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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 July 9, 2008 (full PDF issue) |
| CMS invites public comment on establishing prices for new CPT codes to be added to the 2009 lab fee schedule
Pathologists, other physicians urged to sign up for the 2008 Physician Quality Reporting Initiative––‘It’s not too late,” says CMS, ‘to qualify for bonus payment’
CMS finalizes hospital conditions of participation requirements to prevent hepatitis C infection in blood transfusions
Fee for metabolic panel code 80047 hit with steep reduction
CMS clarifies coverage rules for screening pelvic exams––see Medicare Preventive Service Update
Protest halts A/B MAC contract to National Heritage Insurance Corp.
Lab Institute 2008 Alert
Full Article |
| CMS Proposes 2009 Physician Fee Schedule Rule |
| Pathologists and other physicians face a negative update of 5.4 percent under the proposed 2009 Medicare physician fee schedule rule just released by the Centers for Medicare and Medicaid Services. The figure could be revised, CMS noted, in the final rule to be published in November.
Full Article |
| Senate Set for Showdown on Medicare Physician Fee Fix |
| At press time, as Congress reconvenes after the Independence Day recess, the Senate is set to consider Medicare legislation that would roll back the July 1 cut of 10.6 percent in pathology and other physician fees and grant payment increases through 2009, extend the pathology "grandfather" protection for independent clinical laboratories, and repeal the lab competitive bidding demonstration.
Full Article |
| CMS Invites Input on Pricing New Lab Codes for 2009 |
| The Centers for Medicare and Medicaid Services will hold a July 14 public meeting to receive recommendations on assigning payment rates for CPT codes new to next year’s Part B clinical laboratory fee schedule.
Full Article |
| ‘You Still Have Time to Sign Up for 2008 Quality Reporting’ |
| That’s the message to pathologists and other physicians from a top official at the Centers for Medicare and Medicaid Services, explaining new options to make it easier to participate in the voluntary Physician Quality Reporting Initiative (PQRI) for 2008 and qualify for a bonus payment of 1.5 percent on total allowed charges payable under the physician fee schedule during the approved reporting period. Participants also receive confidential feedback on their performance relative to all other professionals who successfully reported the same measures.
Full Article |
| CMS Finalizes Rule on Hepatitis C and Transfusion Safety |
| The Centers for Medicare and Medicaid Services published a final rule in the June 27 Federal Register aimed at preventing hepatitis C virus (HCV) infections among patients in hospitals that receive Medicare and Medicaid funding. The rule also aims to "create opportunities for disease prevention that, in most cases, can occur many years after recipient exposure to a donor," CMS noted.
Full Article |
| Medicare Preventive Service Update |
| Citing misleading information in the Medicare manual, the Centers for Medicare and Medicaid Services has issued the following clarification of coverage rules for a screening pelvic exam (including a clinical breast exam):
Full Article |
| CMS Lowers Fee for Metabolic Panel Code 80047 |
| In a steep reduction in reimbursement for CPT 80047—Basic metabolic panel (ionized calcium)—Medicare began paying for the panel at the rate for 80048, Basic metabolic panel (total calcium), effective July 1. CPT 80047 was added to the 2008 Part B lab fee schedule that took effect Jan. 1.
Full Article |
| Protest Halts MAC Contract to National Heritage Insurance |
| The recent award of a Medicare A/B MAC contract to National Heritage Insurance Corp. is on hold, following a protest filed with the Government Accountability Office. The GAO is reviewing the issue and is due to rule in early September, CMS announced. The dispute affects clinical labs, pathologists, and other providers in Alaska, Washington, Oregon, and Idaho (Jurisdiction 2).
Full Article |
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