Test for All Diagnosed

  • Mar 5, 2019

The American Society of Breast Surgeons is recommending that all women diagnosed with breast cancer be offered genetic testing for inherited mutations. The organization released new genetic testing guidelines for breast cancer in which it said that BRCA1, BRCA2, and PALB2 testing should be offered, along with testing of other genes if warranted by clinical findings or family history, to all...

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Medicare, Medicaid Spending Per Enrollee Slower Than Private Plans

  • Mar 5, 2019

Medicare and Medicaid spending saw significantly slower growth per enrollee than private payer expenditures over the last decade, a new report from the Urban Institute shows. The public payers may have experienced the fastest rate of spending growth from 2006 to 2017. But enrollment is largely to blame for the rise in Medicare and Medicaid spending, and spending per enrollee during the period...

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CMS Proposes Rule Regarding the Exchange of Electronic Health Information Which Impacts Hospitals, Clinicians and Government Payors

  • Mar 5, 2019

The Proposed Rule first seeks to require Medicare Advantage organizations, Children’s Health Insurance Program (CHIP) managed care entities, state Medicaid and CHIP Fee-For-Service (FFS) programs and Qualified Health Plans (QHP) (Covered Entities), to make patient claim and encounter data available in a standardized format through an Application Programming Interface (API). In 2018, CMS...

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BCBSKS Update – Medical Policies

  • Mar 5, 2019

The following medical policies have been published to the BCBSKS website. Please see the Revision section of the policy to identify changes. https://www.bcbsks.com/CustomerService/Providers/MedicalPolicies/policies.shtml Bone Mineral Density Studies Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors Gene Expression Profiling for Cutaneous...

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CMS Office of the Actuary Releases 2018-2027 Projections of National Health Expenditures

  • Mar 5, 2019

National health expenditure growth is expected to average 5.5 percent annually from 2018-2027, reaching nearly $6.0 trillion by 2027, according to a report published today by the independent Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS).  Similar to the findings in last year’s report, the report found that by 2027, federal, state and local governments are...

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MDxHealth, LifeLabs Ink Distribution Agreement for Prostate Cancer Assay

  • Mar 5, 2019

MDxHealth announced today that it has signed a distribution agreement with LifeLabs to offer MDxHealth's SelectMDx assay in Canada. Researchers will test liquid biopsy samples in MDxHealth's clinical diagnostic laboratory in Irvine, California, while LifeLabs will reimburse MDxHealth for all testing services performed at the lab.

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Regulators Look to Increase Interoperability and Patient Access to Health Data

  • Mar 5, 2019

CMS' Proposal: Interoperability and Patient Access Proposed Rule CMS released the Interoperability and Patient Access Proposed Rule on February 11th. This proposal aims to increase the level of access that patients have to the information they need to make informed, responsible health care decisions, including data about prices, costs, and outcomes. CMS' role here cannot be...

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Local Coverage Determinations (LCDs) – Revised MM10901

  • Mar 5, 2019

CR 10901 notifies MACs that, in accordance with Section 4009 of H.R. 34-21st Century Cures Act (Public Law No: 114-255), the Centers for Medicare & Medicaid Services (CMS) is updating the “Medicare Program Integrity Manual” with detailed changes to the LCD process. CR# R863PI

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