Diagnostic Testing and Emerging Technologies
LAB COMPLIANCE ADVISOR
LAB INDUSTRY REPORT
NATIONAL LAB REPORTER
As of August 31, 2022, labs and other providers must use the new ABN labeled with the appropriate federal OMB Number (0938-0566) and CMS-R-131 to ensure they can bill Medicare beneficiaries for any lab tests or other services that Medicare doesn’t cover.
According to a recent OIG report, CMS is not doing a good job collecting the Medicare overpayments OIG auditors are uncovering. However, CMS recently rejected almost all of the recommendations in that report, suggesting all is not well between the two federal agencies.
OIG says the agency is leaving millions of dollars on the table, but CMS doesn’t want to hear it.
Renewed Advance Beneficiary Notice of Noncoverage (ABN) Form (OMB 0938-0566) must be used as of August 31.
D.C. Circuit Court of Appeals agrees with lab industry that CMS got Medicare lab pricing all wrong, but says it’s unable to intervene.
