Latest News
CMS Accepting 2022 MIPS Exception Applications
CMS has announced it is now accepting MIPS Exception applications for clinicians and groups who have been impacted by public health emergency in 2022.
Lessons from Executive War College 2022
Every year the sky is falling, at least that’s how it seems. I have been attending Executive War College since the 90s and thank God we’ve been able to change and adapt with the dramas of running a healthcare business. These are things I learned from presentations by Robert Michel, editor-in-chief of the Dark Report, and others:
Items to Watch as the Public Health Emergency Winds Down
Due to a number of COVID funds being exhausted or close to tapped out, this is likely to be the final extension. Here are some items to keep in mind as labs and pathologists prepare for the potential end of the PHE.
UHC Moving Forward with Change Acquisition Amid DOJ Challenge
UnitedHealth says it plans to complete the acquisition of Change Healthcare despite an ongoing legal challenge from the Department of Justice (DOJ) that aims to block the deal.
Cigna to Cap PC Clinical Pathology Reimbursement at $5 Beginning July 1
Letters from Cigna dated April 1st, 2022, are not an April Fools’ Prank. It appears that Cigna is attempting a new additional tactic to manage their payment of the Professional Component of Clinical Pathology (PCCP).
20 Years of Vachette
As Vachette Pathology celebrates its 20th anniversary, founder Mick Raich looks back on what he's learned during that time.
Pathology Job Market Struggling to Meet Increasing Demand
"Gone may be the days where one person who was more broadly trained could effectively advise whole laboratories comprehensively on what patients need and how to go about arranging that as an in-house offering," says Tara Luellen, Vice President of Lab Director Services.
HRSA Uninsured Program no longer accepting claims for COVID testing, vaccine administration
The HRSA Uninsured Program said claims for COVID testing and treatment will stop being accepted on March 22 at 11:59 p.m.
Timeline for repayment of Medicare Advances, recoupment rate
Impacted providers should expect to see 25% of their total Medicare payments to be recouped during the first 11 months of the repayment period. If repayment has not been completed within that timeframe, the recoupment rate will increase to 50% for 6 months.
Case Study: Biller’s Contract Breach Results in Client Settlement
When a client went uncompensated for months of work due to a biller’s breach of contract, we were able to fight on their behalf to recover a $25,000 settlement.
Artificial Intelligence: Payers vs Medical Billers Round One
There are some interesting changes in the medical billing world surrounding artificial intelligence (AI). There is an AI war going on with payers and billers in the revenue cycle management (RCM) arena and the winner will be the one who invests in AI quickest and maintains their edge in technology. We are just beginning to see this technology utilized, but several firms are already in the game.
New codes created for monoclonal antibody bebtelovimab following FDA EUA
On Feb. 11, the FDA authorized the emergency use of the monoclonal antibody bebtelovimab for the treatment of COVID-19 in adult and pediatric patients.
CAP asks UHC to forgo Designated Diagnostic Provider program
The College of American Pathologists (CAP) has joined six other provider advocacy groups in formally requesting UnitedHealthcare (UHC) forgo its Designated Diagnostic Provider (DDP) program that was launched last summer in an attempt to further tighten the payer's network and direct patients to preferred laboratories.
Early 2020 MIPS data again reveals declining participation
Early 2020 Merit-based Incentive Payment data released this week by CMS shows pandemic reporting flexibility is likely to keep the penalty pool small.
COVID-19 PHE receives another 90-day extension
The Covid-19 Public Health Emergency has been extended for an additional 90 days after HHS Secretary Xavier Becerra signed off on the extension late last week.
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