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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 December 17, 2007 (full PDF issue) |
| HHS advisory panel recommends new directions in federal oversight of genetic testing: see the Focus
—New draft report to the HHS Secretary released for comment
—General advice to HHS
—CMS urged to strengthen CLIA oversight, including development of proficiency testing or robust alternatives
—FDA urged to take broad consultative approach to regulating lab-developed tests
—Coverage and reimbursement gap
—Regulatory status of currently available genetic tests
—Oversight at the state level
Medicare Claims Advisory: January 1 is key NPI deadline
Medicare continues to reduce improper claims payments
Washington Watch: Waiting for Medicare’s final 2008 lab fee schedule
Full Article |
| Time Running Out for Physician Fee Fix |
| Prospects for congressional action to block a 10% cut in Medicare payments to pathologists and other physicians next year are murky at press time, as House and Senate negotiators remain at odds over a fee fix and how to pay for it. Though blocking the cut could be attached to an omnibus spending bill, Senate Finance chairman Max Baucus (D-MT) has raised the possibility that the pay issue may even be put off until January.
Full Article |
| CMS Forging Ahead with Lab Bidding Demo in San Diego |
| The Centers for Medicare & Medicaid Services took another big step toward the launch of its Part B lab competitive bidding demonstration with a December 5 bidder’s conference for clinical labs in San Diego, the first of two sites for the pilot project. z
Full Article |
| Advisory Panel Prescribes Changes for CMS, FDA in Genetic Test Oversight |
| As genetic testing becomes more widely embedded in clinical practice and as technological advances transform the way the testing is performed, what adaptations are needed in federal oversight policy to address quality and safety concerns, and what value for patients would be gained by additional and/or revised government regulation?
Full Article |
| January 1—Key Deadline for Use of National Provider Identifier |
| Effective January 1, 2008, Medicare contractors will reject 837I electronic claims and UB04 paper claims without a National Provider Identifier (NPI) in fields identifying the primary provider (billing and pay-to). Legacy identifiers paired with NPIs in the primary provider fields will still be acceptable, as will legacy-only numbers in secondary provider fields.
Full Article |
| Medicare Improper Claims Payment Continues to Drop |
| Citing stepped-up oversight, the Centers for Medicare & Medicaid Services said the error rate for Medicare fee-for-service (FFS) claims continued to fall this year, to 3.9% from 4.4% in 2006 and 14.2% in 1996, when the improper payment rate was first reported.
Full Article |
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