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...]

ENFORCEMENT TRENDS

FISH Test Crackdown against 21st Century Oncology Nets Nearly $25 Million… and Counting

$24.86 million. That's how much a whistleblower has made for the government and herself—so far—in a case against 21st Century Oncology for alleged fraudulent billing of fluorescence in situ … [Read more...]

ENFORCEMENT

OIG Targets Sleep Study Tests

If your lab performs sleep studies on Medicare patients, beware. It is now a high-priority target for federal fraud and abuse enforcement. Here is a look at the risk you face and what you can do to … [Read more...]

COMPLIANCE PERSPECTIVES

Crosswalked Codes in 2017 Clinical Laboratory Fee Schedule

CPT Code Crosswalked To 80305 (Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical … [Read more...]

REIMBURSEMENT

2017 Medicare Lab Payments: The 9 Changes that May Affect Your Reimbursements

As the clock ticks down to 2018 and the new Protecting Access to Medicare Act of 2014 (PAMA) system for lab payments, the Centers for Medicare and Medicaid Services (CMS) issued final Medicare payment … [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

Compliance Perspectives: PAMA—What We Know So Far, What You Need to Know to Comply

After much lobbying and debate from stakeholders in the laboratory industry, the Centers for Medicare & Medicaid Services (CMS) is moving forward with implementation of the Protecting Access to … [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...]


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