Billing News Jun 2019



HHS Publishes Fact Sheet on Direct Liability of Business Associates Under HIPAA

  • June 5, 2019

On May 24, 2019, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a new fact sheet providing a compilation of all provisions through which a business associate may be held directly liable with the HIPAA Privacy, Security, Breach Notification, and Enforcement regulations. Under the Final Rule...

Read



Test for Circulating Tumor DNA Wins FDA Breakthrough Designation

  • June 5, 2019

FDA has granted breakthrough device designation for Natera's test to detect and quantify circulating tumor DNA (ctDNA) after surgery in the blood of patients already diagnosed with some types of cancer and combined with certain drugs, Natera said Monday.  Natera said the FDA breakthrough designation will help support the company's...

Read



New Washington Law Requires Advance Notice to the Attorney General for Certain Healthcare Transactions

  • June 5, 2019

Starting January 1, 2020, hospitals, health systems, and many other healthcare providers must give notice to the Attorney General 60 days in advance of closing certain transactions. Signed into law by the Governor on May 7, 2019.  The law has no minimum dollar threshold and will require reporting even for very small transactions that are...

Read



New Law Expands Kickback Liability for Laboratories, Recovery Homes, and Clinical Treatment Facilities

  • June 5, 2019

Clinical laboratories, recovery homes, and clinical treatment facilities should take note of a new law that expands kickback liability to non-governmental payors. Similar to the prohibitions under the federal anti-kickback statute (AKS), EKRA generally prohibits (1) the solicitation or receipt of any remuneration in return for referring a patient...

Read



See You in Court!

  • June 5, 2019

DNA testing is changing the practice of medicine, but laws in the US aren't keeping up with the progress of technology. Now, doctors are already facing a pile of lawsuits that sometimes hold them liable for how they offer, interpret, and counsel patients about genetic tests. The LawSeq project is aiming to ameliorate that dynamic. The 3-year, $2...

Read



Adjustment of Claims for Retroactive Rate Updates of Select Radiology Codes

  • June 5, 2019

EPC Letter P47528: The Department of Health Care Services (DHCS) updated provider reimbursement rates for select radiology codes, effective retroactively for dates of service on or after October 1, 2015. If the rate was increased, the adjustment is positive. If the rate was reduced, the adjustment is negative. The California Medicaid Management...

Read



Annual Report to the Nation: Overall Cancer Mortality Continues to Decline

  • June 5, 2019

The latest Annual Report to the Nation on the Status of Cancer finds that, for all cancer sites combined, cancer death rates continued to decline in men, women, and children in the United States from 1999 to 2016. Overall cancer incidence rates, or rates of new cancers, decreased in men from 2008 to 2015, after increasing from 1999 to 2008 and...

Read



MolDX Local Coverage Determination (LCD) Updates and LCD Article Updates: Part A and Part B - L37709

  • June 5, 2019

The Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification (NAATs) L37709 A/B MAC LCD was revised. The Billing and Coding: Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification (NAATs) A56593 A/B MAC Article was revised. Covered ICD-10 Codes Group 1: Codes added ICD-10 codes R19.7...

Read