Getting Republicans and Democrats to agree on anything these days is a Herculean task, even during a global pandemic. One of the rare points of consensus is with regard to the notion that all … [Read more...]
Testing Strategy
The Biden Administration Initiates New Plan for National COVID-19 Testing
February 21, 2021
As with any other aspect of public life, the philosophy and views of the individual occupying the White House ultimately impact the direction of healthcare and diagnostics in the U.S. However, when a … [Read more...]
Enforcement Alert
OIG to Audit Medicare Part B Lab Testing During the Pandemic
February 20, 2021
Fraudulent and abusive billing of lab services has long been a favorite target of OIG enforcers. And with the unprecedented surge of COVID-19 testing during the public health emergency, it’s hardly … [Read more...]
Focus On
How the Transition from Trump to Biden Will Affect Federal Regulation and Reimbursement
February 19, 2021
“Meet the new boss. . . same as the old boss.” The Who’s “Won’t Get Fooled Again” is a rock classic; but as far as U.S. presidents and federal regulation are concerned, the “new boss” is almost … [Read more...]
HHS
Hospital Price Transparency Is Here—But How Will It Be Enforced?
January 29, 2021
With just three days left in 2020, last-ditch efforts to derail HHS’ controversial new hospital transparency rules before they took effect on Jan. 1 failed when the U.S. Court of Appeals for the … [Read more...]
Utilization Management
CMS Proposes New Regulations to Streamline and Speed Up Payor Prior Authorization
January 4, 2021
As its days dwindle down, the Trump administration proposed regulatory changes designed to ease prior authorization rules and improve provider and patient access to medical records. Specifically, the … [Read more...]
REIMBURSEMENT
Labs and Private Payors Clash Over Reimbursement of COVID-19 Testing
November 27, 2020
Things are getting ugly. The unfortunate convergence of resurgent COVID-19 cases, lingering testing supply bottlenecks and Thanksgiving are once more stretching labs to the breaking point and fraying … [Read more...]
CMS Says Improper Medicare Fee-for-Service Payments Are Down $15 Billion Since 2016
November 17, 2020
CMS is claiming that its “aggressive corrective actions” have saved taxpayers over $15 billion in improper Medicare Fee-For-Service (FFS) payments over the past four years. According to the November … [Read more...]
Business Trends
Labs Partner with Airlines to Offer COVID-19 Testing to Travelers
November 17, 2020
civCOVID-19 has greatly complicated air travel from country to country and even state to state. While entrance rules vary from place to place, a number of jurisdictions are allowing travelers to avoid … [Read more...]
Reimbursement
CMS Disguises COVID-19 Rate Cut as Incentive to Process Tests Faster
November 2, 2020
Few would argue that the current turnaround time for COVID-19 testing is too long. But there are good reasons why it’s taking labs so long to process and report test results, including unprecedented … [Read more...]
