Monday, September 21, 2026

When Does MolDx Change Its Mind? The Prelude Papers

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When does MolDx change a non-coverage proposed LCD into a coverage final LCD? Famously, this happened once in the last few years, regarding ...

CMS Posts Cy2025 Part B National Utilization Data

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 CMS has posted CY 2025 National Part B utilization data as simple Excel files.  Find them here: https://www.cms.gov/data-research/statistic...

PAMA is Brutal on Top-End Kitted MoPath Tests

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 Here's a section quoted from my blog on PAMA Pricing 2027: Lesson: PAMA is brutal on kitted molecular tests Once again, PAMA Is brutal...

Public Comments on Physician Fee Schedule Proposals for CY2027

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CMS accepted comments on the proposed Physician Fee Schedule rules for 2027 until September 14, 2026. Comments are posted and searchable her...

CMS Posts "PAMA" Lab Fee Schedule for 2027 Forward

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 CMS has posted data on PAMA pricing for laboratory tests.   The private payor payment rates, effective in 1H2025, are used to set a new cli...
Wednesday, September 16, 2026

Can AI Get PAMA News From Investor Calls?

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I asked both CLAUDE and CHAT GPT to scan recent lab industry investor calls for PAMA news and predictions.   I include CLAUDE below; the two...

Very Brief Blog; Convergent Genomics Exits via Veracyte Acquisition

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  https://www.genomeweb.com/diagnostics/molecular/liquid-biopsy/gnw-veracyte-acquisition-convergent-genomics-20260915/ Here is the headline ...

Watchdog Releases Documentation of WISER Prior Auth Problems; How to Upgrade FOIA to Lawsuit

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The watchdog EFF Electronic Frontier Foundation has released 1000 pages of CMS documents, which in part lay out problems with launcher WiSER...

Very Brief Blog: CMS Updates NCD Wait List

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CMS has provided a September 2026 update of its "wait list" for future NCDs.   CMS also flags recently completed NCDs. Find it her...
Sunday, September 13, 2026

Genomeweb: Alarm Over CMS Rule on Lab Algorithms

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  See a subscription article at Genomeweb about "algorithm only testts." By Adam Bonislawski, 9/11/26, here: https://www.genomeweb...

Do Current Fraud Press Releases Flag the Pending CRUSH Regulation?

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 Last winter, CMS introduced the CRUSH anti-fraud program, with an RFI in the Federal Register.  Since August 2026, that has matured to a pr...

The Evergreen HHS Press Release: Recyling Rural Health Investment News

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Header: In July 2025, Congress passed a huge tax bill that included $billions in spending for rural health, especially rural health technolo...
Thursday, September 10, 2026

AMA CPT Asks Weird Social Equity Questions; RFK Jr Goes on Attack

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It's no secret that AMA CPT applications are full of now-sounds-dated language about whether an applicant's CPT code " perpetua...
Wednesday, September 9, 2026

You Better Learn the Biggest Myth About Payor Coverage of Diagnostics

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  "The Coverage Myth in Diagnostics" In an interview, I was asked, "What's the biggest myth you hear repeated?'   Tha...

AI Corner: The strange path to remote monitoring coding, and the latest twist

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 Somone asked me about the "complexified" coding of remote monitoring, a current hot topic at CMS. I'm not a native expert, so...