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...]
HEALTH CARE REFORM
Latest Legal Challenge to ACA May Mean a Hot Mess for Insurance Markets
October 22, 2018
FEE SCHEDULES
Medicare Reimbursement: Labs Propose Solutions to PAMA Part B Pricing Problem
October 15, 2018
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
October 15, 2018
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
October 11, 2018
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
October 11, 2018
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
October 10, 2018
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...]
HEALTH CARE REFORM
Health Insurance Market: Two Recent Changes & Their Impact on Labs
October 1, 2018
Amid all the talk of sweeping reform of the health insurance marketplace, the smaller, interim changes get overlooked despite their direct impact on labs and other providers. Two such changes took … [Read more...]
HEALTH CARE REFORM
Medicare Reimbursement: How CMS Price Transparency Proposal Could Hurt Labs & Patient Relations
September 24, 2018
Last April, CMS issued a proposed rule to make Medicare rates more transparent. While designed to "empower patients and reduce administrative burden," the proposed changes would literally come at a … [Read more...]
PAMA
PAMA Unlocks Golden Age for Innovative Diagnostics
July 30, 2018
By Chance Scott bio The publication of the 2018 Clinical Laboratory Fee Schedule (CLFS) in January saw a long and heated debate within the lab community come to fruition. When Congress … [Read more...]
HEALTH CARE REFORM
ACA: DOJ Won’t Defend Individual Mandate in Court—But 16+ States Will
June 18, 2018
One of the DOJ's principal roles is to defend the federal laws in court cases challenging their constitutionality. But the agency has made it known that it will not be doing that in a lawsuit brought … [Read more...]
