Payor Coverage: Page 4

CAP suspends facility accreditation inspections
The U.S. suspension was approved by the U.S. Centers for Medicare and Medicaid Services (CMS) and took effect March 17. It applies to all inspections aside from immediate jeopardy complaint visits and follow-ups, CAP explained to members.
March 17, 2020
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CMS starts COVID-19 pricing at $36 per test
The release of payment rates complements the agency's release of codes for COVID-19 testing in March and February and will enable healthcare providers and clinical labs to bill for the diagnostic tests. CMS is instructing labs to use Healthcare Common Procedure Coding System (HCPCS) code U0001 for tests developed by the U.S. Centers for Disease Control and Prevention and code U0002 for tests developed by other entities.
March 12, 2020
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Blue Cross waives costs for COVID-19 testing
Blue Cross said it encourages anyone showing symptoms of COVID-19 to contact their health provider before they visit an office or emergency room. The provider can evaluate their symptoms before determining if diagnostic testing is appropriate.
March 8, 2020
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Revival of VALID Act draws mixed response
The issue of diagnostics regulation has emerged as a political lightning rod, with some faulting the Trump administration's response to the outbreak and others blaming what they claim is a history of federal overregulation of clinical labs.
March 8, 2020
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CMS adds new code for coronavirus tests
The code (U0002) can be used by laboratories to bill for tests for SARS-CoV-2 infection and the respiratory disease caused by the virus, COVID-19, using diagnostics that are not provided by the U.S. Centers for Disease Control and Prevention (CDC). CMS issued the first code, U0001, to track patients tested with the CDC's own diagnostic for the coronavirus.
March 5, 2020
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CDC coronavirus test comes to labs | A closer look at payment policy | CRISPR drives diagnostics
Dear LabPulse Member,
February 10, 2020
CMS delays data reporting for labs
Per the Protecting Access to Medicare Act (PAMA) of 2014, labs are required to report a range of data points for clinical diagnostic laboratory tests that are not advanced assays, including Healthcare Common Procedure Coding System (HCPCS) codes, associated private payor rates, and volume data.
January 16, 2020
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T2 Biosystems recruits Chembio's John Sperzel as new CEO
In the statement about the appointment, T2 noted that during his tenure at Chembio, Sperzel established U.S. and international sales teams that generated significant growth, and the company also made commercial investments in Latin America and Southeast Asia. Sperzel is replacing John McDonough, who will continue to serve as nonexecutive chairman of the board.
January 8, 2020
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Congress skips surprise billing, passes LAB Act
Per the LAB Act data reporting requirements on payments for lab services associated with the Protecting Access to Medicare Act of 2014 (PAMA) will be delayed for one year. Furthermore, an independent study will be commissioned on data collection and rate setting for lab services.
December 22, 2019
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Top 10 LabPulse stories for 2019
In the No. 1 position was a story by contributing writer Joseph Constance that ran in November about how to manage the transition to lab automation. It's no surprise that lab managers are turning to automation to improve efficiency and generate new revenue as a means of compensating for declining reimbursement. Similarly, artificial intelligence promises gains in efficiency through the automation of some processes of clinical evaluation, in theory allowing more time for human analysis where it is really needed. It's early days yet for AI, and we will be following the trials and tribulations.
December 22, 2019
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CVS Health paves way for genetic testing of cancer patients
The program -- dubbed Transform Oncology Care -- revolves around a web-based prescribing portal that will direct oncologists to gene panel testing through partner Tempus, which provides a broad range of DNA and RNA sequencing services. It will be enabled through the company's CVS Caremark pharmacy benefit manager subsidiary and is now open to patients enrolled in Aetna commercial insurance plans in 12 U.S. states. The program will also be marketed to other insurance companies.
December 11, 2019
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Disability agency urges crackdown on prenatal genetic testing
The NCD, which is an independent government agency charged with advising policymakers, examined the effects of genetic testing on disabled communities and analyzed the various factors that influence prenatal genetic testing. Its findings were published in the report, titled "Genetic Testing and the Rush to Perfection," on October 23.
October 30, 2019
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