New CMS TCET Rule Likely Won’t Hasten Medicare Coverage of Breakthrough Devices
Recently proposed rule seems too stringent to reduce the lag between FDA approval and Medicare coverage.
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Proposed Rule Puts Labs at Greater Risk of FCA Liability
CMS recently proposed a rule that would make the False Claims Act rule the standard for overpayments under the Affordable Care Act regulations.
CMS Proposes Modest Increase to Hospital IPPS Rates
Unsurprisingly, the American Hospital Association and other industry groups don’t think that increase is anywhere near adequate.
Correction: PAMA Relief—CMS 1450 14x TOB Labs DO Count!
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Medicare Appeals: CMS Tries to Speed the Process & Unjam the Backlog
From - National Intelligence Report
On Oct. 2, CMS proposed revisions to rules for appealing adverse Medicare claim determinations (Proposed Rules). The goal is to speed the process that…
Florida Doctor Jailed 5 Months for Lying to a Medicare Auditor
From - National Intelligence Report
Lying to a Medicare auditor or otherwise obstructing a Medicare audit is a crime that can get you jailed…
Medicare Reimbursement: Labs Propose Solutions to PAMA Part B Pricing Problem
From - National Intelligence Report
CMS recently issued its annual proposed rule on 2019 Medicare Part B reimbursement. For many labs, the number one concern is…
Stark Relief: Comments Urge Change but Don’t Expect Anything Too Dramatic
From - Diagnostic Testing & Emerging Technologies
After decades of resistance, CMS is giving serious indications of its willingness to entertain changes to relieve the…
CMS Mulls Stark Law Relief: This Time It May Be for Real
From - National Intelligence Report
After decades of complaining about the Stark Law, the lab industry may now have an actual opportunity to secure meaningful relief…
How to Adjust to the April 2018 Medicare Beneficiary Cards
By Sean McSweeney bio
In a press release on May 30, 2017, the Centers for Medicare & Medicaid Services (CMS) commented regarding their fraud prevention initiative program and their planned changes regarding…
PAMA Reimbursement: CMS Explains How to Get ADLT Status for New Lab Tests
From - National Intelligence Report
Although the 2018 market-based Clinical Laboratory Fee Schedule (CLFS) is officially in effect, implementation of the new PAMA Part B payment rules for lab tests remains…
