News and trends on diagnostics testing, insurance coverage, and reimbursement.
The OIG recommends that CMS direct Medicare contractors to recover the improper payments from providers and strengthen system edits to prevent further improper payments.
New Medicare rates established under PAMA will cause labs to scale back services, and in some cases shut down, the motion states.
BCBS of Illinois is the largest PPO network in the state, covering roughly 7.9 million people.
A PLUGS collaboration with EviCore resulted in the lab benefit manager creating a policy for covering whole-exome sequencing.
An assessment concluded that Oncotype Dx has not demonstrated a significant enough impact on outcomes or cost effectiveness compared to current practice.