FEE SCHEDULES

Newly Proposed PAMA Rates for 2018 Confirm Lab Industry’s Worst Fears

CMS's newly issued preliminary Clinical Laboratory Fee Schedule (CLFS) for 2018 dashes the lab industry's hopes for PAMA relief by making two things painfully clear: There will be no delay in plans … [Read more...]

TRICARE

LDTs: TRICARE Beneficiaries Get At Least 3 More Years of Access

Some of the labs that participate in TRICARE got some good news when the Department of Defense announced that it has extended the so called Approved Laboratory Developed Tests (LDTs) Demonstration … [Read more...]

PAMA

Draft 2018 CLFS Reveals Fundamental Flaws in PAMA Reporting Exercise; Time to Take Action

By Lâle White  bio As XIFIN predicted, the PAMA reporting exercise has resulted in significant proposed laboratory fee cuts. In fact, the multi-year decrease for the top 20 laboratory tests … [Read more...]

DATA

New Laboratory IT Systems Transfer Standard Brings True Interoperability Closer to Reality

The vision of true interoperability of electronic health care information has moved one step closer to reality with the release of a new information technology (IT) standard. Called LIVD, the standard … [Read more...]

FOCUS ON

Kickbacks: Does OIG Green Light of Free Product Replacements Open Door for Lab Freebies?

The OIG's aversion to offering freebies of any kind to referral sources is longstanding and well known. So the Aug. 25, 2017 Advisory Opinion clearing the way for a provider to replace spoiled … [Read more...]

MEDICARE COVERAGE

Reimbursement Trends: 8 Molecular Assays Score Big Coverage Wins from Medicare, Private Insurers

Molecular labs continue to gain ground with insurers. This summer, 8 more genetic assays received positive coverage decisions—4 from Medicare and 4 from private insurers. The winners included Genomic … [Read more...]

COMPLIANCE

Case of the Month: Court Says Labs Must Verify Medical Necessity of Tests that Physicians Order

More often than not, when a lab gets busted for falsely billing Medicare, medical necessity—or the lack thereof—is the reason. While the lab must certify that billed tests are medically necessary, … [Read more...]

TOP OF THE NEWS

Two App Marketplaces Ramping Up Consumer Genomics Offerings

Two personal genome app marketplaces — Sequencing.com (San Francisco, Calif.) and Helix (San Carlos, Calif.)— are now up and running offering consumers a combined total of 55 products for purchase. … [Read more...]

INNOVATION

New Laws: Do-It-Yourself Kits Bring Lab Testing to the Home

Health care in the 21st century is moving toward consumerization of medicine, patient empowerment and increased price awareness resulting from higher out-of-pocket medical expenditures. The growth of … [Read more...]

FALSE CLAIMS

Case of the Month: Foundation Medicine Faces Lawsuits from Shareholders & a Business Rival

Astart-up diagnostics firm on the precipice of a lab product breakthrough becomes a Wall Street darling. But, alas, the product fails to meet its lofty expectations. The firm's stock tanks and the … [Read more...]


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