By Sean McSweeney bio In a press release on May 30, 2017, the Centers for Medicare & Medicaid Services (CMS) commented regarding their fraud prevention initiative program and their … [Read more...]
HEALTH CARE REFORM
ACA: DOJ Won’t Defend Individual Mandate in Court—But 16+ States Will
June 18, 2018
One of the DOJ's principal roles is to defend the federal laws in court cases challenging their constitutionality. But the agency has made it known that it will not be doing that in a lawsuit brought … [Read more...]
INSURERS & PAYORS
Test Ordering & Utilization: Labs Stand to Benefit from Industry Efforts to Minimize Prior Authorization Red Tape
March 16, 2018
Although not specifically directed at labs, a new collaboration between the American Medical Association and insurance giant Anthem may offer solutions to a perennial thorn in the side of labs: payor … [Read more...]
FOCUS ON
Value Care: CMS Value Modifier Programs Ends Not with a Bang but a Whimper
March 5, 2018
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...]
HEALTH CARE REFORM
Medicare Reimbursement: Federal Government Funding Extension Includes a Boatload of Medicare Changes
February 26, 2018
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...]
ACA INSTABILITY
Laboratory Industry Faces Uncertain Regulatory Policy
October 30, 2017
While PAMA captured headlines at G2's 35th annual Lab Institute conference (Washington D.C.; Oct. 25-27), speakers presented how other regulatory efforts, including the Affordable Care Act (ACA), … [Read more...]
HEALTH CARE REFORM
Labs to CMS: Push Back PAMA & Add Hospital Labs to CLFS Mix
August 17, 2017
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...]
HEALTH CARE REFORM
Value-Based Care: AACC Cites Key Role of Lab Professionals in Making It Work
July 26, 2017
Laboratory professionals have a central role to play in supporting the transition to value-based care, according to a new American Academy of Clinical Chemistry (AACC) position statement. Lab … [Read more...]
HEALTH CARE REFORM
Potential Negative Impact of AHCA on Genetic Testing
May 17, 2017
While it remains uncertain what the Senate will do with the American Health Care Act (AHCA), alarm is spreading about the legislation's implications for the estimated quarter of Americans under the … [Read more...]
HEALTH CARE REFORM
Value of Price Transparency Questioned
May 17, 2017
Publishing testing prices in electronic ordering systems for inpatients may not lead to significant changes in clinician ordering behavior or associated fees, according to a study published April 21 … [Read more...]
