LEGISLATION

New Laws: Proposed Federal Legislation Would Allow Medicare Payment for Genetic Counselling

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

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...]

FOCUS ON

Medicare Reimbursement: 2019 CLFS Offers Some PAMA Relief But Not Nearly Enough

The battle between CMS and the lab industry over Medicare Part B pricing for lab tests is intensifying notwithstanding the ACLA's recent court loss and the supposed relief offered by the agency in its … [Read more...]

TESTING TRENDS

New Studies ID Strategies to Address Overuse of Laboratory Testing

The cost and quality of care are the focus of improvement initiatives happening at health systems across the country. Like imaging and other procedures, the necessity of laboratory testing, too, is … [Read more...]

HEALTH CARE REFORM

Latest Legal Challenge to ACA May Mean a Hot Mess for Insurance Markets

After a series of setbacks, Republicans challenging the constitutionality of the Affordable Care Act (ACA) and its individual mandate are back at it. And this time they may win. Here's a look at the … [Read more...]

FEE SCHEDULES

Medicare Reimbursement: Labs Propose Solutions to PAMA Part B Pricing Problem

CMS recently issued its annual proposed rule on 2019 Medicare Part B reimbursement. For many labs, the number one concern is the proposed extension of the controversial PAMA "market pricing" scheme to … [Read more...]

LEGISLATION

Case of the Month: ACA Constitutionality Is Back in Play & This Time It May Get Taken Down

After a series of court setbacks, Republicans challenging the constitutionality of Obamacare, aka, the Affordable Care Act (ACA) are back at it. And this time they got a good shot to win. Here's a … [Read more...]

FALSE CLAIMS

PAMA: ACLA Loses Court Lab Fees Battle But May Still Win Regulatory War

It was a long shot to begin with. But that doesn't ease the disappointment of what happened in a Washington, DC courtroom when a federal judge tossed a lab industry lawsuit challenging the legality of … [Read more...]

FOCUS ON

Industry Buzz: ACA Constitutionality Is Back in Play

After a series of court setbacks, Republicans challenging the constitutionality of Obamacare, aka, the Affordable Care Act (ACA) are back at it. And this time they may win. Beating a Dead Horse? The … [Read more...]

CMS

Reimbursement Trends: OIG Report Shows Slight Uptick in 2017 Medicare Part B Lab Payments

On Jan. 1, 2018, the new Medicare Part B PAMA Clinical Laboratory Fee Schedule (CLFS) in which lab test reimbursements are based on a single national fee lab schedule for lab tests rather than 57 … [Read more...]


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