Genetic Counseling Medicare Payment Bill Introduced in Congress

  • Jul 8, 2019

A bill granting the US Centers for Medicare & Medicaid Services the authority to recognize certified genetic counselors as healthcare providers and reimburse them for their services was introduced in the US Congress last week. The study, which relied on interviews, published data, and a claims analysis, projected $4 billion in potential Medicare savings over a decade if certified genetic...

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Empire - BCBS New York - Changes to Timely Filing Requirements for Medicare Advantage

  • Jul 8, 2019

Effective September 1, 2019, we will amend the Medicare Advantage Attachment of your Empire Provider Agreement(s) to require the submission of all professional claims within ninety (90) days of the date of service. This means all claims submitted on and after October 1, 2019, will be subject to a ninety- (90) day timely filing requirement, and Empire will refuse payment if the claims...

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US Senate Hearings Consider Bipartisan Proposal to Change Patent Laws; Could Have Big Impact on Dx

  • Jul 8, 2019

A US Senate panel will today begin hearings on a proposal to write new patent legislation that could greatly expand eligible subject matter. The draft bill contains changes to several sections of the statutes covering patent law: it provides a legal definition for the term "useful" and states that inventions need only be useful, and not "new," as stated in the current statute. The draft bill...

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FDA Issues Draft Recommendations for Biotin Interference Testing

  • Jul 8, 2019

The US Food and Drug Administration has issued draft guidance that provides recommendations on testing for biotin interference with in vitro diagnostic devices. Today's draft guidance, building on a safety communication that the agency issued in 2017, provides additional recommendations to IVD manufacturers about testing for biotin interference as well as recommendations about...

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Interpace Diagnostics Thyroid Assays Covered by Independence Blue Cross

  • Jul 8, 2019

Interpace Diagnostics said today that Independence Blue Cross has agreed to cover Interpace's thyroid tests, ThyGeNext and ThyraMir, for patients with thyroid cancer. Independence covers about 2.5 million individuals in Philadelphia and Southeastern Pennsylvania.

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CMS Administrator Touts Changes to RAC Program

  • Jul 8, 2019

Administrator Seema Verma recently highlighted changes to the Recovery Audit Program that are intended to make the program more provider friendly. Recovery Audit Contractors (RACs) review payments made to healthcare providers under Medicare Fee-for-Service plans. CMS will be providing better oversight of RACs in several ways, including by requiring RACs to have a 95% accuracy score. RACs also...

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Frequently Asked Questions: Technical Assessments for Next Generation Sequencing (NGS) Tests

  • Jul 8, 2019

Updated 6/27/2019 Question: Do we need to submit a TA for each single gene assay or sub-panel that is done as part of a larger hotspot panel, but with masking of the other genes? Answer: The TA must show that the test for which a claim is being submitted was validated. If the test was validated as part of the validation of a larger panel or platform validation, that is fine. If you...

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Medical Policy Updates - Regence

  • Jul 8, 2019

Commercial medical policies - changes effective July 1, 2019 Genetic Testing Chromosomal Microarray Analysis (CMA) for the Genetic Evaluation of Patients with Developmental Delay, Intellectual Disability, Autism Spectrum Disorder, or Congenital Anomalies (#58) Changed policy name Added to the medical necessity criteria testing of adults for the same indications as testing of pediatric...

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