMS).

There are many risk areas with clinical laboratory billing practices. What are things that our clinical laboratory to do mitigate these risks and to ensure compliance with CMS regulations?

Compliance Standard 2: Medically Unnecessary Testing

What is it?

The excessive and improper use of clinical laboratory services for reasons not related to the medical needs of the patient. Examples include:
Excessively large laboratory panels, which are more expensive. Sometimes are ordered in the absence of medical necessity.

Excessive urine drug testing, sometimes done to increase provider reimbursement.

Answer why this violates compliance standards, such as the Anti Kickback Statue and answer what are actions that our laboratory can do to prevent these violations.