SAFETY

Diagnostic danger in the lab: Time to reform how we process orders

By Oleg Bess, M.D.  bio I don't know about you, but I was stunned by the findings from a recent report published by Coverys, a national liability insurer, which I feel should put the entire … [Read more...]

FOCUS ON

Emerging Tests: Medicare to Cover Next Gen-Sequencing Tests for Advanced Cancer

In the PAMA era, there are two salient trends in Medicare Part B lab reimbursements: Sharply lower prices for traditional tests; and Wider coverage of newly emerging tests, including some that … [Read more...]

COMPLIANCE

Physician Referrals: New Rules Offer Some Stark Law Relief but Not Nearly Enough

Like most budget bills, the new federal Bipartisan Budget Act of 2018 includes a number of changes to Medicare fraud and enforcement requirements. One set of changes affects the current physician … [Read more...]

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New Laws: Very Quietly, Congress Doubles Penalties for Medicare Fraud & Abuse

Sneaky may be too strong a word. But what is fair to say is that the new hikes in federal health care fraud violation penalties have flown totally under the radar despite their obvious and immediate … [Read more...]

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DOJ to Prosecutors: Show Tough Love to Whistleblowers with Weak Cases

A newly leaked internal Justice Department memo signals a new prosecution policy that may make it harder for whistleblowers to bring qui tam whistleblower lawsuits under the False Claims Act (FCA). … [Read more...]

FOCUS ON

Medicare Reimbursement: CMS Launches New LVA Process for Settling Payment Appeals

While Part B lab reimbursements may be going down, the good news is that it just became easier to challenge Medicare payment denials. Here is an overview of the new CMS Low Volume Appeals settlement … [Read more...]

ANNUAL SURVEY

Outreach Survey Focuses on Clinical Laboratory Industry Trends Amidst Greatest Disruption in Three Decades

By Jeff Myers  bio Accumen Inc. is pleased to announce the launch of the 17th Annual National Hospital and Health System Laboratory and Outreach Survey. The survey is designed to capture … [Read more...]

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Value Care: CMS Value Modifier Programs Ends Not with a Bang but a Whimper

Thanks for nothing. While CMS likes to congratulate itself for using provider pay adjustments to "transform the healthcare delivery system," more often than not, the rhetoric fails to live … [Read more...]

FOCUS ON

Anti-Kickback Statute: OIG Eyes Changes to Safe Harbor Rules

As it does every year, the OIG is reviewing the federal Anti-Kickback Statute (AKS) current safe harbor rules. The deadline to comment: end of business, Feb. 26. Here's a quick rundown of what's at … [Read more...]

HEALTH CARE REFORM

Medicare Reimbursement: Federal Government Funding Extension Includes a Boatload of Medicare Changes

The government shutdown fiasco is having an impact on Medicare spending and reimbursement. But the crucial details are being buried in the legislative paperwork. So we decided to ferret them out for … [Read more...]


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