Compliance Resources


Important Compliance Links

Below are important compliance links, as specified in the 2023 Referring Providers Annual Notice.

PECOS

More information on PECOS and how to enroll in the system may be viewed at:

False Claim Act

The Office of Inspector General (OIG) takes the position that physicians or other individuals authorized by law to order laboratory tests, who knowingly cause a false claim submission to any federally funded program, may be subject to sanctions or remedies available under civil, criminal, and administrative law, such as the False Claims Act.

Medicare Program Integrity Manual

Centers for Medicare & Medicaid Services (CMS) provides signature requirements guidance via CMS Change Request CR9225, CR9332:

The 2023 Medicare Clinical Laboratory Fee Schedule

The 2022 Medicare Clinical Laboratory Fee schedule may be viewed and downloaded at:

Local Coverage Determinations (LCD) guidelines and Medicare Coverage Articles, Noridian, LLC, a Nevada Medicare Part B carrier

Local Coverage Determinations (LCD) guidelines may supplement or be in addition to the National Coverage Determinations and give direction for medical necessity on selected tests.

Medicare LCD #36668: Controlled Substance Monitoring and Drugs of Abuse Testing

Medicare Coverage Article #A55001: Controlled Substance Monitoring and Drugs of Abuse Testing

Other laboratory LCDs and Medicare Coverage Articles are available at:

Advance Beneficiary Notice of Noncoverage (ABN)

Please find additional information about ABNs at:

Compliance with Federal Beneficiary Inducement Statute, Anti-Kickback Statute, Stark Law and EKRA

MD Labs' policy is to fully comply with the Medicare Beneficiary Inducement Statute, Anti-Kickback Statute (AKS), Stark Law, and Eliminating Kickback in Recovery Act (EKRA). Please review the following web pages for more information: