TAG:
medicare physician fee schedule
Prostate Biopsy Claims Affected by Policy Change
CEO SUMMARY: Quietly, with no fanfare and little advance public notice, the Medicare program is taking steps to change reimbursement policy for prostate biopsies. On August 7, 2012, Palmetto GBA adopted the new policy published on January 1, 2012, by the National Correct …
Paper Requisition Signature Rule Contradicts 2001 Actions
CEO SUMMARY: Last year, the Centers for Medicare and Medicaid Services (CMS) used publication of the proposed 2011 Medicare Physician Fee Schedule to introduce new language that would require, as of January 1, 2011, that all paper requisitions for clinical laboratory tests for Me…
More Reimbursement Threats for Lab Testing
WE ARE NOW WELL INTO THE FIRST MONTH OF 2011 and already there are plenty of signs that reimbursement for both clinical laboratory testing and anatomic pathology testing will come under siege from a variety of sources this year. Take, for example, the rather rapid action by the Centers for M…
Did CMS Err in Issuing New Anti-Markup Rules?
CEO SUMMARY: In the latest anti-markup rules that took effect on January 1, CMS may have unintentionally stated that the anti-markup rule doesn’t apply when a pathologist is reviewing histology slides. While the rule itself is unclear, the commentary that accompanies the rule s…
New Senate Bills Include Repeal of Competitive Bid
CEO SUMMARY: One proposed Senate bill would repeal the laboratory competitive bidding demonstration project, replace the 10.1% cut to physician fees with a 1.1% increase, and extend the so-called technical component (TC) grandfather clause. Senator Max Baucus (D-Montana),…
CMS Expected to Revise Condo Lab & TC/PC Rules
CEO SUMMARY: Expectations are that the Centers for Medicare & Medicaid Services (CMS) will take further action to rein in anatomic pathology arrangements used by physicians to capture revenue from their patient referrals. This may happen as soon as next month, when CMS publishes the 2…
Powerful Trends Reshaping Anatomic Path Profession
CEO SUMMARY: THE DARK REPORT presents its newest biannual review of macro trends reshaping the anatomic pathology profession. These macro trends reveal a profession undergoing change and transformation on multiple fronts. New competitors are crowding into the market, payers and accreditin…
CMS Spotlights AP as It Delays Anti-Markup Rule
CEO SUMMARY: When Medicare officials postponed implementing a new anti-markup rule late last month, it did so because of questions about how the new rule will be applied. However, the Centers for Medicare & Medicaid Services (CMS) did implement an aspect of the anti-markup rule on Jan…
December 31, 2007 “Intelligence: Late Breaking Lab News”
There’s late-breaking news affecting new federal rules for the anti-markup provisions scheduled to become effective on January 1, 2008. Just days ago, the federal Centers for Medicare & Medicaid Services…
Medicare Rules Tighten Anatomic Path Mark-ups
CEO SUMMARY: Effective on January 1, 2008, new rules take effect that restrict the circumstances under which physicians can mark up the anatomic pathology services provided to their patients. However, ambiguities in how the rules are written are likely to make the intent of the new rules …
CURRENT ISSUE
Volume XXXI, No. 5 – April 8, 2024
The fragmentation of consumer markets is reflected in clinical lab services, and The Dark Report examines this trend and how it will impact labs in the coming years. Also, The Dark Report notes that the FDA has issued a controversial memo to reclassify many high-risk IVD assays.
See the full table of contentsHow Much Laboratory Business Intelligence Have You Missed?
Lab leaders rely on THE DARK REPORT for actionable intelligence on important developments in the business of laboratory testing. Maximize the money you make-and the money you keep! Best of all, it is released every three weeks!
Sign up for TDR Insider
Join the Dark Intelligence Group FREE and get TDR Insider FREE!
Never miss a single update on the issues that matter to you and your business.