REIMBURSEMENT

Medicare Reimbursement: CMS Issues New Medical Review Instructions to Contractors

On Aug. 14, CMS issued new marching orders to Medicare Administrative Contractors (Contractors). The message: Tighten up the way you target suppliers and providers for medical review. The Targeted … [Read more...]

CMS

Labs Keep Up the Pressure to Delay PAMA & Add Hospital Lab to CLFS Formula

The lab industry continues to wait nervously for word from CMS regarding PAMA. Demand 1: Fix the Fee Schedule Methodology The industry's paramount concern remains the formula CMS proposes to use to … [Read more...]

REIMBURSEMENT

3 Things We Learned from New OIG Report on 2015’s Top 25 Lab Tests by Medicare Payment

Buried in the back of the Office of Inspector General (OIG) recent report on 2015 Medicare payments for Part B lab tests are three key revelations about the new Protecting Access to Medicare Act of … [Read more...]

PAMA

PAMA Update: OIG Status Report on Implementing New Medicare Fee Schedule for Part B Lab Tests

Transition to the new Medicare Part B payment system for lab tests under the Protecting Access to Medicare Act of 2014 (PAMA) is in full swing and about to heat up. With D-day set for Jan. 1, 2018, … [Read more...]

REIMBURSEMENT

Industry Questions How Many Hospital Labs Will Be Reporting Under PAMA

When the Centers for Medicare & Medicaid Services (CMS) announced in mid-June the final rules governing the Protecting Access to Medicare Act (PAMA), it drew praise from several groups that had … [Read more...]

FEE SCHEDULES

Pathology, Cytology Face Potential Cuts in 2017 Physician Fee Schedule

CPT Code 88305 is headed to the chopping block again. The Centers for Medicare & Medicaid Services (CMS) has suggested cutting the technical component of 88305—a tissue examination and a primary … [Read more...]

REIMBURSEMENT

Labs Get One-Year Reprieve under Final PAMA Rule, New Rates Delayed until 2018

Labs must now begin preparations in earnest to comply with private payor rate reporting requirements under the Protecting Access to Medicare Act of 2014 (PAMA). After much lobbying, debate and delay, … [Read more...]

DATA

CMS Releases Data on Medicare Payments to Providers, Including Clinical Labs

By Kelly A. Briganti, Editorial Director, G2 Intelligence For a third year in a row, the Centers for Medicare & Medicaid Services (CMS) has released updated data regarding Medicare payments … [Read more...]

ENFORCEMENT

Theranos Faces New Challenges and Increasing Federal Scrutiny

Theranos continues to face challenges concerning its Newark, Calif., laboratory as its initial response to Centers for Medicare & Medicaid Services (CMS) failed to resolve inspection issues and … [Read more...]

CLIA

CMS Issues Deficiency Letter to Theranos

Theranos is once again in the media spotlight due to negative attention it has received from a government regulatory agency. Last year, the U.S. Food and Drug Administration (FDA) released documents … [Read more...]


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