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U.S. Department of Health and Human Services

Attorney Advises Labs to Track Genetic Test LCDs

CEO SUMMARY: Skyrocketing numbers of genetic test referrals and telehealth claims since 2016 are getting the full attention of both federal prosecutors and auditors from Medicare and private health insurers. The DOJ has filed criminal cases against a growing number of telehealth pro…

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On Appeal, ACLA Gains PAMA Victory in Court

CEO SUMMARY: Last month, a U.S. Court of Appeals issued a ruling that criticized how the Department of Health and Human Services originally implemented the Protecting Access to Medicare Act of 2014 (PAMA). This ruling was a win for the American Clinical Laboratory Association in its…

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PAMA Cuts Might Be Reduced to Zero for 2023

CEO SUMMARY: Congress may soon vote on a new bill that permanently reduces the amount of price cuts to Medicare Part B lab test prices, as specified under the Protecting Access to Medicare Act of 2014 (PAMA). The Saving Access to Laboratory Services Act (SALSA) eliminates a 15% paym…

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OIG: 25% of Medicare Inpatients ‘Harmed in Hospitals’ Pre-COVID

CEO SUMMARY: This year’s report to Congress on patient harm in hospitals—prepared by the Office of the Inspector General (OIG)—determined that one in four Medicare beneficiaries suffered harm while an inpatient in a hospital. The report garnered little attention outside the he…

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Judge Vacates Provision in No Surprises Act

  CEO SUMMARY: It …

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March 14, 2022 Intelligence: Late-Breaking Lab News

Telehealth proved to be popular with Medicare patients during the SARS-CoV-2 pandemic. The federal U.S. Department of Health and Human Services (HHS) reported telehealth visits for Medicare beneficiaries increased in 2020 by an incredible 63 times—from approximately 840,000 in 2019 to 52.7 m…

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