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CMS Has Largest-Ever Public Meeting – Discusses Pricing Lab Test Codes

On June 22, 2020, CMS held its largest-ever annual public meeting for pricing new laboratory test codes. In addition, it was the first-ever meeting held only virtually. Nearly 30 different organizations offered comments on some 130 new codes. A full transcript of the meeting is available at the blog “Discoveries in Health Policy.” The blog’s author, Bruce Quinn MD PhD, told XIFIN...

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U.S. National Institutes of Health (NIH) Announces the Rapid Acceleration of Diagnostics (RADx) Initiative for COVID-19: Here’s What Laboratories Need to Know to Participate

The National Institutes of Health (NIH) announced a new initiative aimed to accelerate innovative development and commercialization of COVID-19 testing technologies to speed delivery of accurate, easy to use, scalable tests to all Americans.1 The $1.5 billion investment of Federal stimulus funding introduced the Rapid Acceleration of Diagnostics (RADx) Initiative to provide funding for the rapid...

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CMS Suspends the Expansion of the Accelerated and Advance Payments Program During the COVID-19 Pandemic for Part B Suppliers

Effective April 26, 2020, CMS is no longer accepting new applications for Advanced Payment Program loans from Part B suppliers including laboratories and reevaluating all new and pending applications for the Accelerated Payment Program.1 Since the announcement of the Expanded Accelerated and Advanced Payment Program on March 28, 2020, CMS has processed 45,000 applications and dispersed over...

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CMS Expands Payment Program to Provide Labs Temporary Relief from Declining Revenues

Due to the impact of the recent coronavirus pandemic, CMS Administrator Seema Verma has expanded the CMS Accelerated and Advance Payment Program for the duration of the public health emergency.1 The streamlined process designed to assist healthcare providers and suppliers “stay afloat” during the current COVID-19 crisis will now take days rather than weeks for requests to be processed. For...

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Is Your Lab Developing COVID Related Tests? Receive Federal Funding Resources

In response to the COVID-19 global pandemic, the Biomedical Advanced Research and Development Authority (BARDA), part of the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR), has expanded funding opportunities up to $749K to establish public-private partnerships with diagnostic providers for the purpose of developing solutions to mitigate the public health impact of the...

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XIFIN Makes Progress on Misuse of CO-45 Remediations

Last August, XIFIN reported that it had collected evidence of widespread and longstanding misuse of the CO-45 Remittance Advice Reason Code (RARC). The CO-45 is a charge that exceeds the fee schedule/maximum allowable or contracted/legislated fee arrangement. It represents the facility's contractual payment obligation, and the patient cannot be billed for that amount, which, instead, should be...

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Outreach Labs Brace for Forthcoming Transparency Regulations

The Centers for Medicare and Medicaid Services’ (CMS) new hospital price transparency regulations will go into effect on January 1, 2021. Outreach labs are anticipating new challenges as a result of the rules.According to Adam Bonislawski’s article in 360DX, “Labs Brace for Potential Plusses, Minuses of Price Transparency Regulations,” the new regulations could: Interfere with a lab’s...

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Recapping the NILA Lab Leaders Forum and Mid-Winter Meeting

Last weekend’s NILA conference covered a number of items currently impacting laboratories across the country. Several topics, in particular, saw repeated discussions and, in some cases, vigorous debate from the audience. Here are the hottest topics and key takeaways from the NILA meeting:Prior Authorization’s Pinch This was potentially one of the most intriguing discussions revolved around prior...

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