HEALTH CARE REFORM

High-Deductible Plans Tied to Reduced Use of Health Care, Including Diagnostic Testing

People enrolled in high-deductible health plans (HDHPs) cut their use of health services, including laboratory testing, according to a study published in the October issue of Health Affairs. HDHPs … [Read more...]

HEALTH CARE REFORM

High-Deductible Plans Tied to Reduced Use of Health Care, Including Diagnostic Testing

People enrolled in high-deductible health plans (HDHPs) cut their use of health services, including laboratory testing, according to a study published in the October issue of Health Affairs. HDHPs … [Read more...]

HEALTH CARE REFORM

PAMA Implementation: PLA Codes for Advanced Dx Tests Are Off to a Flying Start

PAMA implementation is so sweeping that it requires a shift in not just payment paradigm but also CPT codes. This has served as the impetus for development of a new class of codes known as … [Read more...]

ACA INSTABILITY

Laboratory Industry Faces Uncertain Regulatory Policy

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...]

UNANIMOUS ABOUT PRIORITY

Association Representatives Say PAMA is #1 Concern for Lab Industry

In the kick-off event of G2 Intelligence's 2017 Laboratory Institute (Washington D.C.; Oct. 25-27), representatives of the biggest laboratory-related associations shared their top priorities, which … [Read more...]

REIMBURSEMENT TRENDS

Billing & Coding: Proposed New Molecular Pathology Crosswalk Codes for 2018

The newly proposed 2018 Clinical Laboratory Fee Schedule includes over 130 crosswalked CPT codes, including roughly 30 new codes for molecular pathology tests. New Crosswalked Molecular Pathology … [Read more...]

MEDICARE COVERAGE

“Applicable Labs”: The Fly in the PAMA Market-Based Pricing Ointment

The lab industry has no objection to basing Medicare payments for lab tests on the actual rates charged to payors in the private market. What has the industry so upset is how CMS has executed the … [Read more...]

MEDICARE COVERAGE

Medicare Reimbursements: Part B Lab Payments Slightly Down for 2016, Reports OIG

The OIG released its report on Medicare Part B payments for lab tests in 2016. The punchline: Lab payments over the past three years remain incredibly consistent in terms of both amount and … [Read more...]

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...]

HEALTH CARE REFORM

Labs to CMS: Push Back PAMA & Add Hospital Labs to CLFS Mix

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...]


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