- 30,395
But isn't *ick a "Deleted Member"?*ick?
DNA cancer screening tables are a medicare scam
- Thread starter AcemanX007
- Start date
I guess but he would not have been able to post anything today..But isn't *ick a "Deleted Member"?
- 30,395
I've seen a post by a deleted member a couple of times before. I wondered how they could post.
I would assume the post was made before they were deleted and then USER ID was changed to deleted after they were banned..I've seen a post by a deleted member a couple of times before. I wondered how they could post.
Rciks ID and posts still show up..https://insurance-forums.com/community/threads/iphone-app-in-our-lifetimes.88601/I've seen a post by a deleted member a couple of times before. I wondered how they could post.
- 30,395
Yeah, I've seen his posts and username since he got the hammer. I also just recently saw some posts of *ick's buddy Al, and he's banned too. They should form a club.
Lance Tinsley
New Member
- 1
This is illegal I work in this industry. It's a clear violation of EKRA any company offering compensation this way can be in serious trouble. This is not compliant with HIPAA and Medicare would have a major problem with this. The OIG could easily enforce kickback laws in a case like this. You need to be a well funded certified HIPAA compliant company with operations built around a flat fee approved structure. This situation the is being described is definatley not compliant. Please read EKRA law and avoid this!
I had not read that law until now. I would say it pretty much says it in a nutshell! It is illegal to get reimbursed or compensated for referring someone to a "lab".
42 CFR § 1001.952 - Exceptions.
section 1001.952(d) of title 42, Code of Federal Regulations
(d)Personal services and management contracts. As used in section 1128B of the Act, “remuneration” does not include any payment made by a principal to an agent as compensation for the services of the agent, as long as all of the following seven standards are met -
(1) The agency agreement is set out in writing and signed by the parties.
(2) The agency agreement covers all of the services the agent provides to the principal for the term of the agreement and specifies the services to be provided by the agent.
(3) If the agency agreement is intended to provide for the services of the agent on a periodic, sporadic or part-time basis, rather than on a full-time basis for the term of the agreement, the agreement specifies exactly the schedule of such intervals, their precise length, and the exact charge for such intervals.
(4) The term of the agreement is for not less than one year.
(5) The aggregate compensation paid to the agent over the term of the agreement is set in advance, is consistent with fair market value in arms-length transactions and is not determined in a manner that takes into account the volume or value of any referrals or business otherwise generated between the parties for which payment may be made in whole or in part under Medicare, Medicaid or other Federal health care programs.
(6) The services performed under the agreement do not involve the counselling or promotion of a business arrangement or other activity that violates any State or Federal law.
(7) The aggregate services contracted for do not exceed those which are reasonably necessary to accomplish the commercially reasonable business purpose of the services.
For purposes of paragraph (d) of this section, an agent of a principal is any person, other than a bona fide employee of the principal, who has an agreement to perform services for, or on behalf of, the principal.
