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OIG – Fraud and Abuse Study with COVID-19 Testing

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS

According to the Office of Inspector General (OIG), “The coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented demand for diagnostic laboratory testing to determine whether an individual has the virus. Beyond the COVID-19 tests, laboratories can also perform add-on tests, for example, to confirm or rule out diagnoses other than COVID-19.”

This is in turn bringing to light some concerns of program integrity concerning add-on testing done in conjunction with COVID-19 Testing. The concerns are partially due to more relaxed rules for physician order during the public health emergency. The study is looking for trends in laboratory data testing and will determine if there is fraudulent billing of unnecessary add-on testing. The findings will be announced in 2021.