Yesterday, Palmetto posted updated fees on the 6 codes for which CCLA had submitted gapfill information, plus two codes that were not part of the gapfill project. The changes range from 9% to 189% increase:
Blue plans attempting to reconcile the non-standard claims filing rules imposed by BCBS associated with the termination of the BlueCard program are running afoul of state and federal regulations; from non-adherence to HIPAA electronic standards to ignoring state assignment laws.
The new system turns a straightforward process into an unnecessarily complicated and expensive one. Is the BCBS Association, forcing the Blues to enforce their exclusivity arrangements that disadvantage regional labs and prohibit them from competing in the market place?
Palmetto GBA announced that they obtained a new contract with CMS to develop a registry for Molecular diagnostic tests that would establish a new Z-code for each test using McKesson's proprietary software.