Latest News
Medi-Cal rate methodology boosted under new law
California pathologists who have grown frustrated with retroactive recoupments from Medi-Cal in recent years due to their outdated rate-setting methodology now have some relief after California Gov. Gavin Newsom signed a comprehensive health care budget bill (AB 133) on July 27.
Final 2020 MIPS scores now available for review
oviders who participated in the 2020 MIPS Performance Period may now view their final scores. Participants also now have the option to request a targeted review if they believe any errors were made in calculating their bonus or penalty for the 2022 payment year.
Opinion: Is healthcare set to face a pandemic bubble?
In 2020 and early 2021, more than $4 trillion was pumped directly into society, including funding for healthcare providers and facilities. While most Americans spent last year wondering if the world was collapsing, healthcare had one of its best years ever.
Covid-19 Public Health Emergency extended again
he Covid-19 Public Health Emergency has been extended for an additional 90 days after HHS Secretary Xavier Becerra signed off on the extension Monday.
2022 Proposed MPFS: See impact to pathology, labs
Pathologists and independent laboratories will experience a handful of significant payment reductions for key services if CMS adopts changes released Tuesday in the 2022 Medicare Physician Fee Schedule (MPFS) Proposed Rule.
UHC eliminates some OON non-emergency coverage
As part of a new policy update, UnitedHealthcare will no longer cover non-emergency services members receive from out-of-network facilities outside their service area, effective July 1.
UHC indefinitely delays Lab Test Registry
UnitedHealthcare announced Thursday it is delaying implementation of its Lab Test Registry "until further notice" due to Covid.
Opinion: Cigna PC/CP decision likely a temporary reprieve
So, what does this recent development actually mean? Most likely, Cigna will slowly and by degrees stop paying for the professional component of clinical pathology.
Webinar: Strategies for getting your laboratory in-network
Struggling to get your lab in-network as commercial payers continue to tighten their networks? Sign up for Lighthouse Lab Services next webinar to learn how to break through this difficult process!
Case study: Insurer holding payments over tax ID confusion
It has recently come to our attention that a large national health plan is denying payment for a pathology group due to confusion over their tax ID number.
HHS sets reporting, spending deadlines for Provider Relief Fund payments
Health care providers who received distributions from the Health and Human Services Provider Relief Fund during the Covid-19 Public Health Emergency now have instruction on how to report on the use of those funds after HHS published new rules Friday.
Medicare nearly doubles payment for at-home Covid-19 vaccinations
In an effort to get more Covid-19 vaccinations into the arms of the general public, the Biden Administration announced Wednesday that Medicare payments for in-home vaccinations will be nearly doubled from the current rate.
Cigna to continue paying professional component of clinical pathology
After previously stating its intent to stop paying the professional component of clinical pathology, Cigna has reversed course and will continue paying for these services, according to CAP.
Case study: A/R collection strategy leads to $120k in recovered payments
Recently, Vachette was hired by a laboratory client under new management to review their outstanding accounts receivable (A/R). The goal was to assess the full scope and realistic collectability of their outstanding payments, while at the same time analyzing the...
OIG identifies $3.4 million in Medicare Advantage overpayments to Anthem
The HHS OIG recently revealed CMS overpaid Anthem about $3.4 million in Medicare Advantage payments due to the payer failing to meet federal coding rules.
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