In early August, Representatives Scott Peters (D-CA) and John Shimkus (R-IL) introduced in the US House of Representatives a bill to provide "certain undiagnosed children under the Medicaid program" … [Read more...]
LEGISLATION
New Laws: Congress Tables Bill to Make Whole-Genome Sequencing Available to Medicaid Kids
August 26, 2019
REIMBURSEMENT
PAMAgeddon: Congress Tables Bill to Delay Next Round of Price Reporting for One Year
July 16, 2019
The PAMA data collection process has been a lightning rod for criticism from almost the moment CMS unveiled it. And now Congress may be getting ready to intervene. A newly proposed bill called … [Read more...]
TECHNOLOGY
10x Genomics Ordered to Pay $23.9 Million for Infringing Bio-Rad’s Patents
January 25, 2019
Case: The Federal District Court jury found that 10x willfully infringed three genetic analysis technology patents that Bio-Rad licensed from the University of Chicago on an exclusive basis. … [Read more...]
LEGISLATION
New Broad All-Payor Kickback Law Impacting Laboratories, Commission-based Compensation and more
January 14, 2019
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...]
PUBLIC HEALTH
Industry Buzz: Obamacare Repeal Sends Tremors through Insurance Markets
December 18, 2018
What came as a Christmas gift to many Republicans may be a lump of coal in the stocking of many others. On December 14, a federal judge in Texas ruled that the entire Affordable Care Act (aka, … [Read more...]
LEGISLATION
New Laws: Proposed Federal Legislation Would Allow Medicare Payment for Genetic Counselling
December 14, 2018
A new bill introduced in the U.S. House of Representatives in October calls for CMS to recognize certified genetic counselors as healthcare providers. Here's a quick overview of the bill and why it … [Read more...]
HEALTH CARE REFORM
Health Insurance Market: Two Recent Changes & Their Impact on Labs
October 1, 2018
Amid all the talk of sweeping reform of the health insurance marketplace, the smaller, interim changes get overlooked despite their direct impact on labs and other providers. Two such changes took … [Read more...]
HOSPITAL OUTREACH
Case of the Month: Fraud or Legitimate Rural Hospital Lab Outreach Business?
September 26, 2018
A North Carolina lawsuit pitting one of the nation's largest health insurers and a national hospital management company raises novel legal issues that test the legal limits of provider contracts … [Read more...]
ANTI-KICKBACK
Case of the Month: Individual Principles Hit with $114.1 Million Verdict for Role in HDL Blood Test Fraud
July 3, 2018
Roughly three years ago at this time, mega-scandals were in the news featuring diagnostic giants like Millennium, Health Diagnostic Laboratory (HDL), Biodiagnostic Laboratory Service and the like. But … [Read more...]
COMPLIANCE
Physician Referrals: New Rules Offer Some Stark Law Relief but Not Nearly Enough
April 11, 2018
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...]
