The Eliminating Kickbacks in Recovery Act (EKRA), a law that became effective in October 2018, extended federal kickback prohibitions to services provided by recovery homes, clinical treatment facilities, and laboratories...more
CMS recently published a proposed rule that would substantially revise the methodology used to pay for clinical laboratory tests that continue to be compensated separately by Medicare. Medicare Program; Medicare Clinical...more
10/20/2015
/ Centers for Medicare & Medicaid Services (CMS) ,
Clinical Laboratories ,
Clinical Laboratory Testing ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part A ,
Medicare Part B ,
Medicare Part C ,
Medicare Part D ,
PAMA ,
Payment Methods ,
Payment Rates ,
Reporting Requirements
Labs Attempt to Counter Exclusive Lab Arrangements -
With increasing frequency, clinical laboratories have found themselves unable to receive any payments for tests performed for individuals whose third-party insurer...more
There has been question for some time whether in evaluating certain discount arrangements involving clinical laboratory tests under the federal antikickback statute (FAS), discount charges should be measured against the...more
In previous Payment Matters articles, we described a policy included in the 2014 hospital outpatient prospective payment system (OPPS) final rule that would “package” certain clinical laboratory tests into OPPS, and CMS...more
In a previous Payment Matters article, we described a new CMS policy under which, effective January 1, 2014, hospitals would no longer be permitted to bill Medicare separately for clinical laboratory tests for hospital...more
Hospitals Lose Right to Bill Separately for Laboratory Tests for Outpatients -
As part of its calendar year 2014 hospital outpatient prospective payment system (OPPS) policy changes, the Centers for Medicare & Medicaid...more