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Revisiting the ‘Substantially in Excess Rule’

BY NOW, NEARLY EVERY LAB MANAGER knows that Medicare lab test fee cuts will commence in just 13 months, on Jan. 1, 2018. The federal Centers for Medicare & Medicaid Services estimates that the final rule for PAMA private payer market price reporting will produce cuts of $5.4 billion over 10 years. (See TDRs, November …

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