REIMBURSEMENT

Medicare Reimbursement: MIPS Bonuses Are Easy to Earn, IF You Can Get into the Program

On July 11, CMS announced the results of 2018, Year 2 under the Merit-based Incentive Payment System (MIPS). Bottom line: The total number of clinicians participating declined from 1.06 million to … [Read more...]

PAMA

Explaining the Legal News: Why ACLA Court Win Boosts Chances of PAMA Pricing Relief

By now, you've no doubt heard the news that the American Clinical Laboratory Association (ACLA) "won" its lawsuit against CMS over PAMA lab pricing. Only it's not as simple as that. The favorable US … [Read more...]

HEALTH CARE REFORM

Developing Story: Doubt Grows as Obamacare Court War Enters Round 2

Heartburn over the survival of Obamacare is back with a vengeance. It reawakened seven months ago, after a Texas U.S. District Court found The Affordable Care Act unconstitutional—not just the … [Read more...]

Compliance Heads Up: New Kickback Safe Harbors Rule Is Almost Ready

After months of promises, posturing and public consultation, the Department of Health and Human Services is getting ready to unveil a proposed rule to liberate labs and other providers from the … [Read more...]

COMPLIANCE

New OIG Report Confirms that Labs Are Still on the Enforcement Radar

After a recent dip, OIG enforcement activity has seemingly rebounded, at least in terms of total recoveries. That's the basic punchline from the newly published OIG Semiannual Report to Congress … [Read more...]

LEGISLATION

New Broad All-Payor Kickback Law Impacting Laboratories, Commission-based Compensation and more

By Danielle Sloane bio and Chris Climo bio In a recent piece of federal legislation intended to address the opioid crisis across the United States, Congress enacted a new all-payor kickback … [Read more...]

FALSE CLAIMS

Dissolution: The Final Act of the Theranos Tragedy

Just five years ago, Theranos was a Silicon Valley sensation with a valuation of over $9 billion. While black turtlenecked Elizabeth Holmes supplied the charisma, the heart of the Theranos phenomenon … [Read more...]

COMPLIANCE CORNER

Stark Relief: Change Seems Imminent but Less Dramatic than Industry Wants

CMS is giving serious indications of its willingness to entertain Stark Law relief. Back in June, CMS issued a Request for Information (RFI) seeking public comments and suggestions on changes to … [Read more...]

CYBERSECURITY

HIPAA Briefing: Can Patients Sue Labs for Privacy Breaches?

Violating HIPAA restrictions subjects your lab to fines and other penalties dished out by the HHS Office of Civil Rights (OCR) and other regulators. But can the individual victims whose personal … [Read more...]

CONSUMER FRAUD

The End May Be Near for Theranos & Elizabeth Holmes

Four years ago, Theranos was a $10 billion company poised to turn a breakthrough blood testing technology into a diagnostics dynamo to the tune of $70 billion in annual sales. Today, the company and … [Read more...]


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