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 | GCR June 2008 (full PDF issue) |
| OIG cuts providers some slack on integrity agreements
Court tosses out pathology anti-markup lawsuit
Committee recommends additional oversight of genetic tests
CMS mandates switch to single Medicare ABN by Sept. 1
Where have all the non-waived POLs gone? See Perspectives
CMS revisits controversial Stark provision
News in brief
Full Article |
| Court Dismisses Case Against Anti-Markup Rule |
| A federal district court May 5 vacated a preliminary injunction order blocking the Centers for Medicare & Medicaid Services from enforcing a provision in an anti-markup rule that would have made substantial changes to the way physicians bill for anatomic pathology diagnostic testing services (Atlantic Urological Associates PA v. Leavitt).
Full Article |
| OIG Modifies Self-Disclosure Protocol: Integrity Agreements No Longer Required |
| Health care providers who resolve fraud matters using the Department of Health and Human Services Office of Inspector General’s (HHS OIG) provider self-disclosure protocol generally will no longer be required to enter into corporate integrity agreements (CIAs).
Full Article |
| Committee Recommends Additional Oversight of Genetic Tests |
| In its final report on gaps in the oversight of genetic testing, the Health and Human Services Secretary’s Advisory Committee on Genetics, Health & Safety (SACGHS) has urged the Centers for Medicare & Medicaid Services (CMS) to increase proficiency testing in this rapidly expanding market. The panel also recommended that the Food & Drug Administration (FDA) expand its regulation to all lab tests, including lab-developed tests (LDTs).
Full Article |
| CMS Mandates Switch to Single Medicare ABN by Sept. 1 |
| The Centers for Medicare & Medicaid Services (CMS) has issued a revised Advanced Beneficiary Notice (ABN) that clinical laboratories and other providers billing Part B must use by no later than September 1 of this year.
Full Article |
| Where Have All the Non-Waived POLs Gone? |
| Before the Clinical Laboratory Improvement Amendments of 1988 (CLIA) took effect in 1992, significant numbers of primary care physician office laboratories (POLs) performed tests that are now classified as moderate and high complexity. At that time, no quality requirements existed for POLs and reimbursement for lab tests was generous in comparison to today, since managed care was virtually nonexistent and Medicare fee cuts and freezes had not yet begun.
Full Article |
| CMS Revisits Controversial Stark Provision |
| The Centers for Medicare & Medicaid Services (CMS) is revisiting a controversial provision it finalized in the Phase III Stark rule in 2007 that requires doctors with financial interests in physician organizations to "stand in the shoes" of those organizations for the purpose of complying with the physician self-referral law.
Full Article |
| News in Brief (0806) |
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Genetic Anti-Discrimination Bill: President Bush is expected to sign into law legislation protecting patients from discrimination based on their genetic information. The legislation, H.R. 493 as amended, cleared Congress May 1. The measure bars employers from using genetic information in decisions on hiring, firing, job placement, or promotion. It prohibits group health plans and other health insurers in both the group and the individual market from using genetic information to deny coverage or set premium…
Full Article |
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