Industry Trends

Medicaid Provider Enrollment Required Jan 1 for Managed Care

Medicaid Provider Enrollment Required to Receive Payments from Managed Care Plans Federal Rule 42 CFR 438.602 states that Medicaid managed care providers who order, refer, or render covered services must fully enroll as a “billing” provider with the state Medicaid agency by January 1, 2018, to receive payments from managed care plans. The original date […]

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REMINDER: UHC Genetic and Molecular Test Registration Deadline is Approaching

UnitedHealthcare (UHC) is launching an online prior authorization program for genetic and molecular testing performed in an outpatient setting for fully insured UHC Commercial Plan members.* Effective Nov. 1, 2017, participating physicians will be required to obtain prior authorization for molecular and genetic tests, selecting from a list of registered tests performed by registered laboratory […]

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Seven Proposals for Red Tape Relief for Laboratories from ACLA

In July of this year, Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH) announced a new initiative, dubbed the Medicare Red Tape Relief Project, designed to “deliver relief from the regulations and mandates that impede innovation, drive up costs, and ultimately stand in the way of delivering better care for Medicare beneficiaries.” Applauding the […]

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CMS Updates PQRS Payment Adjustments Policy for 2017-2018

December 28, 2016 CMS Updates PQRS Payment Adjustments Policy for 2017, 2018 By: Deanna Rasch, Technical Communication Specialist On December 21, 2016, the Centers for Medicare and Medicaid Services (CMS) announced that it will not apply negative 2017 or 2018 payment adjustments to eligible individual healthcare professionals (EPs) or group practices that were unable to […]

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Quadax Is Ready for PAMA Reporting

By: Jen Sprandel, Technical Communication Specialist Updated 4-2017 The Protecting Access to Medicare Act of 2014 (PAMA) revised the payment methodology for clinical diagnostic laboratory tests paid under the Medicare Clinical Laboratory Fee Schedule (CLFS). Under PAMA, CMS will base 2018 clinical laboratory fee schedule payment rates on private payer rates as reported by applicable […]

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