Billing News Jul 2020



The Idaho Patient Act and its Impact on Medical Debt Collections

  • July 7, 2020

The highly publicized Idaho Patient Act, signed into law on March 16, 2020, was created to protect consumers from unfair medical debt collection practices. Proponents asked for increased transparency into healthcare facility and provider charges for products and services and safeguards against unreasonable attorney fees and costs arising out of...

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Vermont Updates Data Breach Notification Law

  • July 7, 2020

Vermont recently amended its data breach notification law. The changes will go into effect July 1, 2020. As amended, the definition of “personal information” now includes the following when combined with a consumer’s first name or first initial and last name: Individual taxpayer identification number, passport number, military...

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Certain COVID-19 Serology/Antibody Tests Should Not Be Used - Letter to Clinical Laboratory Staff and Health Care Providers

  • July 7, 2020

The U.S. Food and Drug Administration (FDA) recommends that clinical laboratories and health care providers stop using COVID-19 antibody tests that are listed on FDA’s “removed” test list, found on the FDA’s FAQs on Testing for SARS-CoV-2 webpage.  The “removed” test list includes tests where significant clinical performance...

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New COVID Codes Released on 6/25 (87426, 0223U, 0224U)

  • July 7, 2020

To address the ongoing clinical need to report testing, the CPT Editorial Panel has added one new Category I code (87426) to provide increased specificity for reporting immunoassay antigen testing and two new proprietary laboratory analyses (PLA) testing codes (0223U, 0224U). The AMA expedited the publication of these CPT codes to the AMA website...

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Trend Analysis of Medicare Laboratory Billing for Potential Fraud and Abuse With COVID-19 Add-on Testing

  • July 7, 2020

The coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented demand for diagnostic laboratory testing to determine whether an individual has the virus. Beyond the COVID-19 tests, laboratories can also perform add-on tests, for example to confirm or rule out diagnosis other than COVID-19. However, OIG has program integrity concerns...

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OIG to Audit $50B in Coronavirus Relief Funds Given to Providers

  • July 7, 2020

The Office of the Inspector General (OIG) at HHS recently announced that it will audit the distribution of $50 billion in coronavirus relief funds to hospitals and other eligible healthcare providers. In the announcement released at the end of May, the OIG said the audit will determine the effectiveness of HHS controls over the awarding...

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COVID-19 Pandemic Response, Laboratory Data Reporting: CARES Act Section 18115

  • July 7, 2020

Public Law 116-136, § 18115(a), the Coronavirus Aid, Relief, and Economic Security (CARES) Act, requires “every laboratory that performs or analyzes a test that is intended to detect SARSCoV-2 or to diagnose a possible case of COVID-19” to report the results from each such test to the Secretary of the Department of Health and Human Services (HHS...

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BCBS - Medical Policy and Clinical Guideline Updates - June 2020

  • July 7, 2020

Policy Updates / Medical Policy & Clinical Guidelines The following Anthem Blue Cross and Blue Shield medical policies and clinical guidelines were reviewed on February 20, 2020 for Indiana, Kentucky, Missouri, Ohio and Wisconsin. New medical policies and/or clinical guidelines.  NOTE *Precertification required  NOTE *...

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