Medicare Part B spending on lab testing isn’t following the Protecting Access to Medicare Act (PAMA) script. In FY 2018 and 2019, the first two years under the PAMA system, Medicare payments under the … [Read more...]
IN THE NEWS
Theranos Wunderkind Elizabeth Holmes Convicted on Federal Fraud Charges
January 12, 2022
It looks like Elizabeth Holmes will be trading in her trademark black turtleneck for an orange jumpsuit. On Jan. 4, a federal jury convicted the former Theranos CEO and co-founder once hailed as the … [Read more...]
ENFORCEMENT
Federal Enforcers Crack Down on Fraudulent Billing of Genetic Tests
January 12, 2022
Genetic tests are becoming a favorite target for federal fraud enforcers. So, if your lab bills Medicare, Medicaid, and other federal health care programs for these tests, you need to pay especially … [Read more...]
Legislation
The Sun Is About to Set on the Controversial Trump Era “SUNSET” Rule
January 12, 2022
As part of its wider strategy to free business from cumbersome regulation, the Trump administration adopted a rule that would have imposed a Hobson’s choice on the Department of Health and Human … [Read more...]
ENFORCEMENT
Omicron Forces FDA to Temporarily Shut Down Inspections
January 12, 2022
It’s déjà vu all over again. With new COVID-19 cases surpassing record highs, the FDA announced on Jan. 5 that it is once more calling a temporary halt to domestic and foreign inspections. It’s the … [Read more...]
COVID-19
White House Ups Effort to Resolve Rapid, At-Home COVID-19 Test Shortages
January 11, 2022
While it has been far more active in promoting the use of rapid COVID-19 antigen testing than its predecessor, the Biden administration has been playing catchup on this issue from the moment it took … [Read more...]
National Lab Reporter Newsletter Archive
December 30, 2021
By clicking on any of the links below you agree that you are the only person who is accessing your single user NLR subscription license and that you are not sharing your username and password with … [Read more...]
Current Issue of NLR
December 30, 2021
Before You Download Please read the following user agreement and confirm your acceptance of the terms before you download NLR content: I agree that I am the the only person who is accessing my … [Read more...]
FY 2021 OIG Enforcement Outcomes Continue Long-Term Downward Trend
December 16, 2021
The COVID-19 pandemic continues to take a bite out of the volume of OIG enforcement action. All major metrics were down again in FY 2021, albeit at a less dramatic rate than in FY 2020. That’s one of … [Read more...]
Billing & Coding Alert
CMS Recognizes 3 New CLIA-Waived (CW) Tests
December 16, 2021
CMS announced three new CLIA-waived complexity tests that labs will be allowed to bill to Medicare, effective January 3, 2022. Here are the key details you need to know to ensure maximum reimbursement … [Read more...]
