TAG:
medicaid managed care plan
Nine Lab Groups Say New NCCI Policy Is Inconsistent
CEO SUMMARY: By its name alone, the National Correct Coding Initiative (NCCI) Policy Manual implies that it will be accurate and consistent with other coding initiatives. But nine groups representing various clinical laboratories say NCCI guidelines that the federal Centers for Medicare a…
New Federal Law Changes How CMS Sets Lab Prices
CEO SUMMARY: CMS wanted more power to cut the prices it pays for clinical lab testing. A significant part of the lab industry wanted more transparency and consistency in how CMS established coverage guidelines and prices for new lab tests. Congress appears to have attempted to craft a law…
“Free Testing” Strategy Stirs the Pot in Tenn.
CEO SUMMARY: In Tennessee, the state’s Medicaid HMO plan has been at odds with Quest Diagnostics Incorporated, which is using the “free testing” strategy to expand its share of the market. In recent months, TennCare Select has taken active steps to insure its physicians understand tha…
“Waiver of Charges”: What Makes It Work
CEO SUMMARY: Little-used in the 1990s, when laboratory test ordering and billing practices were under intense scrutiny by federal regulators, the strategy of “free testing” is popping up in more regions around the country. To comply with compliance guidelines, labs using this strategy g…
“June 23, 1997 Intelligence: Late Breaking Lab News”
Joint Venture Hospital Laboratory network (JVHL) of Detroit added a not her hospital system to its growing regional laboratory network. M-Labs, the laboratory division of the University of Michigan Health System, joined JVHL. This is the eighth hospi…
CURRENT ISSUE
Volume XXVII, Number 16 – November 16, 2020
UNWELCOME CHANGES to how labs do business are forcing labs to cope with high demand for COVID-19 testing while dealing with government and private payers interfering with normal operating procedures. Medicare has new requirements and payment rates for COVID-19 tests. Also reported here are UnitedHealthcare’s new Laboratory Test Registry Protocol, and California’s new COVID-19 testing laboratory that is diverting lab instruments, supplies, and test kits away from hospital and independent labs in the state.
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