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This biweekly newsletter provides concise, independent coverage and analysis of fast-breaking lab, pathology, blood banking, imaging and diagnostic radiology news from the Nation's Capital.
You'll find out about:
- Medicare payment and policy directives Billing guidelines and coding changes for diagnostic facilities
- CLIA & MQSA regulatory mandates, changes and interpretations
- Congressional actions & legislative initiatives
- Federal compliance requirements
- OIG anti-fraud initiatives
- Stark self-referral prohibitions
Plus you will get other legal news regarding FDA oversight of in vitro diagnostics, blood banks, and radiological devices OSHA, NRC, and state safety standards.
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 | NIR January 15, 2007 (full PDF issue) |
| FDA clears new blood test to screen for Chagas disease
RVU changes in 2007 mean lower pathology PC payments, higher rates for flow cytometry, other pathology TC codes
Lab, pathology lobbies line up their priorities for the new Congress––see Focus
—Medicare physician fee fix
—Bonus payments & P4P programs
—Competitive bidding for Part B lab services
—Expanded ‘home brew’ controls
—Cytology proficiency testing
Feds offer states financial gains to beef up false claims actions
CMS yanks notice to contractors on ending the pathology TC ‘grandfather’ protection
Down syndrome screening advised for all expectant mothers
Washington Watch: On a personal note
Full Article |
| Claims Will Be Paid at Correct ’07 Rates, CMS Assures Doctors |
| Pathologists and other physicians can rest assured that their Part B claims for services on and after January 1, 2007, will be paid at the new rates mandated by Congress, the Centers for Medicare & Medicaid Services says. In enacting the Tax Relief & Health Care Act (P.L. 109-432) last month, Congress approved a zero update to physician fees, averting the 5% cut scheduled to take effect under the statutory update formula.
Full Article |
| Medicare Fee Fix Tops Physicians’ Legislative Agenda |
| Pathologists and other physicians escaped a 5% cut in their Medicare fees this year and got a zero update instead from the lame-duck session of the GOP-run 109th Congress. Now, they face an even steeper cut in 2008 unless the Democratic-run 110th Congress intervenes.
Full Article |
| FDA Okays New Blood Screening Test for Chagas Disease |
| The Food & Drug Administration has approved a new test to screen blood donors for a blood-borne parasite that causes Chagas disease, a serious and potentially fatal parasitic infection. The test, called the Ortho T. cruzi ELISA Test System, detects antibodies to the Trypanosoma cruzi parasite and is the first such test approved by the FDA.
Full Article |
| Pathology RVU Changes = Lower PC Rates, Some TC Gains |
| Though Congress intervened to block a 5% across-the-board cut in Medicare spending for physician services in 2007, pathologists will still see a steep cut this year. The Centers for Medicare & Medicaid Services projects a 6% cut in total pathology allowed charges, due mainly to changes in practice expense relative value units (RVUs) in the Part B physician fee schedule.
Full Article |
| Key Laboratory, Pathology Priorities for the New Congress |
| Even before officially taking control of the 110th Congress, Democratic leaders promised to give priority to a broad range of healthcare issues, including coverage of an estimated 47 million uninsured Americans, expanded stem cell research, and changes to the Medicare prescription drug benefit and Medicare managed care program.
Full Article |
| CMS Rescinds Notice Ending Pathology TC Protection |
| In a January 5, 2007 transmittal, the Centers for Medicare & Medicaid Services made it official—the agency told its local contractors to disregard previous instructions and continue to make Part B payments to qualified independent laboratories for the technical component of pathology services to hospital inpatients and outpatients for another year (CMS Change Request 5468).
Full Article |
| States Get Financial Incentive to Beef Up False Claim Laws |
| The clinical laboratory industry knows all too well the legal hazards posed by the federal False Claims Act (FCA). Throughout the 1990s in particular, the government wielded the Act to wring multimillion-dollar settlements from large labs nationwide to resolve allegations of fraudulently billing Medicare and Medicaid for medically unnecessary testing.
Full Article |
| Washington Watch: On a Personal Note |
| Here, we typically shine the spotlight on what’s doing with politicians, administration officials, and industry lobbies. This time, we’d like the light to shine on a dedicated public servant we’ve known for a long time.
Full Article |
| Down Syndrome Screening Urged for All Pregnancies |
| The American College of Obstetricians & Gynecologists (ACOG) is recommending that all pregnant women, regardless of age, be offered screening for Down syndrome and other fetal chromosomal abnormalities in the first trimester of pregnancy, according to revised clinical management guidelines published in this month’s issue of Obstetrics & Gynecology.
Full Article |
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