Our firm is engaged by many clients to evaluate Medicare Local Coverage determinations (a.k.a. "Medicare LCD") in specific regulatory compliance matters involving medical coding and medical billing for Medicare and…
HITECH Act and HIPAA Omnibus Rule HIPAA was enacted in 1996, the ARRA HITECH Act in 2009, the HIPAA Omnibus Rule in 2013. In January 2020, a Federal Court ruled…
Medicare Part D and the Affordable Care Act Medicare Part D first covered Americans in 2005. The Patient Protection and Affordable Care Act (“ACA” or “PPACA”) of 2010 brought noteworthy…
Medicare Local Coverage Determinations for Genetic Testing Medicare Technical Assessment for Molecular Assays To determine coverage for genetic test Medicare LCD, the Centers for Medicare and Medicaid (CMS) requires a…
PAID Act Plus SMART Act Requires NGHPs to Report or Pay Penalties The Medicare, Medicaid and SCHIP Extension Act (MMSEA) of 2007 contains mandatory insurer reporting in Section 111 for…
Laboratory CPT Codes Laboratory CPT codes and pathology CPT codes include services primarily reported to evaluate specimens obtained from patients (body fluids, cytological specimens, or tissue specimens obtained by invasive/surgical…
1. What is Medicare Part B is and what does it cover? Medicare is health insurance for: People 65 or older Under 65 with certain disabilities People of any age…
During the pandemic, when an American citizen domiciled in a state is deprived of civil rights by the state, was the deprivation of civil rights done appropriately according to the…
What Is a Formulary? In its simplest form, a formulary is a list A drug formulary is a preferred drug list. The list of medications on the formulary changes based…
In October 2020 and April 2021, the U.S. National Security Administration posted advisories regarding known vulnerabilities that Chinese and Russian hackers use to breach U.S. and other networks. Our Observations:…
Esoteric Testing Market Segments The esoteric testing market segments can be seen in their simplest form in two areas: chemiluminescence immunoassay enzyme-linked immunosorbent assay radioimmunoassay, mass spectrometry, flow cytometry, real-time…
