CMS

Medicare Reimbursement: CMS Proposes MACRA Physician Performance Requirements for 2018

On June 30, CMS issued a Proposed Rule addressing a key part of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) implementation: the Quality Payment Program (QPP) for 2018, the second … [Read more...]

HEALTH CARE REFORM

Labs to CMS: Push Back PAMA & Add Hospital Labs to CLFS Mix

The lab industry continues to wait nervously for word from CMS regarding PAMA. Demand 1: Fix the Fee Schedule Methodology The industry's paramount concern remains the formula CMS proposes to use to … [Read more...]

FEE SCHEDULES

CORRECTION: Molecular Assays Stave Off Big Cuts in 2017 Clinical Laboratory Fee Schedule

  Editor's Note: The lead story in the November 25, 2016 issue of LIR is about changes to the 2017 Clinical Laboratory Fee Schedule affecting reimbursement for clinical laboratory tests. The … [Read more...]

ENFORCEMENT

Theranos Announces Settlement Agreements with CMS and Arizona Attorney General

After facing federal and state government scrutiny for more than a year, Theranos has reached agreements with the Centers for Medicare & Medicaid Services (CMS) and the Arizona Attorney General to … [Read more...]

ENFORCEMENT

Theranos Settles with CMS and Arizona Attorney General

After facing federal and state government scrutiny for more than a year, Theranos has reached agreements with the Centers for Medicare & Medicaid Services (CMS) and the Arizona Attorney General to … [Read more...]

ENFORCEMENT

CMS, OIG Reps Address PAMA, Fraud Enforcement at ACLA Annual Meeting

At the American Clinical Laboratory Association annual meeting in Washington, D.C. March 23, representatives of the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector … [Read more...]

PAMA

OIG Surveys How CMS is Doing on PAMA Implementation

With D-day set for Jan. 1, 2018 for implementation of a new payment methodology for lab services under the Protecting Access to Medicare Act of 2014 (PAMA), the Office of Inspector General (OIG) just … [Read more...]

CMS

PAMA Update: CMS Guidance and Reporting Information Trickles In

The Centers for Medicare & Medicaid Services (CMS) promised more details would be coming once it released the final rule implementing the Protecting Access to Medicare Act of 2014 (PAMA) this past … [Read more...]

PATIENT SAFETY

CMS Pushes Cuts in HAIs, Promotes Antibiotic Stewardship

As part of a comprehensive push to improve patient safety through a reduction in hospital-acquired infections (HAIs), the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule this … [Read more...]

FEE SCHEDULES

Are Commercial Payers Using Proposed CMS Gapfill Rates to Ratchet Down Reimbursement?

During the summer, the Centers for Medicare & Medicaid Services (CMS) published proposed interim gapfill prices for 15 molecular tests. The agency said it would likely publish final prices later … [Read more...]


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