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...]

COMPLIANCE

OIG Calls on CMS to Do Better at Medicare Collecting Overpayments

The system Medicare uses to detect and recover overpayments isn't working as well as it should be, according to a new OIG report. The Overpayment Collection System CMS relies on special contractors … [Read more...]

REIMBURSEMENT

Brief Your CEO: The 4 Key Takeaways from the OIG 2016 Part B Lab Payments Report

As PAMA payment system D-Day creeps closer, the OIG issued its report on 2016 Medicare lab payments. Spoiler Alert: It was more of the same in 2016. Part B payments for lab tests over the past three … [Read more...]

PAMA

Draft 2018 CLFS Reveals Fundamental Flaws in PAMA Reporting Exercise; Time to Take Action

By Lâle White  bio As XIFIN predicted, the PAMA reporting exercise has resulted in significant proposed laboratory fee cuts. In fact, the multi-year decrease for the top 20 laboratory tests … [Read more...]

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...]

OIG REPORT

CMS Dished Out $729.4 Million in Wrongful EHR Incentive Payments & We’re Going to Get that Money Back

Wrongful payments of Electronic Health Records (EHR) incentives are at the focus of two of the month's biggest stories in health care compliance. The first came down on May 31 when the Justice … [Read more...]

REIMBURSEMENT

CMS Exercises Enforcement Discretion for PAMA Reporting

As we previously reported, the Centers for Medicare & Medicaid Services (CMS) has indicated that laboratories had sought relief from the March 31 deadline for reporting applicable information … [Read more...]


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