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Taking Advantage of Payor Contracts: Pitfalls of Hospital Pass-Through Billing Arrangements

First few Article Sentences

There are numerous new laboratory referral arrangements that involve billing which may implicate several laws at both the Federal and State level. Due to reduced reimbursements and narrower payor networks, these arrangements on the surface may seem advantageous and attractive as a means to increase revenues and align new clients. However, the health insurers as payors of pass-through laboratory claims are now recognizing and making attempts to stop the flow of these potentially fraudulent and lucrative schemes through lawsuits and tougher contracting.

Cooper, Richard S.

Beasley, Donna M.

McDonald Hopkins, LLC

Law, Provider Reimbursement

August 1, 2018

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