| Coding |
| ACLA
has worked for years to become a participant in the development
and revision of CPT codes for clinical laboratory tests... |
| |
| Coding and Reimbursement of Flow Cytometry |
| In 2003, the Centers for Medicare and Medicaid Services proposed in the annual... |
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| Competitive
Bidding Laboratory Services |
| The
American Clinical Laboratory Association strongly opposes
any effort to impose competitive bidding arrangements for
diagnostic laboratory payments under Part B of Medicare
or state Medicaid programs... |
| |
| "Condo" Labs |
| Recent
regulatory changes affecting the billing of anatomical
pathology services, highly complex
diagnostic services that are an important factor in detecting
the presence of cancer and other diseases, have
fueled the establishment of new types of abusive arrangements... |
| |
| Co-Payments |
| Federal
and state proposals to create co-payments with Medicare
and Medicaid programs... |
| |
| Oversight of Laboratory Developed Tests |
| For
several years, FDA officials have indicated they are reconsidering
the exemption for in-house developed laboratory tests,
which exempts most laboratory-developed tests from FDA
oversight and regulation... |
| |
| Fraud
and Abuse |
| ACLA
is active on a variety of issue areas within healthcare
fraud and abuse. |
| |
| Health
Care Information Technology |
| Increasingly, clinical laboratories are using information technology (IT) innovations
to improve patient care, as well as to promote the highest level of efficiency
and affordability... |
| |
| Medically Unlikely Edits (MUEs) |
|
CMS, working through a National Correct Coding Initiative (NCCI) contractor, has proposed maximum allowable number of units of service per patient, per day referred to as Medically Unbelievable Edits (MUEs). Unlike some NCCI edits, MUEs cannot be bypassed with NCCI-associated modifiers.
|
| |
| OIG
Proposed Rule on Excessive Charges |
| On
September 15, 2003, the HHS Office of the Inspector General
(OIG) proposed regulations providing guidance on the application
of Medicare and Medicaid program exclusion authority for
submitting claims containing excessive charges... |
| |
| Public
Health |
| ACLA has become increasingly involved with public health issues over the past
few years. Bioterrorism (including the attacks in New York on 9/11, and the
use of anthrax as a biological weapon), and emerging infectious disease threats
(e.g. SARS, West Nile Virus) resulted in ACLA meeting with HHS Secretary
Tommy G. Thompson... |
| |
| Reimbursement
for Laboratory Services |
| Prior
to 1984, Medicare reimbursement for laboratory services
was paid on a reasonable charge basis, and 80 percent of
laboratory services were billed by physicians. A significant
share of lab services was performed by independent laboratories
that billed physicians who in turn billed Medicare... |
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| State
Issues |
| ACLA is active on a variety of state laboratory issues. |
| |
| The Value of Laboratory Services |
| Clinical
laboratory testing plays an essential part in the delivery
of quality health care. Laboratory tests provide physicians
with objective data needed to promptly diagnose and effectively
treat and monitor disease... |
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