Utilization and Other Regulations

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The page below is a sample from the LabCE course Medicare Compliance for Clinical Laboratories (retired 2/17/2021). Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Utilization and Other Regulations

Laboratories must not induce physicians to order unnecessary tests through their marketing or education activities:
  • They must monitor the use of laboratory services by their clients.
  • They must correct any situation where something they did caused an unnecessary increase in test utilization.
Cost Reports
  • Hospital laboratories must ensure that information used in hospital Medicare cost reports is accurate and includes only those costs which are appropriate.
  • Laboratories must follow all CLIA and OSHA regulations; failure to do so may result in a False Claims Act violation.