The battle between CMS and the lab industry over Medicare Part B pricing for lab tests could be on the road to resolution notwithstanding the ACLA's recent court loss. But even as the legal battle … [Read more...]
PAMA
Medicare Reimbursement: CMS Provides Needed PAMA Relief—But Newly Covered Hospital Labs Must Report in 2019
January 21, 2019
ENFORCEMENT
Provider Fined for Not Taking Compliance Measures Required by Its CIA
January 19, 2019
Case: Nearly 10 years ago, a new Affordable Care Act rule requiring labs and other providers to investigate their credit balances for potential Medicare overpayments took effect. In 2015, Pediatric … [Read more...]
CMS
CLIA: CMS Proposes 20% Fee Increase—and Further Increases Could Follow
January 15, 2019
As if Year 2 of PAMA lab fees wasn't enough, CMS dished out another dose of agita to the lab industry: CLIA fees will be going up 20%, effective this year. Background For those of you who are new to … [Read more...]
CMS
Post-PAMA: Government Report Warns of Medicare Overspending(!) for Lab Tests
December 31, 2018
As if the deep price cuts inflicted by PAMA weren't infuriating enough, now the US Government Accountability Office (GAO) is claiming that labs may be getting overpaid. In a report issued late … [Read more...]
FOCUS ON
Medicare Reimbursement: CMS Provides Needed PAMA Relief—But Newly Covered Hospital Labs Must Report in 2019
December 21, 2018
The battle between CMS and the lab industry over Medicare Part B pricing for lab tests could be on the road to resolution notwithstanding the ACLA's recent court loss. But even as the legal battle … [Read more...]
CORRECTION
Correction: PAMA Relief—CMS 1450 14x TOB Labs DO Count!
December 20, 2018
Two articles appearing on the G2 website, "CMS Offers Some PAMA Relief But Not Nearly Enough" (G2 Compliance Advisor/Lab Compliance Advisor) and "2019 CLFS Offers Some PAMA Relief But Not Nearly … [Read more...]
CORRECTION
Correction: PAMA Relief—CMS 1450 14x TOB Labs DO Count!
December 20, 2018
Two articles appearing on the G2 website, "CMS Offers Some PAMA Relief But Not Nearly Enough" (G2 Compliance Advisor/Lab Compliance Advisor) and "2019 CLFS Offers Some PAMA Relief But Not Nearly … [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...]
PAMA
Medicare Reimbursement: ACLA Court Appeal Maintains 2-Front War for PAMA Relief
December 14, 2018
It's official. The ACLA is appealing the September federal court decision to dismiss its PAMA lawsuit (ACLA v. Azar). Here's a quick rundown of the three things you need to know. 1. The Legal … [Read more...]
COMPLIANCE PLANS
OIG Monthly Work Plan Review: November 2018
December 3, 2018
This month, there were six new Work Plan items, two of which have implications for at least some labs. 1. CDC's Oversight of the President's Emergency Plan for AIDS Relief Funds Issue: Through the … [Read more...]
