HealthValue Group Executes COVID-19 Testing FMV Benchmarks to Avoid Kickback Lawsuits
Denver, Colorado--(Newsfile Corp. - September 22, 2022) - Denver-based healthcare fair market value (FMV) and appraisal firm HealthValue Group has implemented COVID-19 testing FMV benchmarks to help assist labs and specimen collection enterprises with supportable and highly defensible rates for specimen collection services. These benchmarks are a valuable element of the contracting process.
The rapid expansion of COVID-19 testing and vaccination resulted in a barrage of fraud in the healthcare industry, leading to specimen collection businesses that perform a portion of COVID tests. These businesses collect samples from patients, then the samples are sent to the actual laboratory for testing. Laboratories across the country were making deals and arrangements with "testing sites'' to collect specimen samples in deal sizes often worth millions of dollars.
Federal healthcare laws preclude the labs from paying more than fair market value (FMV) for each patient specimen. If they pay too much, it constitutes an illegal kickback and potentially violates the federal Anti-Kickback Statute (AKS) and the Eliminating Kickbacks in Recovery Act (EKRA).
The Eliminating Kickbacks in Recovery Act was enacted in 2018 and it prohibits the payment of remuneration in return for referring a patient to a recovery home, clinical treatment facility, or laboratory. It's based on the Anti-Kickback Statute, which applies only to federally funded health insurance programs, such as Medicare and Medicaid. The act, broadly applies to any "health care benefit" program, including commercial insurance.
With their program, HealthValue Group as a healthcare appraisal and consulting firm establishes FMV metrics for various clinical and management services so that healthcare providers can construct deals and arrangements under compliant and ethical terms.
"Over the past 12 to 18 months, we've gathered research and data on the nascent business of 'specimen collection services'. These specimen collection services are more commonly referred to as testing sites," Chris David, Managing Partner of HVG mentioned.
Laboratories are required to pay an FMV fee for specimen collection services regardless of how many patient samples they receive in return. The AKS and EKRA laws disallow healthcare providers from paying for certain services based on the volume or value of the services.
HealthValue Group, based in Denver, CO, is a healthcare FMV and appraisal firm with clients in over 28 states. They provide traditional business appraisals of all types of healthcare-related entities. HVG also issues FMV opinions on a myriad of professional and administrative service arrangements. The firm is a trusted advisor and consultant to life science companies, laboratories, health systems, hospitals, CEO, CFOs, compliance officers, in-house counsels, and outside counsels.
A detail of HVG’s COVID-19 specimen collection FMV capabilities can be found at https://healthvaluegroup.com.
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