BILLING AND COLLECTIONS

Medicare Reimbursement: New HOPPS Date of Service Rules for ADLTs & Molecular Pathology Tests Take Effect

Here's what labs that bill Medicare for outpatient lab tests need to know about the new CMS rules exempting advanced diagnostic laboratory tests (ADLTs) and molecular pathology tests from Hospital … [Read more...]

PAMA

PAMA Unlocks Golden Age for Innovative Diagnostics

By Chance Scott  bio The publication of the 2018 Clinical Laboratory Fee Schedule (CLFS) in January saw a long and heated debate within the lab community come to fruition. When Congress … [Read more...]

BILLING & COLLECTIONS

Getting Paid: Medicare to Cover Next Gen-Sequencing Tests for Advanced Cancer

In the PAMA era, there are two salient trends in Medicare Part B lab reimbursements: Sharply lower prices for traditional tests; and Wider coverage of newly emerging tests, including some that … [Read more...]

OVERPAYMENTS

CMS to OIG: Get Back the $66.3 Million You Improperly Paid to Labs for Urine Validity Tests

As if times were not already tense enough for labs that bill Medicare for urine drug tests, the OIG ratcheted up the pressure another notch on Feb. 20 by issuing a new report chiding CMS for making … [Read more...]

REIMBURSEMENT

Out of Network: 6 Frequently Asked Questions

By Richa Singh  bio As labs face an increasingly challenging reimbursement environment, more providers are doubling down on out-of-network strategies to maximize on collections … [Read more...]

INDUSTRY NEWS

CAP Files Amicus Brief in Support of ACLA Motion for Summary Judgement in PAMA Lawsuit

The College of American Pathologists (CAP) filed an amicus curiae brief in support of a motion by the American Clinical Laboratory Association (ACLA) for summary judgement to set aside how the … [Read more...]

CLFS 2018

CMS Ignored Congressional Intent in Implementing New Clinical Lab Payment System Under PAMA, ACLA Charges in Suit

The government agency that runs the Medicare program failed to follow a congressional directive to implement a market-based laboratory payment system, thereby jeopardizing Medicare patients' access to … [Read more...]

PAMA

CMS Ignores Flawed Processes, Finalizes 2018 PAMA Pricing; Labs Need to Take Immediate Action to Offset Impending Lean Times

By Kyle Fetter  bio The final 2018 clinical laboratory fee schedule (CLFS) is out, and it is evident that the argument that the Centers for Medicare & Medicaid Services (CMS) PAMA … [Read more...]

COMPLIANCE

Medicare Reimbursement: CMS Finalizes Hospital Outpatient Prospective Payment Changes for 2018

With all of the PAMA commotion, the 2018 Medicare Hospital and Ambulatory Surgical Outpatient Prospective Payment System (OPPS) final rule has flown under the radar. In case you don't feel like … [Read more...]

INCREASING REVENUE

Conference Ends With Optimistic Outlook for Laboratories

Despite the PAMA cloud overhanging the laboratory industry, G2's 35th annual Lab Institute conference (Washington D.C.; Oct. 25-27) ended on an optimistic note with David Nichols and Drea Langston, … [Read more...]


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