National Intelligence Report
This biweekly newsletter provides concise, independent coverage and analysis of fast-breaking lab, pathology, blood banking, imaging and diagnostic radiology news from the Nation's Capital. You'll find out about: Medicare payment and policy directives Billing guidelines and coding changes for diagnostic facilities CLIA & MQSA regulatory mandates, changes and interpretations Congressional actions & legislative initiatives Federal compliance requirements OIG anti-fraud initiatives, Stark self-referral prohibitions, plus other legal news FDA oversight of in vitro diagnostics, blood banks, and radiological devices OSHA, NRC, and state safety standards.
June 22, 2009 - Table of Contents
Repeal of the system used to update Medicare physician fees each year—long a legislative priority of pathology and other medical groups—could come sooner rather than later under a proposal by House committees preparing health care reform legislation.
President Barack Obama has proposed $313 billion more in reduced Medicare and Medicaid spending over 10 years to help pay for his health care reform agenda. The bulk of the savings would come from hospitals, drug companies, and physician imaging services.
Recently introduced Senate legislation would change Medicare policy to allow independent laboratories offering complex, advanced diagnostic tests to bill Medicare directly for the tests when ordered less than 14 days after a patient’s hospital discharge.
Senate and House committees have begun the contentious task of writing health care reform legislation in an ambitious timeframe, amid concerns on all sides about its cost and Republican criticism that the process is too important to rush. But the Democratic chairmen are confident they can have bills ready for floor action before the August recess so that the measures can be reconciled in September and a final version can get to the president in October.
Bipartisan legislation has been introduced in the House that would make permanent the “grandfather” provision that allows independent clinical laboratories to bill Medicare Part B separately for the technical component (TC) of pathology services to hospital inpatients and outpatients. This provision is set to expire at the end of this year.
The July 1 update to the list of CLIA waived tests includes the latest tests approved by the Food and Drug Administration for this category. New waived tests are approved on a flow basis and are valid as soon as approved.
A federal appeals court has upheld the government’s one-year revocation of a laboratory’s CLIA certificate for referring proficiency testing (PT) samples to another lab for analysis before submitting its own results. The court denied a petition for review filed by Wade Pediatrics in Muskogee, Okla.
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