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...]
HEALTH CARE REFORM
Industry Buzz: When It Comes to Obamacare, Uncertainty Is the Only Certainty
January 15, 2019
Last month, a U.S. District Court Judge ruled that the Affordable Care Act, aka Obamacare, is unconstitutional—not just the individual mandate but the whole bloody law. But if you were expecting … [Read more...]
HEALTH CARE REFORM
Case of the Month: Texas Court Strikes Down Obamacare—So, Now What?!
December 31, 2018
What came as a Christmas gift to many Republicans could be a lump of coal in the stockings of health insurers and the patients they cover. On Dec. 14, a federal judge in Texas did the unthinkable by … [Read more...]
HEALTH CARE REFORM
Compliance Perspectives: PAMA Pitfalls & Survival Strategies
December 31, 2018
PAMA's deep Medicare reimbursement cuts have had a devastating impact on the lab industry. Recent CMS changes in the 2019 Final Rule should provide a degree of pricing relief but not until 2021. In … [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...]
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...]
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...]
TESTING TRENDS
New Studies ID Strategies to Address Overuse of Laboratory Testing
October 29, 2018
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...]
