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Blog Posts by Tag: Compliance

ACLA Issued a Statement to CMS on Automated Chemistry Test Panels

After claims from the Government Accountability Office (GAO) in November of 2018 that labs unbundling automated chemistry test claims will correlate to a drastic increase in Medicare spending, many industry thought leaders are responding. Most recently, ACLA has released a statement claiming that GAO’s assumptions are not backed by Medicare’s public claims data, or by ACLA’s own survey conducted...

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Hidden Landmines in Revenue Cycle Management: 4 Rules of Report Analysis to Follow (Part 3)

This is the third post of a three-part blog series focused on key areas of business performance management for pathology practices, diagnostic laboratories, and molecular diagnostic providers. The other blog posts in this series can be found here: Part 1 and Part 2 At the recent Executive War College, I had the honor of presenting with Diana Richard and...

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Final Steps in Preparing for the PAMA Reporting Period (Part 2)

In our last post of this series, we identified “The First Steps in Preparing for the PAMA Reporting Period” as confirming your laboratory’s applicable lab status, executing an RCM data review, and assigning a project team and project team lead. Once you have carried out these steps, there are four additional steps to be taken before you complete your submission.  Step 4:...

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Meeting Compliance Requirements – Why EHR Revenue Cycle Modules Aren’t Enough for Hospital Labs (Part 2)

As discussed in Part 1 of this 4-part series, too often we see hospital and health system leaders expecting outreach and outpatient laboratories to use the hospital’s enterprise revenue cycle management (RCM) module that is offered as part of the EMR/EHR software. While the health system may believe that the enterprise RCM system is the most cost-effective option, this fails to take into account...

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New Study Demonstrates GAO’s PAMA Report Based on Faulty Assumptions

In a XIFIN blog post from April 5, we address that the Government Accountability Office (GAO) report entitled, “Medicare Laboratory Tests Implementation of New Rates May Lead to Billions in Excess Payments” appears to demonstrate a misunderstanding of how price and panel bundling work in laboratory billing and reimbursement.The report appears to suggest that American Medical Association (AMA)...

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Key Considerations for Lab Leaders Regarding the Eliminating Kickbacks in Recovery Act of 2018 (EKRA)

Authors: Marty Barrack, Senior Vice President & General Counsel, XIFIN Rina Wolf, Vice President Commercialization Strategies, Consulting & Industry Affairs, XIFIN The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment...

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Compliance Leaders: How to Keep up with Changing Compliance Requirements

The business of diagnostics and health systems gets more complicated all the time, and the increasing complexity of your compliance obligations can at times seem overwhelming. You know that your compliance obligations start with meeting the requirements of the Federal Sentencing Guidelines for an effective compliance program. You are aware that means that you need to exercise diligence to...

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Revenue and Finance Leaders: Compliance Requirements Keep Changing. How can you Keep up?

The business of diagnostics and health systems gets more complicated all the time, and the increasing complexity of your company’s compliance obligations can at times seem overwhelming. If you manage revenue operations or work in finance, you know how to support your company’s compliance program, but you may not be aware of all the challenges your compliance department faces or how you can...

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