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Reimbursement news and insurance coverage updates.
The lawsuit also alleges Anthem failed to delete inaccurate diagnosis codes, leading to inflated risk-adjustment payments from Medicare.
If the bill passes in its current form, PAMA reporting would be delayed until January 2022 and rate cuts scheduled for 2021 would be put off to 2022.
The reimbursement contract provides about 9 million additional men access to the urine-based, genomic EPI test, Bio-Techne said.
A pathologists' group has pointed out that the bill covers only EUA tests, and patients receiving tests with pending regulatory status may receive surprise bills.
The agency will reimburse at about $35.91 per test for CDC assays and about $51.31 per test for non-CDC assays.